[Retrospective study of urogenital fistula in Burkina Faso from 2001 to 2003]. / Bilan rétrospectif des fistules urogénitales obstétricales de 2001 a 2003 au Burkina Faso.

The purpose of this study was to analyze aspects of obstetric urogenital fistulae to provide a foundation for implementation of a national control program in Burkina Faso. A cross-sectional study with quantitative and qualitative components was carried out in 47 hospitals in January 2004. The quantitative component consisted of analyzing available data for 2001, 2002 and 2003. The qualitative component consisted of interviewing women with fistulae to evaluate the impact of the disease on the quality of life and persons in charge of the health reference centers to identify the difficulties and needs of the facility. In the 3-year study period, 1,500,000 deliveries were attended and 347 fistulae were identified in the health reference centers. The incidence rate of obstetric fistulae was 23.1 per 100 000 deliveries (CI 95% 20.8-25.7). Women with fistulae were young and usually without paid employment. Many had a history of dystocia during the labor. Most fistulae were recent, small or average in size and located at the level of the vesico-vaginal septum. The failure rate of surgical treatment was about 17.5%. Four of the 12 women interviewed reported social alienation and ostrasization. Only 4 of the 47 hospitals studied had a personnel qualified to manage women with urogenital fistula on a daily basis. One NGO assisted women in obtaining care. Proposals for improvement of the situation were considered at a national validation workshop. These findings support the need to implement a national program that should be evaluated to see lessons learned from this study.

Prevalence and risk of HIV infection among female sex workers in Burkina Faso.

Little information is available regarding human immunodeficiency virus (HIV) infection among female sex workers (FSW) in Burkina Faso, West Africa. A cross-sectional study was conducted in Ouagadougou and Bobo-Dioulasso, the 2 largest cities of the country, to determine the prevalence of HIV infection and other sexually transmitted diseases (STDs) among FSWs, and to investigate the factors which were associated with HIV infection in this population. From October to November 1994, 426 FSWs were recruited. The method of anonymous and unlinked HIV screening recommended by the World Health Organization (WHO) was used. The overall HIV seroprevalence was 58.2% (95% confidence interval: 53.4-62.9) and 52.6% of FSWs had at least one STD agent. The most common STDs were trichomoniasis (23%), syphilis (15%) and gonorrhoea (13%). In a logistic regression analysis, risk factors for HIV infection were high gravidity (> or = 2 pregnancies), low perception of personal risk of HIV infection, syphilis and the presence of genital warts. These results suggest that FSWs in Burkina Faso need better information about HIV transmission and prevention and then need better access to STD detection and management services.

Bilan retrospectif des fistules urogenitales obstetricales de 2001 a 2003 au Burkina Faso

Pour analyser les fistules urogenitales au Burkina Faso en vue de la mise en place d'un programme national; une etude transversale a visee quantitative et qualitative en janvier 2004 a ete realisee dans les formations sanitaires de reference. L'etude quantitative a analyse les donnees disponibles sur les annees 2001; 2002 et 2003. L'etude qualitative a permis d'interviewer des femmes vivant avec la fistule et les responsables des services de sante. Au cours des 3 ans sur environ 1 500 000 accouchements attendus dans le pays; 347 cas de fistules ont ete identifies soit un taux d'incidence de 23;1 pour 100 000 accouchements (IC a 9520;8 - 25;7). Les femmes avec fistules etaient jeunes et surtout sans emploi remunere avec des antecedents de dystocie a l'accouchement. Les fistules etaient le plus souvent recentes; de tailles petites ou moyennes et localisees au niveau de la cloison vesico-vaginale. Les resultats de la chirurgie etaientmarques par un taux d'echec de l'ordre de 17;5. Quatre femmes sur 12 interviewees ont declare avoir ete abandonnees par le conjoint. Sur 47 hopitaux visites; seulement 4 avaient un personnel qualifie pour la realisa- tion de la prise en charge quotidienne des fistules. Une organisation non gouvernementale aidait les patientes pour l'obtention de soins. Un atelier national de validation a permis de faire des propositions pour l'amelioration de la situation. Les resultats montrent la necessite de la mise en place d'un programme national qui devrait etre evalue pour voir les acquis obtenus apres cette etude