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FPMRS Fellow Michele O'Shea, MD, Awarded $5,000 For Picture-based Study of POP/UI In Kenya

Tuesday, April 14, 2020
Michele O'Shea

The Josiah Charles Trent Memorial Foundation Endowment Fund has awarded $5,000 to Urogynecology Fellow Michele O'Shea, MD, for a study to create a picture-based scale to assess patient symptoms of prolapse and incontinence (rather than relying on written language) in Kenya. This has never been done before, according to Dr. O'Shea. The title of the study is Pictures to Assess Prolapse and Incontinence in Kenya (PAPRIKA).

The objective of the study is to develop a patient-centered pictoral scale that captures patients’ symptoms of pelvic organ prolapse (POP) and urinary incontinence (UI), and to describe patient and providers’ experiences with POP and UI in Kisumu, Kenya.

Dr. O'Shea's mentor for the study is Megan Huchko, MD, MPH, who holds a dual appointment as Associate Professor in the Department of Obstetrics & Gynecology and the Duke Global Health Institute (where she serves as Director of the Center for Global Reproductive Health).  

"Pelvic floor disorders (PFDs) represent a significant health burden worldwide, though its prevalence, impact on patients’ quality of life, and access to treatment remains relatively understudied, especially in low and middle-income countries (LMICs) where the emphasis has historically been placed on obstetric fistula," notes Dr. O'Shea.  "Existing epidemiologic studies of pelvic organ prolapse and urinary incontinence in LMICs are limited by the lack of appropriate, validated instruments to assess POP and UI. This has resulted in prevalence data drawn from a heterogeneous range of instruments which had either never been validated, or validated in an unrelated population. To date, we are not aware of any published studies on POP or UI epidemiology in western Kenya."

She adds that the main reason for pursuing treatment for either POP or UI is presence of bothersome symptoms. Thus, it is critical to ensure patients’ symptoms are accurately assessed. In a population with heterogeneous levels of education and literacy, using an illustration-based scale developed through a patient-centered process may help to bridge the literacy gap and more easily capture patients’ pelvic floor symptoms than would otherwise be accomplished with written language.