Predictors of late presentation for obstetric fistula repair in Abakaliki, South-East Nigeria

Adebayo BC Daniyan, Johnson A. Obuna, Olapeju W. Daniyan, Emmanuel N. Yakubu, Kenneth C. Ekwedigwe, Sophia O. Mbamalu

Abstract

Late presentation is a challenge to reducing the backlog of obstetric fistulas. We aimed to identify characteristics of women presenting late for repair in order to improve patient recruitment. It was a cross-sectional comparative study. Data was collected from the women and the hospital notes using proforma and analysed using SPSS. Associations between categorical variables were determined using Chi-square. Predictors of late presentation were determined using logistic regression. A P-value of <0.05 was statistically significant. The mean time of presentation was 42.3 months. Late presentation was significantly associated with age >35 years, parity < 3, not having a spouse, and trauma. On logistic regression, women aged 35 years and above were five times more likely to present late compared with younger ones (AOR= 5.192, 95%CI 1.839-14.660, P=0.002), while women with parity >3 were five times less likely to present late compared with those <3 (AOR= 0.208, 95%CI 0.073-0.587, P=0.003). In conclusion, most patients presented late. Although age, parity, having a spouse, and aetiology were associated with time of presentation, age >35 years and parity < 3 were the significant predictors of late presentation. Recruitment for early repair should be a priority area of the national policy for the elimination of obstetric fistula. (Afr J Reprod Health 2021; 25[4]: 76-81)

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