title: Urinary incontinence in women in rural Pakistan: prevalence, severity, associated factors and impact on life.
abstract: OBJECTIVE
  To estimate the prevalence of urinary incontinence (UI) and its subtypes in women in rural Pakistan, associated factors, severity and impact on daily life.
  
  
  METHODS
  Population-based, cross-sectional study.
  
  
  METHODS
  A rural community in Sindh Province, Pakistan.
  
  
  METHODS
  Randomly selected women aged 15 years or older.
  
  
  METHODS
  A three-level random sampling strategy was used to select women: a random sample of health centres; a random sample of Lady Health Workers (LHWs) from each health centre; and a random sample of women in the LHW catchment areas. The LHWs used an interview-based structured questionnaire to collect data from women.
  
  
  METHODS
  Urinary incontinence reported by women.
  
  
  RESULTS
  Among the 5064 participants (response rate 95.8%) the prevalence of any UI was 11.5% (581/5064; 95% CI 10.6-12.3). The most common subtype was stress incontinence, with a prevalence of 4.7% (95% CI 4.1-5.3), followed by urge incontinence, with a prevalence of 3.2% (95% CI 2.7-3.7), mixed incontinence, with a prevalence of 2.8% (95% CI 2.3-3.2), other incontinence, with a prevalence of 0.4% (95% CI 0.2-0.5) and continuous incontinence, with a prevalence of 0.5% (95% CI 0.3-0.6). Older age, higher parity and marriage at an early age were independently associated with UI. We found that 52% of women with UI reported leakage at least daily, and 45% reported a great or moderate impact on their daily life. Only 15.7% of women with UI had consulted a doctor.
  
  
  CONCLUSIONS
  The prevalence of UI reported in rural Pakistan was lower than is generally found in studies from the developed world, but among the women affected it commonly occurred on a daily basis and impacted on their everyday lives, yet few had obtained medical advice.
authors.affiliation: Department of Obstetrics & Gynaecology, Aga Khan University, Karachi, Pakistan.
authors.forename: A H
authors.initials: AH
authors.lastname: Jokhio
authors.affiliation: Department of Obstetrics & Gynaecology, Aga Khan University, Karachi, Pakistan.
authors.forename: R M
authors.initials: RM
authors.lastname: Rizvi
authors.affiliation: Department of Obstetrics & Gynaecology, Aga Khan University, Karachi, Pakistan.
authors.forename: J
authors.initials: J
authors.lastname: Rizvi
authors.affiliation: School of Health and Population Sciences, College of Medical and Dental Sciences University of Birmingham, UK.
authors.forename: C
authors.initials: C
authors.lastname: MacArthur
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult