TITLE:
Diagnosis Delay and Assessment of the Quality of Life of Patients with Endometriosis Using the Endometriosis Health Profile 5 Questionnaire in a Sub-Saharan Population
AUTHORS:
Monzango Sibo, Mboloko Esimo, Mputu Lobota, Itewa Monka, Kitenge Kia Kayembe, Tambola Grace, Samba Kevine, Maesheka Patrick, Ntanga Kabuya, Amba Naomie, Maxime Fastrez, Buka Ikoko, Ndjukendi Ally, Sangana Georges, Barhayiga Berthe, Mbanzulu Pita, Longo Mbenza, Clément Ferrier, Emile Darai
KEYWORDS:
Diagnosis Delay, EHP-5, Endometriosis, Quality of Life, Sub-Saharan
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.5,
May
31,
2023
ABSTRACT: Context: Endometriosis is a pathology that directly affects the daily lives of
women with frequent impairment of their quality of life. In our environment,
medical, socio-cultural, financial factors and factors related to the
organization of the health care system greatly delay its diagnosis. The
objectives of the present study were to determine the diagnosis delay and to
assess the quality of life before surgery of women with endometriosis using the
specific Endometriosis Health Profile 5 (EHP-5) questionnaire. Methods: We
carried out a descriptive, observational, retrospective study in 8 medical
centers in the City of Kinshasa, from January 2019 to October 2022. A total of 80
women with endometriosis confirmed by laparoscopy (16 diagnostic and 64
operative laparoscopies) and histopathology were interviewed. We used the
revised American Society for Reproductive
Medicine (rASMR) classification, the Endometriosis Fertility Index (EFI)
score was calculated for infertile women and the EHP-5 questionnaire to assess
quality of life. Our data was entered and analyzed using Statistical Analysis
Software 16.1 (STATA 16.1). Results: Diagnosis delay of endometriosis
was on average 12 ± 4.3 years. The overall mean EHP-5 score of all patients
showed a severe deterioration in quality of life (604 ± 235). A negative
relationship was observed between the age of the patient, the diagnostic delay,
and the alteration of the quality of life in patients over 36 years old and
those with about 11 years of diagnostic delay presenting the slight alteration.
Patients with a high social level had very severe quality impairment. Women on
hormonal treatment, those with a history of pregnancy, childbirth, miscarriage
and abortion had a slight and significant deterioration in quality of life (p 0.05). Conclusion: Despite some limitations,
our preliminary study highlights that in sub-Saharan Africa, the diagnosis of
endometriosis is delayed and associated with a severe alteration in quality of
life. Moreover, diagnosis of endometriosis seems to be restricted to women with
high social levels. Therefore, further efforts are required to develop a health
policy to decrease delay for diagnosis with potential benefits on symptoms,
quality of life, fertility while limiting stigma and psychological effects of
this debilitating pathology.