Multicentric Study of 148 New Cases of Female Genital Fistula Niger

Abstract

Introduction: Obstetric fistula is a public health problem but its prevalence remains unknown in Niger. We report epidemiological and anatomopathological status of new cases of female genital fistula. Method: Multicentre prospective study over 15 months (January 1st, 2016 to March 31st, 2017) in 5 national centers for the therapeutic management of female genital fistula. Data were collected from focus groups, observations and pre-established individual survey form and hospital records. Results: During the 15-month survey period, 148 new cases of female genital fistula of obstetric origin were recorded. Patients aged 15 to 19 accounted for 40% of cases. They were married before the age of 16 (55.4%), out of school in 89.2% and 77.2% lived outside the matrimonial home. The patients came from rural areas (96%) of the cases, the labor of delivery lasted more than 24 hours in 71.6% and in 95.3% of the cases the delivery was initiated at home and then finished in a health facility, 33.8% had assisted vaginal delivery (forceps/suction cup), 23% by caesarean section and 10.81% by laparotomy for uterine rupture. Fistula occurred during first delivery (47.3%) and recurrence accounted for 5.4% of cases. Perinatal death accounted for 85.1%. Conclusion: Female genital fistula of obstetric origin remains a major public health problem in Niger despite the efforts made.