Function and disability status among women with fistula using WHODAS2.0: A descriptive study from Rwanda and Democratic Republic of Congo. Issue 2 (31st May 2021)

• Record Type: Journal Article
• Authors: Keyser, Laura; Myer, Emily N. B.; McKinney, Jessica; Maroyi, Raha; Mukwege, Denis; Chen, Chi Chiung Grace
• Is Part Of: International journal of gynaecology and obstetrics. Volume 157:Issue 2(2022)
• Page Start: 277
• Page End: 282
• Publication Date: 2021-05-31
• Subjects: disability -- function -- maternal morbidity -- obstetrical fistula -- pelvic fistula -- prolonged obstructed labor; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.13740
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To assess function and disability among women in Rwanda and Democratic Republic of Congo living with fistula and identify characteristics associated with higher disability scores. Methods: Women presenting for fistula care were recruited. Eligible participants underwent a physical examination to classify fistula type and completed the WHO Disability Assessment Schedule 2.0 questionnaire to ascertain the impact of fistula on function across six domains: cognition, mobility, self‐care, getting along, life activities, and participation. Disability scores were calculated (where 0 = no disability and 100 = complete disability). Participants were grouped according to no, low, or high disability status; results were examined to determine the domains most affected. Results: Among 69 participants, fistula type included: vesicovaginal (59.4%), ureterovaginal (14.5%), total absence of proximal urethra (11.6%), and rectovaginal (14.5%). Median disability score was 43.0/100 (interquartile range 26.0–67.0); 83% exhibited high disability status. Life activities and participation in society domains were most affected. Women with rectovaginal fistula reported the lowest scores, and those with total absence of proximal urethra reported the highest scores. Conclusion: WHO Disability Assessment Schedule 2.0 represents a simple, robust measure of global disability status, aligns with research efforts to estimate maternal disability, and may inform health needs and resource allocation for this population. In this study, disability was common, varied by fistula type, and affected physical, mental, and social domains. Abstract : Women with pelvic fistula in Rwanda and Democratic Republic of Congo demonstrate high quantitatively measured disability levels, with greatest impact in life activities and societal participation.