Eze Chinwe Catherine
Uederal University Of Technology, Nigeria
Title: Public Health Impact and Risk Factors Associated With Uterine Leiomyomata Among Women In Imo State, Nigeria
Biography
Biography: Eze Chinwe Catherine
Abstract
Background: Uterine fibroids(UF), also referred to as uterine myomas, leiomyomas, myomatas, or simply fibroid are benign soft-tissue tumours that arise from uterine smooth muscle tissue (myometrium) .Nigeria is thought to have a high prevalence of fibroids due to its indigenous black population, since uterine fibroids are more prevalent in black women .Although uterine leiomyomata affect the reproductive health and well-being of approximately 25% of premenopausal women, risk factors are poorly understood.
Objective: To examine public health impact and associated risk factors associated with UF among women in Imo State, its prevalence of, women’s knowledge about health services and to develop modalities to improve awareness to prevent morbidity and improve quality of life.
Materials and Methods: A four year epidemiological, non-interventional, retrospective and descriptive study research was carried out .The data of all female patients (ages 14-55) within the inclusion criteria that presented with UF during the study period 3rd January 2015 to 3rd January 2019 was obtained from medical records, theatre records of gynaecology clinics and Laboratories selected in Imo State. In addition, a pretested and structured questionnaires structured questionnaire with open interviews was used to collect the data from the subjects. The main outcome measures were socio-demographic data, clinical history, myoma clinical features, symptomatology, and risk factors associated to myomas. Clinical, local and ultra-sonographic examination was done for the morphology of the fibroids. Comparison was done with histological picture for accuracy in clinical and sonographic diagnosis. Multivariable adjustment of risk ratios was based on log binomial regression.
Result: A total of 520 subjects were studied. Fibroids mainly affected those in the reproductive age group (31-40 years). The common clinical presentations- were abdominopelvic mass (95%); menorrhagia (98.7%), infertility (43.9%), anaemia (30.9%) dysmenorrhoea (15.5%), and abdominopelvic pain (15.8%) miscarriages (3.5%) amongst other symptoms. The average uterine size at presentation was 15±9.7 weeks. Most of the patients were nulliparous (76.7%, 79/103) and 51.5% (53/103) were married. The mean age of the women was 35.42yrs ± 9.34 (range, 20-74 years). A significant relationship was found between Level of Education and development of fibroid (R= -0.196; χ2 value= 29.618; p = 0.001) and (R= 0.399, χ2 value= 92.923; p = 0.001) respectively.Majority of the women 88 (44.4%) had tertiary education, (24.7%) secondary, (24.3%) primary and (6.6%) had no formal education. Most of the patients had multiple fibroids, (40.9%) had intramural, (35.4%) submucous and (26.3%) subserous. Out of this number, (216) 37.0% and 45.4% were overweight and obese respectively.
Conclusion: we identified nine possible risk factors that play an important role in UF epidemiology. The UF risk factors with the strongest evidence were age, weight and parity. High-quality prospective observational data are needed to improve our understanding of UF epidemiology, and thus its aetiology and optimal management and early detection thereby reducing morbidity. Health intervention programmes and healthy lifestyle should be encouraged with routine check-ups should be conducted so as to detect and possibly treat such tumours early. Further research is needed to find out biological factors causing fibroids including diet, stress, and environmental factors and adequate resources towards managing symptomatic patients at a subsidized rate.
Key words
Uterine fibroids, leiomyoma, incidence, prevalence, risk factors, Imo Epidemiology.