Title: The problem of infertility in western Equatoria.

POPLINE Document Number: 018117

Author(s):

Modawi O

Source citation:

Khartoum, Sudan, Univ. of Khartoum, 1965. 149 p.

Abstract:

A survey was conducted to investigate the problem of infertility among the tribes of Western Equatoria. The selection of these tribes was motivated particularly by reports of the magnitude of the problem of infertility and depopulation in this area. The total population of all the Chiefdoms surveyed in the 1962-63 period was 100,8484; the total number of married women surveyed was 7111. The incidence of infertility was very high among the tribes in the Zande and Moru districts ranging from 24% among the Avokaya to 60% among the Zande. The Zande and Makraka tribes showed exceptionally high infertility rates, 51% among the Zande and 47% among the Makraka. There was no problem of infertility among the tribes of Yei district except the Makraka. The Fajulla, Kakwa, and Kaliko were very fertile. Analysis of the obstetrical and family histories of 353 unselected Makraka couples yielded a primary infertility rate of 47% and a secondary infertility rate of 16%. All the women who were studied showed an extreme desire for children, and they willingly accepted repeated and painful examinations. Bimanual pelvic examinations were performed on 198 unselected women to detect evidence of pelvic inflammation or other abnormalities. The diagnoses of chronic pelvic infections were based on the history of the presence of vaginal discharge together with palpable tender adnexal abnormalities. The adnexal inflammatory tuboovarian masses were gross in 16 women (10%). Among the fertile women, 8 (22%) showed signs of infection. Tumors (other than inflammatory) were found in 17 infertile women (11%) and in none of the fertile women. Cervical erosion was encountered in 16 women (13.2%). The position of the uterus was checked in all cases and was retroverted in 16 of 36 fertile women and 60 of 153 infertile women (40%). Lateral displacement was occasionally found in association with adnexal inflammatory masses and tumors. The uterus was very small and conical in 5 infertile women. The Kahn serological test for syphilis was performed in 285 women; 28 (10%) were serologically positive for syphilis. The positive cases were equally shared by the fertile and infertile women. The clinical investigations performed on 241 infertile women and 228 men (from the Zande and Makraka tribes) included general physical examination, gynecological examination of the pelvic organs, vaginal and cervical smears, tubal insufflation, examination of the male genital organs, urethral smears, and semen analysis. The following were among the most clinical findings associated with infertility. In the female there was a high incidence of pelvic inflammatory lesions in 49% and blockage of the fallopian tubes in 58.2%. Gonococci were detected in 0.9% of the smears. In the males there was deficient semen in 60.5% associated with hydroceles (11.9%), varicoceles (4.4%), epididymoorchitis (6.6%), and clinical testicular atrophy (7%). The physical causes of infertility could be due to venereal diseases, postpartum pelvic infections, and filariasis.

Keywords:

Surveys
Sudan
Infertility
Sexually Transmitted Diseases
Incidence
Infections
Pelvic Infections
Midwives and Midwifery
Nutrition
Marriage Patterns
Family Characteristics
Sampling Studies
Studies
Research Methodology
Africa, Northern
Africa
Developing Countries
Reproduction
Reproductive Tract Infections
Diseases
Measurement
Health Personnel
Delivery of Health Care
Health
Marriage
Nuptiality
Family and Household