Generic placeholder image

Current Pediatric Reviews

Author(s): Sara Abdoli, Seyedeh Zahra Masoumi* and Ensiyeh Jenabi

DOI: 10.2174/1573396317666210224143714

DownloadDownload PDF Flyer Cite As
Investigation of Prevalence and Complications of Female Genital Circumcision: A Systematic and Meta-analytic Review Study

Page: [145 - 160] Pages: 16

  • * (Excluding Mailing and Handling)

Abstract

Objective: The present study was conducted to investigate the complications of circumcision and determine its prevalence in the studied areas.

Methods: In this study, the electronic databases of Scopus, PubMed, SID, Web of Science and Magiran were selected to search the total population of observational studies published in Persian and English on the prevalence and circumcision complications in girls. The keywords searched for this purpose were as follows: female genital mutilation, Infibulations, Epidemiologic Methods, Clitorectomies, Female Circumcision, Clitorectomy, Clitoridectomy Complications, Prevalence, associated disease, coexistent conditions, and sequels associated with concomitant conditions, and coexistent disease and their Persian equivalent words. Prevalence estimates of all studies were pooled using a random-effects model at a confidence level of 95%. The bias in the published results of the studies and any reporting errors were examined using Begg and Egger’s statistical tests. Out of 3756 studies, 45 articles were included in the study after excluding irrelevant and repetitive articles.

Results: After reviewing the articles in this field, it was determined that female genital mutilation has sexual complications, problems during childbirth, physical and psychological complications. The prevalence of female genital circumcision in the world and Iran in the study areas was obtained using the random effect model, which was estimated to be 61% (95%, CI = 0.49, 0.73) and 61% (95%, CI = 0.52, 0.70), respectively. In other areas, the prevalence was reported to be close to zero. In total, among different countries of the world, of the 207,709 participants surveyed, 110,596 had undergone female genital circumcision (110,596 of 207,709).

Conclusion: The effects of female genital mutilation on girls are high and require government intervention in various countries.

Keywords: Female circumcision, clitorectomy, prevalence, complications, meta-analysis, systematic review.

Graphical Abstract

[1]
Muteshi JK, Miller S, Belizán JM. The ongoing violence against women: Female Genital Mutilation/Cutting. Reprod Health 2016; 13(1): 44.
[http://dx.doi.org/10.1186/s12978-016-0159-3] [PMID: 27091122]
[2]
Organization WH. WHO guidelines on the management of health complications from female genital mutilation World Health Organization. 2016.
[3]
Unicef. Female Genital Mutilation/cutting: a Global Concern. UNICEF's Data Work on FGM/C: Unicef 2016.
[4]
Haji Foghaha M, Golozar S, Alizadeh S. Female genital mutilation: religious coercion or cultural requirement? IJOGI 2016; 19(25): 8-16.
[5]
Mwanri L, Gatwiri GJ. Injured bodies, damaged lives: experiences and narratives of Kenyan women with obstetric fistula and Female Genital Mutilation/Cutting. Reprod Health 2017; 14(1): 38.
[http://dx.doi.org/10.1186/s12978-017-0300-y] [PMID: 28288664]
[6]
Toubia NF, Sharief EH. Female genital mutilation: have we made progress? Int J Gynaecol Obstet 2003; 82(3): 251-61.
[http://dx.doi.org/10.1016/S0020-7292(03)00229-7] [PMID: 14499972]
[7]
Klein E, Helzner E, Shayowitz M, Kohlhoff S, Smith-Norowitz TA. Female genital mutilation: health consequences and complications—a short literature review. Obstet Gynecol Int 2018; 2018: 7365715.
[http://dx.doi.org/10.1155/2018/7365715] [PMID: 30116269]
[8]
Champagne BJ, McGee MF. Rectovaginal fistula. Surg Clin North Am 2010; 90(1): 69-82.
[http://dx.doi.org/10.1016/j.suc.2009.09.003] [PMID: 20109633]
[9]
Female genital mutilation: female genital mutilation is recognized internationally as a violation of the human rights of girls and women: fact sheet World Health Organization. 2014.
[10]
Vloeberghs E, van der Kwaak A, Knipscheer J, van den Muijsenbergh M. Coping and chronic psychosocial consequences of female genital mutilation in The Netherlands. Ethn Health 2012; 17(6): 677-95.
[http://dx.doi.org/10.1080/13557858.2013.771148] [PMID: 23534507]
[11]
Halle-Ekane G, Guidona N, Mbuagbaw L, Mengouo A, Mbu R. Female Genital Mutilation and Obstetric Outcomes inthe Far-North Region, Cameroon: A Case-Control Study. Arch Curr Res Int 2019; 1-9.
[12]
Hartling L, Milne A, Hamm MP, et al. Testing the Newcastle Ottawa Scale showed low reliability between individual reviewers. J Clin Epidemiol 2013; 66(9): 982-93.
[http://dx.doi.org/10.1016/j.jclinepi.2013.03.003] [PMID: 23683848]
[13]
Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994; 50(4): 1088-101.
[http://dx.doi.org/10.2307/2533446] [PMID: 7786990]
[14]
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315(7109): 629-34.
[http://dx.doi.org/10.1136/bmj.315.7109.629] [PMID: 9310563]
[15]
Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions John Wiley & Sons. 2011.
[16]
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327(7414): 557-60.
[http://dx.doi.org/10.1136/bmj.327.7414.557] [PMID: 12958120]
[17]
Bjälkander O, Bangura L, Leigh B, Berggren V, Bergström S, Almroth L. Health complications of female genital mutilation in Sierra Leone. Int J Womens Health 2012; 4: 321-31.
[http://dx.doi.org/10.2147/IJWH.S32670] [PMID: 22870046]
[18]
Milaat WA, Ibrahim NK, Albar HM. Reproductive health profile and circumcision of females in the Hali semi-urban region, Saudi Arabia: A community-based cross-sectional survey. Ann Saudi Med 2018; 38(2): 81-9.
[http://dx.doi.org/10.5144/0256-4947.2018.81] [PMID: 29620540]
[19]
Bogale D, Markos D, Kaso M. Prevalence of female genital mutilation and its effect on women’s health in Bale zone, Ethiopia: a cross-sectional study. BMC Public Health 2014; 14(1): 1076.http://www.biomedcentral.com/1471-2458/14/1076
[http://dx.doi.org/10.1186/1471-2458-14-1076] [PMID: 25318832]
[20]
Kaplan A, Hechavarría S, Martín M, Bonhoure I. Health consequences of female genital mutilation/cutting in the Gambia, evidence into action. Reprod Health 2011; 8(26): 26.
[http://dx.doi.org/10.1186/1742-4755-8-26] [PMID: 21967670]
[21]
Yirga WS, Kassa NA, Gebremichael MW, Aro AR. Female genital mutilation: prevalence, perceptions and effect on women’s health in Kersa district of Ethiopia. Int J Womens Health 2012; 4: 45-54.
[http://dx.doi.org/10.2147/IJWH.S28805] [PMID: 22371659]
[22]
Tag-Eldin MA, Gadallah MA, Al-Tayeb MN, Abdel-Aty M, Mansour E, Sallem M. Prevalence of female genital cutting among Egyptian girls. Bull World Health Organ 2008; 86(4): 269-74.
[http://dx.doi.org/10.2471/BLT.07.042093] [PMID: 18438515]
[23]
Ndikom CM, Ogungbenro FA, Ojeleye OA. Perceptionand Practice of Female Genital Cutting Among Mothers in Ibadan, Nigeria. International Journal of Nursing and Health Science 2017; 4(6): 71-80.
[24]
Mitike G, Deressa W. Prevalence and associated factors of female genital mutilation among Somali refugees in eastern Ethiopia: a cross-sectional study. BMC Public Health 2009; 9(1): 264.
[http://dx.doi.org/10.1186/1471-2458-9-264] [PMID: 19635149]
[25]
Morison L, Scherf C, Ekpo G, et al. The long-term reproductive health consequences of female genital cutting in rural Gambia: a community-based survey. Trop Med Int Health 2001; 6(8): 643-53.
[http://dx.doi.org/10.1046/j.1365-3156.2001.00749.x] [PMID: 11555430]
[26]
Gebremariam K, Assefa D, Weldegebreal F. Prevalence and associated factors of female genital cutting among young adult females in Jigjiga district, eastern Ethiopia: a cross-sectional mixed study. Int J Womens Health 2016; 8: 357-65.
[http://dx.doi.org/10.2147/IJWH.S111091] [PMID: 27563257]
[27]
Yasin Y. Prevalence of female genital mutilation among school girls in El Mansoura Center, El-Dakahlia Governorate, Egypt iosr-jdms 2014; 13: 11-76..
[28]
Okonofu FE, Larsen U, Oronsaye F, Snow RC, Slanger TE. The association between female genital cutting and correlates of sexual and gynaecological morbidity in Edo State, Nigeria. BJOG 2002; 109(10): 1089-96.
[http://dx.doi.org/10.1111/j.1471-0528.2002.01550.x] [PMID: 12387460]
[29]
Al-Hussaini TK. Female genital cutting: types, motives and perineal damage in laboring Egyptian women. Med Princ Pract 2003; 12(2): 123-8.
[http://dx.doi.org/10.1159/000069119] [PMID: 12634469]
[30]
Osifo DO, Evbuomwan I. Female genital mutilation among Edo people: the complications and pattern of presentation at a pediatric surgery unit, Benin City. Afr J Reprod Health 2009; 13(1): 17-25.
[31]
Johnson OE, Okon RD. Perception and practice of female genital cutting in a rural community in southern Nigeria. Afr J Reprod Health 2012; 16(4): 132-9.
[PMID: 23444550]
[32]
Sharfi AR, Elmegboul MA, Abdella AA. The continuing challenge of female genital mutilation in Sudan. Afr J Urol 2013; 19(3): 136-40.
[http://dx.doi.org/10.1016/j.afju.2013.06.002]
[33]
Dehghankhalili M, Fallahi S, Mahmudi F, Ghaffarpasand F, Shahrzad ME, Taghavi M, et al. Epidemiology, regional characteristics, knowledge, and attitude toward female genital mutilation/cutting in southern Iran. J Sex Med 2015; 12(7): 1577-1583..
[34]
Pashaei T, Rahimi A, Ardalan A, Felah A, Majlessi F. Related factors of female genital mutilation (FGM) in Ravansar)Iran). J Womens Health Care 2012; 1(2)
[http://dx.doi.org/10.4172/2167-0420.1000108]
[35]
Varol N, Dawson A, Turkmani S, et al. Obstetric outcomes for women with female genital mutilation at an Australian hospital, 2006-2012: a descriptive study. BMC Pregnancy Childbirth 2016; 16(1): 328.
[http://dx.doi.org/10.1186/s12884-016-1123-5] [PMID: 27793119]
[36]
Essén B, Bödker B, Sjöberg N-O, Gudmundsson S, Östergren P-O, Langhoff-Roos J. Is there an association between female circumcision and perinatal death? Bull World Health Organ 2002; 80(8): 629-32.
[PMID: 12219153]
[37]
Gebremicheal K, Alemseged F, Ewunetu H, et al. Sequela of female genital mutilation on birth outcomes in Jijiga town, Ethiopian Somali region: a prospective cohort study. BMC Pregnancy Childbirth 2018; 18(1): 305.
[http://dx.doi.org/10.1186/s12884-018-1937-4] [PMID: 30029634]
[38]
Rodriguez MI, Say L, Abdulcadir J, Hindin MJ. Clinical indications for cesarean delivery among women living with female genital mutilation. Int J Gynaecol Obstet 2017; 139(1): 21-7.
[http://dx.doi.org/10.1002/ijgo.12234] [PMID: 28602042]
[39]
Kaplan A, Forbes M, Bonhoure I, et al. Female genital mutilation/cutting in The Gambia: long-term health consequences and complications during delivery and for the newborn. Int J Womens Health 2013; 5: 323-31.
[http://dx.doi.org/10.2147/IJWH.S42064] [PMID: 23843705]
[40]
Kizilhan JI. Impact of psychological disorders after female genital mutilation among Kurdish girls in Northern Iraq. Eur J Psychiatry 2011; 25(2): 92-100.
[41]
Köbach A, Ruf-Leuschner M, Elbert T. Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations. BMC Psychiatry 2018; 18(1): 187.
[http://dx.doi.org/10.1186/s12888-018-1757-0] [PMID: 29895282]
[42]
Ibrahim ZM, Ahmed MR, Mostafa RM. Psychosexual impact of female genital mutilation/cutting among Egyptian women. Hum androl 2012; 2(2): 36-41..
[43]
Mahmoudi O, Hosseini E. Psychosexual complications of female genital mutilation for couples: A comparative study. Majallah-i Danishgah-i Ulum-i Pizishki-i Kirmanshah 2017; 20: 135-40.
[44]
Shay TZ, Haidar J, Kogi-Makau W. Magnitude of and driving factors for female genital cutting in schoolgirls in Addis Ababa, Ethiopia: A crosssectional study. S Afr j child health 2010; 4(3): 78-82..
[45]
Barakat AA, Mosleh H. Prevalence of Female Genital Cutting among University Students in Egypt. J Am Sci 2012; 8(11): 15-21.
[46]
Alsibiani SA, Rouzi AA. Sexual function in women with female genital mutilation. Fertil Steril 2010; 93(3): 722-4.
[http://dx.doi.org/10.1016/j.fertnstert.2008.10.035] [PMID: 19028385]
[47]
Yassin K, Idris HA, Ali AA. Characteristics of female sexual dysfunctions and obstetric complications related to female genital mutilation in Omdurman maternity hospital, Sudan. Reprod Health 2018; 15(1): 7.
[http://dx.doi.org/10.1186/s12978-017-0442-y] [PMID: 29310689]
[48]
Birge Ö, Akbaş M, Özbey EG, Adıyeke M. Clitoral keloids after female genital mutilation/cutting. Turk J Obstet Gynecol 2016; 13(3): 154-7.
[http://dx.doi.org/10.4274/tjod.32067] [PMID: 28913112]
[49]
Yousef F, Hamed A, Mostafa N. Female Genital Cutting: Prevalence, knowledge and attitude of Sohage University level Students. Upper Egypt EJCM 2017; 35(1): 17-25.
[50]
Yasin BA, Al-Tawil NG, Shabila NP, Al-Hadithi TS. Female genital mutilation among Iraqi Kurdish women: a cross-sectional study from Erbil city. BMC Public Health 2013; 13(809): 809.
[http://dx.doi.org/10.1186/1471-2458-13-809] [PMID: 24010850]
[51]
Wahlberg A, Johnsdotter S, Ekholm Selling K, Källestål C, Essén B. Factors associated with the support of pricking (female genital cutting type IV) among Somali immigrants - a cross-sectional study in Sweden. Reprod Health 2017; 14(1): 92.
[http://dx.doi.org/10.1186/s12978-017-0351-0] [PMID: 28789667]
[52]
Elduma AH. Female Genital Mutilation in Sudan. Open Access Maced J Med Sci 2018; 6(2): 430-4.
[http://dx.doi.org/10.3889/oamjms.2018.099] [PMID: 29531618]
[53]
Mohammed ES, Seedhom AE, Mahfouz EM. Female genital mutilation: current awareness, believes and future intention in rural Egypt. Reprod Health 2018; 15(1): 175.
[http://dx.doi.org/10.1186/s12978-018-0625-1] [PMID: 30333019]
[54]
Obi A, Igbinadolor O. Prevalence of female genital mutilation and its determinants among pregnant women in Benin City, Nigeria. Journal of Community Medicine and Primary Health Care 2018; 30(2): 12-21.
[55]
Abiodun AA, Oyejola BA, Job O. Female circumcision in Nigeria, prevalence and attitudes. CPJ 2011. 2011133:17202.2012.
[56]
Tamire M, Molla M. Prevalence and belief in the continuation of female genital cutting among high school girls: a cross - sectional study in Hadiya zone, Southern Ethiopia. BMC Public Health 2013; 13(1): 1120.http://www.biomedcentral.com/1471-2458/13/1120
[http://dx.doi.org/10.1186/1471-2458-13-1120] [PMID: 24304497]
[57]
Sakeah E, Debpuur C, Oduro AR, et al. Prevalence and factors associated with female genital mutilation among women of reproductive age in the Bawku municipality and Pusiga District of northern Ghana. BMC Womens Health 2018; 18(1): 150.
[http://dx.doi.org/10.1186/s12905-018-0643-8] [PMID: 30227845]
[58]
Karmaker B, Kandala NB, Chung D, Clarke A. Factors associated with female genital mutilation in Burkina Faso and its policy implications. Int J Equity Health 2011; 10(20): 20.
[http://dx.doi.org/10.1186/1475-9276-10-20] [PMID: 21592338]
[59]
Sipsma HL, Chen PG, Ofori-Atta A, Ilozumba UO, Karfo K, Bradley EH. Female genital cutting: current practices and beliefs in western Africa. Bull World Health Organ 2012; 90(2): 120-127F.
[http://dx.doi.org/10.2471/BLT.11.090886] [PMID: 22423163]
[60]
Ahadi H, Khadivzadeh T, Seyyedialavi G, Esmaili H. Women’s circumcision in Minab: Prevalence, knowledge, attitude. JQUMS 2003; 7(4): 14-20.
[61]
Bahrami M, Ghaderi E, Farazi E, Bahramy A. The prevalence of female genital mutilation and related factors among women in Kamyaran, Iran. Chronic Dis J 2018; 6(3): 113-9.