Objective : To assess the epidemiological aspects of obstetric fistulas at the Ngaoundere Lutheran Hospital.

Methods : We carried out a hospital-based cross sectional analytic study comparing women with fistulas (subjects), and those without the condition (controls). We compared information from 166 files of fistula patients (2013-2016) with those of 269 parous women recruited prospectively (Feb- April 2017). We used a modified pretested
questionnaire with information on socio-demographic, clinical and reproductive characteristics. Crude odds ratios (OR) and their 95% CI were obtained after bivariate analysis, to determine the factors that were associated with obstetric fistula. The factors that were statistically significant (p<0.05) were modelled into final logistic regression analysis, to determine the independent association.

Results : Some characteristic were unequally distributed; socio-demographic characteristics (age, occupation, marital status, region of origin, religion and level of education) as well as clinical characteristics (age at first childbirth, parity, prenatal care, duration of labour, weight, height and BMI) p≤ 0.001. Among women who consulted the gynaecologist/ urologist, the prevalence of obstetric fistulas was 2.56% (95CI: 1.98-2.58). Factors independently associated with obstetric fistulas were; illiteracy (53% vs.
47%; AOR:7.2; 95% CI [1.8-28.2]), height <150cm (77.9% vs. 22.1%; AOR:8.7;95%CI [2.8-27.4]), inadequate prenatal care (64.9% vs. 35.1%; AOR:7.5; 95%CI [2.8-20.1]), labour duration> 24hours (71.6% vs. 28.4%; AOR:88.2; 95% CI [21.3- 364]) and no use of preventive catheter (52.4% vs.47.6%; AOR:1.7; 95% CI [0.4-3.3]).

Conclusion : Obstetric fistula is commonly associated with illiteracy, short stature, inadequate prenatal care, prolonged labour and no use of preventive catheter.

Esophageal cancer, the seventh most common cancer in the world, exhibits massive geographical variation. Its incidence is highest in China, while Central America and Africa have the world’s lowest rates. The two histological subtypes have different distributions. Squamous Cell Carcinoma (SCC) is the dominant form in the high-burden areas, while Adenocarcinoma (AC), is more evenly distributed in the Western world. Despite the multidisciplinary progress made in treating this disease, the morbidity that follows esophagectomy remains staggeringly high. Estimates place the figure at the high end of the 30-60% range. Meanwhile, the surgery itself has undergone a revolution from old, traditional methods (like the trans hiatal esophagectomy and Ivor Lewis esophagectomy) to a combination of minimally invasive techniques and surgical robots that reduce trauma, improve recovery time, and cut down the complication rate.