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Table 1 Characteristics of studies reporting fistula prevalence included in the review

From: Estimating the prevalence of obstetric fistula: a systematic review and meta-analysis

Author Study area Study design Assessment of fistula Number of fistula Number of women/pregnancies Prevalence(per 1000 WRA)
Community based studies
Muleta et al., 2008 [18] Seven rural administrative regions in Ethiopia Cross-sectional survey of obstetric fistula Women reporting leakage of urine, faeces or both examined in the health facilities 44 (untreated) 19,153 1.62 (1.53, 2.64)
Walraven et al., 2001 [24] Random sample of 20 rural villages in Farafenni, The Gambia Census of all women aged 15-54 for reproductive morbidity External, vaginal speculum and bimanual pelvic examination by female gynaecologist 1 1,038 0.95 (0.02, 5.26)
Kulkarni, 2007 [35] Six PHC areas (urban and rural) in Maharashtra, India Cross sectional survey of non-pregnant, ever married women with proven fertility for reproductive morbidity Clinical examination but unspecified what or by whom 1 1,167 0.86 (0.02, 4.8)
Bhatia et al., 1997 [19] Villages (25% urban, 75% rural) with at least 500 people in Karnataka, India Cross sectional study of all eligible women under 35 with a child under 5 for reproductive morbidity External, vaginal speculum and bimanual pelvic examination by female gynaecologist 1 385 2.6 (0.07, 14.39)
Younis et al., 1993 [29] Two rural villages in Giza, Egypt Cross sectional study of reproductive morbidity in ever-married, non pregnant women. Speculum and bimanual examination by female physicians [1] 0 509 0.0 (0.0 , 7.90)
Deeb et al., 2003 [27] Nabi Sheet, Lebanon Cross sectional study of reproductive morbidity in ever married, non-pregnant women Thorough inspection of external genitalia, with speculum conducted by female physicians [1] 0 506 0.0 (0.0, 7.3)
Al-Riyami et al., 2007 [28] Oman, Mixed National Health Survey 2000 aiming to identify reproductive morbidity. Multi-stage stratified probability-sampling design of 1,968 households with ever married, non-pregnant women Pelvic examination by a trained physician [1] 0 1,662 0.0 (0.0, 2.2)
Al-Qutob, 2001 [26] Ain Al-Basha, Jordan. Semi-urban Random sample of Jordanian women Comprehensive physical and pelvic examination conducted by trained female physician, a nurse/midwife and a laboratory technician [1] 0 379 0.0 (0.0, 9.7)
Bulut et al., 1995 [25] City of Istanbul, Turkey Systematic sample of non-pregnant, ever married parous women who had ever used contraception Physical examination by female physician [1] 0 696 0.0 (0.0, 5.3)
Tehrani et al., 2011 [34] Four provinces of Iran Multi-stage stratified probability-sampling design of non-pregnant non menopausal women 18-45 Comprehensive gynaecological examination of all married women including a speculum examination [1] 0 1117 0.0 (0.0. 3.3)
Studies with hospital based recruitment
Ijaiya and Aboyeji, 2004 [23] Ilorin, Nigeria, urban Hospital review of women with fistula repair Repair 34 32,188 1.1 (0.7, 1.5)
Kalilani-Phiri et al., 2010 [21] Nine districts (urban and rural) in Malawi Hospital record reviews from gynaecological, prenatal, obstetric wards and operating theatres as well as fistula repair services. Only women originating from nine districts included Repair 111 425,865 0.26 (0.2, 0.3)
Mabeya, 2004 [36] West Pokot, Kenya. Rural Hospital record review supplemented by surgeons’ notes. Cases of fistulae presenting to the two rural hospitals that are the main hospitals in the district Repair 66 150,000 0.44 (0.34, 0.55)
  1. [1] These studies were reproductive morbidity studies which did not state in the methods that they were investigating fistula, nor did they report any cases of fistula; however the type of examination used to identify other reproductive morbidities was assessed to have been sufficient that should there have been any cases of fistula they would have been identified.