Laparoscopic diagnosis of endometriosis at Kenyatta National Hospital, Kenya

Abstract

Background: Endometriosis constitutes a serious health issue due to its high affliction of 10% in reproductive age women and its clinical manifestation of infertility and chronic pelvic pain. Worldwide, there is clear documentation of the prevalence of endometriosis in the developed countries; however, the prevalence in black African woman is unknown.
Objective: To determine the prevalence, pattern and clinical presentation of endometriosis in indigenous African women.
Design: A prospective analytical cross-sectional study.
Setting: Kenyatta National Hospital, Kenya between March 2018 and March 2021.
Subjects/Participants: Indigenous African women aged 18 -49 years
Main Outcome Measures: The prevalence of histological confirmed endometriosis and clinical presentation.
Results: The prevalence of histological confirmed endometriosis in indigenous Africans was 4.6% ( 95% CI 0.5–18.4). Laparoscopic visualization diagnosis had a positive predictive value of 33%. Dysmenorrhoea, chronic pelvic pain scale 8-10, dyspareunia, nulliparity and menarche at 13 years and below were significant findings of endometriosis (P<0.001). Physical findings of adnexal tenderness and of nodules in the pouch of Douglas were significant in relation to endometriosis (P<0.001). The most common sites of the endometriosis implants were the Pouch of Douglas and the most common form of endometriosis was endometrioma (40%).
Conclusion: The prevalence of endometriosis in Indigenous African woman is 4.6%. Nulliparity, menarche at the age of 13 and below, dysmenorrhoea, chronic pelvic pain scale 8-10 and dyspareunia were significantly associated with endometriosis. The most common site for endometriosis was the Pouch of Douglas whilst the most common form of endometriosis was endometrioma