Time To Recovery From Obstetric Fistula And Its Predictors Among Obstetric Fistula Patients Admitted At Hamlin Fistula Center, Addis Ababa Ethiopia, 2023, Survival Analysis

Abstract

Background: Obstetric fistula (OBF) is still one of the major causes of maternal morbidity in Ethiopia. Women and girls with obstetric fistula face tremendous types of challenges including. Emotional and social isolation, nerve damage, foot drop, stress incontinence, secondary infertility, renal failure, and other. While surgery can address most obstetric fistula cases there is critical shortage of available treatment. Few facilities provide the necessary surgery and at the current rate of treatment most women will not receive the care they need .delays in treatment can affect women’s willingness to seek help and number of cases a center can handle. Objective: To determine time to recovery from obstetric fistula and its predictors among obstetric fistula patients admitted at Hamlin fistula hospital Addis Ababa 2023. Methods: An institution based retrospective cohort study was conducted among obstetric fistula patients admitted at Hamlin fistula hospital from January, 2017 to Jun, 2023.Simple random sampling technique was used to recruit 513patient records. Data were extracted from the patients’ medical charts and collected by using kobo tool box software. Descriptive statistics was computed to determine characteristics of the patients. The Kaplan-Meier test was used to estimate the distribution of recovery time and the log-rank test to assess the experience of recovery time among different levels of categorical variables. Bivariate and multivariate Cox proportional regression analysis was done at cut point of p value <0.25 with CHR and p value< 0.05 and AHR to considered statistical significant after adjusting confounding variables. Results: The overall recovery rate of the entire cohort was 74.7%,95%CI: (71.1,78.2) and median time of recovery from obstetric fistula was 5.9 weeks(95%CI=5.1, 6.6).Getting physiotherapy after surgery (AHR:1.13,95%CI:1.13,3.02),Urethral status (damaged) AHR:0.43,95CI(0.25,0.76), Length of fistula (2.2.-4cm)(AHR:5.23,95%CI(1.17,12.33), having severe vaginal scarring (AHR: .60,95CI(0.40,0.89)) and moderate vaginal scaring were predictors of recovery from fistula. Conclusion and recommendation: Based on the findings, median recovery time was 5.9 weeks getting physiotherapy after surgery, urethral status, having moderate and severe vaginal scarring were predictors that affect time of recovery from fistula. Hamlin fistula center and other concerned bodies such as health professional and society have to give attention on factors that affect time of recovery from fistula