title: Prevalence of obstetric fistula and symptomatic pelvic organ prolapse in rural Ethiopia.
abstract: OBJECTIVE
  Little is known about the extent to which women in low- and middle-income countries suffer with urological and urogynaecological complications of childbirth. This study measured the prevalence of obstetric fistula and symptomatic pelvic organ prolapse (POP) in east and north Ethiopia.
  
  
  METHODS
  We randomly selected 23,023 women of reproductive age (15-49 years) from 113 villages in East Harraghe, South Gondar and West Gojjam, Ethiopia. Trained local health workers administered a validated face-to-face survey and a team of researchers verified data by readministering a random selection (5 %) of the survey. All suspected fistulae were followed up to confirm a clinical diagnosis.
  
  
  RESULTS
  Mean age was 29.5 [standard deviation (SD) 8.05] years. Only 22 % of women were knowledgeable about the symptoms of fistula. The prevalence of all obstetric fistulae was 6:10,000 reproductive-aged women [95 % confidence interval (CI) 3-8], of untreated fistula 2:10,000 (95 % CI 0-4) and of symptomatic POP 100:10,000 (95 % CI 86-114).
  
  
  CONCLUSIONS
  The prevalence of obstetric fistula in these rural zones of Ethiopia is relatively low and reflects a substantial reduction from previous reports. Significant numbers of women suffer with symptomatic POP, for which surgical and nonsurgical treatments would be beneficial. Obstetric fistula in north and east Ethiopia is relatively low; however, the many women with symptomatic pelvic organ prolapse could benefit from treatment.
authors.affiliation: Hamlin Fistula Ethiopia, Hamlin Fistula Hospital, PO Box 3609, Addis Ababa, Ethiopia. K.ballard@surrey.ac.uk.
authors.forename: Karen
authors.initials: K
authors.lastname: Ballard
authors.affiliation: Hamlin Fistula Ethiopia, Hamlin Fistula Hospital, PO Box 3609, Addis Ababa, Ethiopia.
authors.forename: Fekade
authors.initials: F
authors.lastname: Ayenachew
authors.affiliation: Hamlin Fistula Ethiopia, Hamlin Fistula Hospital, PO Box 3609, Addis Ababa, Ethiopia.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Wright
authors.affiliation: Hamlin Fistula Ethiopia, Hamlin Fistula Hospital, PO Box 3609, Addis Ababa, Ethiopia.
authors.forename: Habtamu
authors.initials: H
authors.lastname: Atnafu
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000453:epidemiology*; D015995:Prevalence; D014624:Vaginal Fistula / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
keywords: Fistula prevalence; Global maternal health; Obstetric fistula; Pelvic organ prolapse