Uterine prolapse and its impact on quality of life in the Jhaukhel-Duwakot Health Demographic Surveillance Site, Bhaktapur, Nepal

• Published in: Global health action Vol. 8; no. 1; p. 28771
• Main Authors: Shrestha, Binjwala, Onta, Sharad, Choulagai, Bishnu, Paudel, Rajan, Petzold, Max, Krettek, Alexandra
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01.01.2015; Taylor & Francis Ltd; Coaction Publishing; Co-Action Publishing; Taylor & Francis Group
• Subjects: Adult; Age; Age Factors; Clinical medical disciplines: 750; College campuses; Colleges & universities; Cross-Sectional Studies; DISTRICT; Educational programs; Emotions; Empowerment; Environmental & Occupational Health; EXPERIENCES; Extended family; Family planning; Female; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Fysisk aktivitet, idrott, hälsa och digital teknik; Gynecology and obstetrics: 756; Gynekologi og obstetrikk: 756; Health Demographic Surveillance Site; Health education; Health problems; Health sciences; Health Status; Health surveillance; Humans; Internal medicine; Interpersonal Relations; Klinisk medisinske fag: 750; Low income groups; Maternal & child health; Medical disciplines: 700; Medical sciences; Medical screening; Medicin; Medicine; Medisinske Fag: 700; Middle Aged; Nepal; Nepal - epidemiology; Nuclear family; Nutrition; Original; PELVIC ORGAN PROLAPSE; Physical Activity, IT and Health; Polls & surveys; PREVALENCE; Prevention; Prevention programs; Prolapse; Public; Public health; Public Health, Global Health, Social Medicine and Epidemiology; Quality of life; Quality of Life - psychology; Reproductive health; RISK-FACTORS; Severity of Illness Index; Sleep; Socioeconomic Factors; Surveillance; Uterine prolapse; Uterine Prolapse - epidemiology; Uterine Prolapse - psychology; VDP; Women; Womens health; Nepal; Sweden; uterine prolapse; Health Demographic Surveillance Site; quality of life; Nepal
• ISSN: 1654-9716; 1654-9880; 1654-9880
• DOI: 10.3402/gha.v8.28771

Uterine prolapse (UP) is a reproductive health problem and public health issue in low-income countries including Nepal. We aimed to identify the contributing factors and stages of UP and its impact on quality of life in the Jhaukhel-Duwakot Health Demographic Surveillance Site of Bhaktapur, Nepal. Our three-phase study used descriptive cross-sectional analysis to assess quality of life and stages of UP and case-control analysis to identify contributing factors. First, a household survey explored the prevalence of self-reported UP (Phase 1). Second, we used a standardized tool in a 5-day screening camp to determine quality of life among UP-affected women (Phase 2). Finally, a 1-month community survey traced self-reported cases from Phase 1 (Phase 3). To validate UP diagnoses, we reviewed participants' clinical records, and we used screening camp records to trace women without UP. Among 48 affected women in Phase 1, 32 had Stage II UP and 16 had either Stage I or Stage III UP. Compared with Stage I women (4.62%), almost all women with Stage III UP reported reduced quality of life. Decreased quality of life correlated significantly with Stages I-III. Self-reported UP prevalence (8.7%) included all treated and non-treated cases. In Phase 3, 277 of 402 respondents reported being affected by UP and 125 were unaffected. The odds of having UP were threefold higher among illiterate women compared with literate women (OR=3.02, 95% CI 1.76-5.17), 50% lower among women from nuclear families compared with extended families (OR=0.56, 95% CI 0.35-0.90) and lower among women with 1-2 parity compared to >5 parity (OR=0.33, 95% CI 0.14-0.75). The stages of UP correlated with quality of life resulting from varied perceptions regarding physical health, emotional stress, and social limitation. Parity, education, age, and family type associated with UP. Our results suggest the importance of developing policies and programs that are focused on early health care for UP. Through family planning and health education programs targeting women, as well as women empowerment programs for prevention of UP, it will be possible to restore quality of life related to UP.