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Ectopic Pregnancy in Africa: A Population-Based Study

Robert J. Leke, MD^*, Nathalie Goyaux, PhD, Tomohiro Matsuda, PhD and Patrick F. Thonneau, MD

From the *Maternity Unit, Hopital Central, Yaounde, Cameroon; French Ministry of Foreign Affairs and Human Fertility Research Group, Yaounde, Cameroon; Human Fertility Research Group, Toulouse, France; and Human Fertility Research Group, INSERM, Paule de Viguier Hospital, Toulouse, France.

Address reprint requests to: Dr. P. F. Thonneau, Human Fertility Research Group, INSERM, Paule de Viguier Hospital, 31059 Toulouse Cedex 9, France; e-mail: thonneau.p{at}chu-toulouse.fr.

OBJECTIVE: To estimate the incidence of ectopic pregnancy in Yaounde, the capital of Cameroon (Central Africa).

METHODS: In 2000, all women admitted for an ectopic pregnancy to health facilities in the city of Yaounde were systematically enrolled. Sociodemographic information on the women and their reproductive history was collected by questionnaire during a face-to-face interview. Medical and obstetrical data (clinical findings at hospital entry, medical history, type of surgery, and final vital status) were collected from gynecologic and surgical files and admission registers.

RESULTS: We recorded 320 cases of ectopic pregnancy in health facilities in the city of Yaounde and we estimated that 40,100 live births occurred during the same study period (January to December 2000). The population-based incidence rate of ectopic pregnancy in the city of Yaounde was 0.79% (95% confidence interval 0.72%, 0.88%) in 2000. Three maternal deaths were recorded giving a mortality rate of 0.94% (95% confidence interval 0.32%, 2.72%).

CONCLUSION: The 0.79% ectopic pregnancy incidence rate observed in this African country must be considered a minimum due to probable underestimation. Nevertheless, this rate is lower than that currently observed in industrialized countries. Late diagnosis, low percentage of conservative treatment, and subsequent maternal deaths are important findings that should encourage African gynecologists to promote ectopic pregnancy prevention programs and to improve the care given to women with ectopic pregnancy.

LEVEL OF EVIDENCE: III