title: Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study.
abstract: OBJECTIVE
  Pelvic floor disorders affect many women in high-income countries. Since little is known about such disorders in Africa, this study aimed at assessing the prevalence and risk factors in an Ethiopian community. We also assessed the validity of a prolapse questionnaire.
  
  
  METHODS
  A community-based cross-sectional study was conducted among 395 women, recruited by a systematic random sampling technique. Women were interviewed about symptoms of urinary incontinence, faecal incontinence and pelvic organ prolapse by female nurses. Additionally, pelvic examinations were performed in 294 (74.2%) participants to assess anatomical prolapse using the simplified Pelvic Organ Prolapse Quantification staging system. Descriptive statistics and logistic regression analyses were employed.
  
  
  RESULTS
  The median age of participants was 35.0 years. Thirty-one women reported urinary incontinence (7.8%), 25 (6.3%) symptomatic pelvic organ prolapse and 2 (0.5%) faecal incontinence. Anatomical pelvic organ prolapse stage II-IV was detected in 162 (55.1%) of women who underwent pelvic examination. The questionnaire for prolapse assessment had poor validity (38.3% sensitivity and 95.4% specificity) even in cases of clinically relevant prolapse (stage III or IV). After adjustment, carrying heavy objects for 5 or more hours a day, history of prolonged labour and highland rural residence were associated with anatomical pelvic organ prolapse.
  
  
  CONCLUSIONS
  Self-reported incontinence seems low in northwest Ethiopia. The prevalence of symptomatic prolapse was low despite a high prevalence of prolapse signs. Notably, heavy carrying and prolonged labour increased the risk of anatomical prolapse stage II-IV. The methods of assessing pelvic floor disorders in a low-income context need further development.
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia. beredomega@gmail.com
authors.forename: Berihun
authors.initials: B
authors.lastname: Megabiaw
authors.forename: Mulatu
authors.initials: M
authors.lastname: Adefris
authors.forename: Guri
authors.initials: G
authors.lastname: Rortveit
authors.forename: Getu
authors.initials: G
authors.lastname: Degu
authors.forename: Mulu
authors.initials: M
authors.lastname: Muleta
authors.forename: Astrid
authors.initials: A
authors.lastname: Blystad
authors.forename: Torvid
authors.initials: T
authors.lastname: Kiserud
authors.forename: Tesfahun
authors.initials: T
authors.lastname: Melese
authors.forename: Yigzaw
authors.initials: Y
authors.lastname: Kebede
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000453:epidemiology*; D010865:Pilot Projects; D017584:Reproductive History; D011795:Surveys and Questionnaires; D055815:Young Adult