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Epidemiology of pelvic organ prolapse in rural Gambia, West Africa

  1. Caroline Scherf1,*,
  2. Linda Morison2,
  3. Alison Fiander1,
  4. Gloria Ekpo3,
  5. Gijs Walraven3

Article first published online: 22 DEC 2003

DOI: 10.1111/j.1471-0528.2002.01109.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 109, Issue 4, pages 431–436, April 2002

Additional Information

How to Cite

Scherf, C., Morison, L., Fiander, A., Ekpo, G. and Walraven, G. (2002), Epidemiology of pelvic organ prolapse in rural Gambia, West Africa. BJOG: An International Journal of Obstetrics & Gynaecology, 109: 431–436. doi: 10.1111/j.1471-0528.2002.01109.x

Author Information

  1. 1

    Department of Obstetrics and Gynaecology, University of Wales College of Medicine, Cardiff, UK

  2. 2

    London School of Hygiene and Tropical Medicine, London, UK

  3. 3

    Farafenni Field Station, Medical Research Council Laboratories, Banjul, The Gambia

**Dr C. Scherf, Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, 396 Fulham Rd, London SW10 9NH, UK.

Publication History

  1. Issue published online: 22 DEC 2003
  2. Article first published online: 22 DEC 2003
  3. Accepted 14 December 2001

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Objectives To investigate the prevalence of pelvic organ prolapse in rural Gambia.

Design Community-based reproductive health survey.

Population 1348 women residing in 20 villages in rural Gambia.

Methods Health questionnaire and standard gynaecological examination to detect symptoms and signs of pelvic organ prolapse and other reproductive diseases. Association between prolapse, socio-demographic data and other morbidities was examined.

Main outcome measures Presence and degree of pelvic organ prolapse.

Results Out of 1067 women consenting to speculum examination 488 (46%) were found to have some degree of prolapse. In 152 women (14%) the prolapse was severe enough to warrant surgical intervention. After adjustment for confounders the likelihood of pelvic organ prolapse increased with parity and age and was higher in women of the Wolof tribe, pregnant women, those with insufficient perineum, and moderately and severely anaemic women. Only 13% of women with moderate or severe prolapse reported symptoms on direct questioning.

Conclusions Pelvic organ prolapse has a high prevalence in this first community-based study of prolapse in West Africa. Many of those affected did not complain about their problem, thus increasing the large, silent burden of reproductive morbidity in this population. Parity was confirmed to be the strongest risk factor followed by age and anaemia. Ethnic origin was a previously unknown risk factor suggesting possible genetic factors in the pathogenesis of prolapse.

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