{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:06:52Z","timestamp":1782515212630,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,3,12]],"date-time":"2013-03-12T00:00:00Z","timestamp":1363046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To gain understanding of care pathways and induced mobility patterns of obstetric fistula patients in French\u2010speaking West African fistula repair centres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We followed prospectively during 18 months a cohort of obstetric fistula patients in Mali and Niger (2008\u20132009). 120 patients were recruited at different stages of their care process in 5 reference fistula repair centres. Follow\u2010up was carried out in repair centres and communities. Quantitative data were collected through close\u2010ended questionnaires at three time points. Medico\u2010social pathways were explored through a longitudinal analysis focusing on six indicators: fistula duration, care process duration, patients' mobility, marital status, number of surgeries and continence status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients' pathways were characterised by their length: fistula duration (median 4\u00a0years), care process duration (median 2.7\u00a0years), aggregated time spent in repair centres during study (median 7\u00a0months). Patients developed four mobility patterns (homebound, itinerant, institutionalised and urbanised). Adverse marital status change continued over time. Sample stratification according to number of previous surgeries revealed differences in care process duration and outcome: 23\/31 new cases (\u22641 surgery) gained continence with a mean of 1.5 surgeries in a median of 0.6\u00a0year while only 17\/78 old cases (\u22652 surgeries) became continent with a mean of 4 surgeries in a median time of 4.9\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The quest for continence does not end with admission to a fistula repair centre. Analysing fistula care experience across time within the varying settings highlights the twofold population and mixed medico\u2010social outcomes that should prompt new development in obstetric fistula care management and research.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12086","type":"journal-article","created":{"date-parts":[[2013,3,14]],"date-time":"2013-03-14T00:32:05Z","timestamp":1363221125000},"page":"524-533","source":"Crossref","is-referenced-by-count":40,"title":["Medico\u2010social pathways of obstetric fistula patients in Mali and Niger: an 18\u2010month cohort follow\u2010up"],"prefix":"10.1111","volume":"18","author":[{"given":"Nathalie","family":"Maulet","sequence":"first","affiliation":[{"name":"Institute of Health and Society Universit\u00e9 Catholique de Louvain Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahamoudou","family":"Keita","sequence":"additional","affiliation":[{"name":"Hospital Nianankoro Fomba of Segou Ministry of Health Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Macq","sequence":"additional","affiliation":[{"name":"Institute of Health and Society Universit\u00e9 Catholique de Louvain Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199609000-00024"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-010-1236-8"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.02.024"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.00875.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02182.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01900.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01419.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1028-4559(10)60063-0"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.04.005"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610903100609"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.06.027"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.06.017"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)32712-8"},{"key":"e_1_2_6_15_1","first-page":"61","article-title":"[Itinerary of women suffering from obstetric fistula in Niger]","volume":"69","author":"Ndiaye P","year":"2009","journal-title":"M\u00e9decine Tropicale (Mars)"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02200.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2010.551519"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441690600648728"},{"key":"e_1_2_6_19_1","first-page":"1734","article-title":"Quality of life following successful repair of vesicovaginal fistula in Nigeria","volume":"11","author":"Umoiyoho AJ","year":"2011","journal-title":"Rural and Remote Health"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-200507001-00002"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.04.015"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.01.006"},{"key":"e_1_2_6_23_1","volume-title":"Obstetric Fistula: Guiding Principles for Clinical Management and Programme Development","author":"World Health Organization","year":"2006"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691050902874777"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2010.491833"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftmi.12086","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.12086","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T14:19:34Z","timestamp":1698502774000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.12086"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3,12]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2013,5]]}},"alternative-id":["10.1111\/tmi.12086"],"URL":"https:\/\/doi.org\/10.1111\/tmi.12086","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3,12]]}}}