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Abstract
Introduction Pelvic floor disorders (PFDs) including urinary incontinence, faecal incontinence and pelvic organ prolapse are common debilitating conditions among women in high-income countries. However, PFDs in women in low/middle-income countries (LMICs) have not been studied extensively. We aim to conduct a systematic review and meta-analysis of the available literature to determine the prevalence of, and/or risk factors for, PFDs in women in LMIC.
Methods and analysis We will search electronic databases including MEDLINE, EMBASE, PsycINFO, CINAHL, Maternity & Infant Care and Google Scholar for eligible studies. Inclusion criteria will be observational studies of healthy women, which have collected data using validated or non-validated tools, are published in English and were conducted in community women in LMICs, defined by the World Bank. A standardised data extraction form will be developed and piloted, based on the template of the Cochrane good practice data extraction form. All included studies will be assessed based on a risk-of-bias tool specifically developed for prevalence studies. Pooled prevalence estimates of PFDs will be generated using RevMan V.5.2.1 software. Forest plots will be generated to display the overall random-effects pooled estimates with CIs. A metaregression will be conducted to identify sources of between-study heterogeneity in the pooled prevalence estimates. We will quantify heterogeneity using the I2 measure and its CI. We will use funnel plots to detect potential reporting biases and small-study effects. We will also conduct a sensitivity analysis to verify the robustness of the study conclusions, assessing the impact of methodological quality, study design, sample size and the effect of missing data.
Ethics and dissemination Our review is entirely based on published data. Thus, an ethics committee approval or written informed consent will not be required for this study as primary data will not be collected. The results will be disseminated by publication of the manuscript in a peer-reviewed journal and/or will be presented at relevant conferences.
PROSPERO registration number CRD42016043881.
- epidemiology
- gynaecology
- urogynaecology
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Contributors RMI, JO, MNK, SMH, DMEH and JF contributed to the generation of ideas for systematic review. RMI, JO and LR contributed to the development of the study protocol and search strategy for the review. All the authors will contribute to the review, revision and finalisation of the search strategy. RMI prepared the first draft of the protocol. JO, MNK, SMH, DMEH, LR and JF reviewed and provided subsequent feedback on the revision of the protocol and its finalisation. All the authors critically revised the first draft for content and contributed to the final draft.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.