Chronic schistosomiasis infection and obstetric fistula repair outcomes in Lubango, Angola: A retrospective chart review

Abstract

To assess the association between chronic schistosomiasis infection, determined by bladder biopsies, and vesicovaginal (VVF) repair outcomes at an urban hospital in Angola. Other objectives were to quantify the prevalence of chronic schistosomiasis among patients with VVF and to assess agreement between pelvic X‐rays and bladder biopsies for chronic schistosomiasis diagnosis.In this retrospective chart review, data were collected on patients who underwent VVF repair between 1 June 2022 and 30 November 2022 including: age, number of previous fistula repairs, Goh classification of fistula, X‐ray and biopsy results, fistula repair outcome, perioperative complications and postoperative incontinence. Age and number of previous repairs were described using means with standard deviations. Goh classification, X‐ray and biopsy results, fistula repair outcome, perioperative complications, and postoperative incontinence were described using frequencies. Parametric and nonparametric tests and Cohen's κ were calculated using R software and Excel.Of the 76 charts retrieved, 60 met inclusion criteria. The overall fistula repair failure rate was 26.7% (n = 16). There was no difference in the fistula repair failure rate between those with (26.9%) and without (26.5%) evidence of chronic schistosomiasis infection (χ2 = 2.33 e‐31, 95% confidence interval [CI]: −0.30, 0.28). The prevalence of chronic schistosomiasis was 43.3%. There was no agreement between X‐ray and biopsy in diagnosing chronic schistosomiasis infection (Cohen's κ = 0.23, 95% CI: −0.001, 0.47).There was no difference in the chance of fistula repair failure between those with evidence of chronic schistosomiasis infection and those without.