Prevalence and associated factors of non-fistulous urinary incontinence among adult women in Bantama, Ghana: a cross-sectional study.

BACKGROUND

Non-fistulous urinary incontinence (UI) is a common but understudied condition in sub-Saharan Africa, despite its well-documented negative effects on women's quality of life. In Ghana, population-based data on its prevalence, associated factors, and impact remain limited.

OBJECTIVE

To determine the prevalence of non-fistulous UI, identify associated factors, and assess its impact on quality of life among women aged 20-69 years in Bantama, Kumasi, Ghana.

METHODS

A cross-sectional household survey was conducted among 374 women selected through multistage cluster sampling in the Bantama sub-metropolis. Data were collected using a structured questionnaire incorporating the King's Health Questionnaire (KHQ) to assess UI symptoms and quality-of-life domains. Descriptive statistics and bivariate analyses were performed.

RESULTS

Of the 411 women approached, 374 participated (response rate: 91%). The mean age was 45.2 years. The prevalence of UI was 32.9%, indicating that approximately one in three women experienced urine leakage. Most affected women reported leakage occurring once a week or less; however, increasing frequency was significantly associated with greater interference with daily activities (χ² = 13.86, p = 0.0078). UI was significantly associated with older age, obesity (particularly Class I), higher parity, menopausal status, history of hysterectomy, and childbirth weight ≥ 2.6 kg. Educational level was not significantly associated with UI. Urge incontinence was associated with poorer quality of life, particularly in emotional ("Feeling Bad") and social ("Personal Relationships") domains, with increasing severity linked to greater emotional distress and social strain.

CONCLUSION

Non-fistulous UI is common among adult women in Bantama and is associated with identifiable reproductive and metabolic risk factors, as well as substantial emotional and social quality-of-life impairments. These findings support the need for routine screening and context-specific UI prevention and management strategies within existing women's health services in Ghana, particularly for older, multiparous, and menopausal women.