report of the rapid assessment of vesico-vaginal fistulae in nigeria

EPIDEMIOLOGY OF VVFOver the past four decades, a number of key studies have been carried out on casesof obstetric fistula. With one exception (Murphy, 1981), these studies are based onhospital records. Most often, they are reports by the gynaecologists or surgeonswho operated on the women. While they give a good indication of the existence offistula in particular areas, these studies of course do not furnish adequate data as toincidence or true extent of the problem (21).Actual incidence of fistula is impossible to calculate. Based on treating about 700cases of obstetric fistula per year in Addis Ababa, it has been suggested that theincidence might be around 55 per 100,000 births in Ethiopia. However, Harrisonsuggested that the incidence might be closer to 80 per 100,000 (25). Frequenciesare sometime given as a proportion of admissions or of gynaecological admissions,and sometimes of deliveries or births. This makes comparison difficult. Thefrequency for deliveries varies from 0.03% in Benin City (23) to 0.39% in Zaria(24).The number of cases of VVF and the frequency of occurrence in Nigeria isunknown.This is largely due to the absence of any large-scale community based studies.However, available hospital reports indicate that VVF occurs in all parts of thecountry.It is commoner in the Northern part of the country and appears to be declining inthe southwestern part of the federation. Dr. Waaldijk working in Katsina and Kanoestimates that worldwide, the incidence of VVF is 1-2 per 1000 deliveries. Thisgives a world prevalence of 0.5 to 2 million (16).18