Determinants and Heterogeneity of Time -to- Recovery from Obstetric Fistula Patients; Comparison of Acceleration Failure Time and Parametric Shared Frailty Models


  •  Million Demissie    

Abstract

Obstetric Fistula is a medical condition that involves an opening or perforation between the vagina and the bladder or the vagina and the rectum. It is a serious, life threatening and often debilitating medical condition that affects thousands of women in developing countries.The study consists of 270 obstetric fistula patients having all required information who were taking treatment at Jimma University Specialized Hospital in south west Ethiopia from January, 2011 to January ,2017. The log-rank and generalized wilcoxon test were used to explore the association between the recovery time and different independent categorical covariates. Then using different baseline distribution parametric models were employed to have an appropriate model for the recovery time/status of the patients based on Akaike information criteria (AIC) of the model. Result of Both log-rank and generalized wilcoxon test showed that there were significant differences among obstetric fistula patients in survival experience of weight , marital status, Residence, Incontinence, Antenatal care, mode of delivery, status of urethra and types of fistula of patients at 5% level of significance. Based on AIC log-normal gamma shared frailty model is an appropriate model and there is heterogeneity between patients with zone. The final model showed that marital status, Residence, Incontinence, Antenatal care, status of urethra and types of fistula were the determinants of recovery status of the patients at 5% level of significance. In Conclusion, the result showed that married women, rural residence, incontinence of urine more than 3 months, hadn’t antenatal care and completely damaged urethra were prolonged time recovery time of patients whereas having recto-vaginal-fistula shorten recovery status than vesico-vaginal fistula group of patients.



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