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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 6/2013

01-06-2013 | General Gynecology

Female genital mutilation and infections: a systematic review of the clinical evidence

Authors: Christos Iavazzo, Thalia A. Sardi, Ioannis D. Gkegkes

Published in: Archives of Gynecology and Obstetrics | Issue 6/2013

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Abstract

Aim

Female genital mutilation (FGM) is a common practice especially performed in women with no anaesthesia or antibiotics and in absence of aseptic conditions. The aim of this systematic review is to explore and analyze for first time in the current literature, the clinical evidence related to the presence of infections in the practice of FGM.

Method

A systematic search of PubMed and Scopus was performed. A combination of the terms “female circumcision”, “genital mutilation”, “genital cutting” and “infection” were used. Studies reporting data on the infections related to patients with FGM were included.

Results

A total of 22,052 patients included, in the study, from African countries. The age ranged from 10 days to 20 years. The procedure was done by physicians, paramedical staff, and other specialties. Type I FGM was performed in 3,115 women while 5,894, 4,049 and 93 women underwent Type II, Type III and unknown type of FGM, respectively. Different types of infections were identified including UTIs, genitourinary tract infections, abscess formation and septicemia or even HIV infection. Moreover, most infections were identified in Type III FGM. The isolated pathogens in the different type of infections, were HIV, Clostridium tetani, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Candida albicans, Trichomonas vaginalis, HSV-2, Pseudomonas pyocyanea, Staphylococcus aureus. The univariate risk of infection ranged from 0.47 to 5.2.

Conclusion

A variety of infections can occur after FGM. The management of these complications in a low-income economy can be a great burden for the families.
Literature
1.
WHO/UNICEF/UNFPA (2008) Female genital mutilation: a joint WHO/UNICEF/UNFPA statement. Geneva WHO
2.
Dirie MA, Lindmark G (1992) The risk of medical complications after female circumcision. East Afr Med J 69:479–482PubMed
3.
The American College of Obstetricians and Gynecologists (2008) Female Genital Cutting: Clinical Management of Circumcised Women. Washington DTACoOaG
4.
Gruenbaum E (2001) The female circumcision controversy: an anthropological perspective. University of Pennsylvania Press, Philadelphia
5.
6.
Mitike G, Deressa W (2009) Prevalence and associated factors of female genital mutilation among Somali refugees in eastern Ethiopia: a cross-sectional study. BMC Public Health 9:264PubMedCrossRef
7.
Nour NM (2008) Female genital cutting: a persisting practice. Rev Obstet Gynecol 1:135–139PubMed
8.
Yoder PS, Abderrahim N, Zhuzhuni A (2004) Female genital cutting in the demographic and health surveys: a critical and comparative analysis. ORC Macro, Macro International, Inc., Calverton
9.
World Health Organisation (WHO) (1995) Female genital mutilation. Report of The WHO Technical Working Group, Geneva
10.
Davis G, Ellis J, Hibbert M, Perez RP, Zimbelman E (1999) Female circumcision: the prevalence and nature of the ritual in Eritrea. Mil Med 164:11–16PubMed
11.
Kun KE (1997) Female genital mutilation: the potential for increased risk of HIV infection. Int J Gynaecol Obstet 59:153–155PubMedCrossRef
12.
Dean A, Sullivan Κ, Soe Μ (2008) OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version 2.2.1. Updated 2008/04/06 [cited 2008/09/18]. http://​www.​OpenEpi.​com
13.
Adetoro OO, Ebomoyi E (1986) Health implications of traditional female circumcision in pregnancy. Asia Oceania J Obstet Gynaecol 12:489–492PubMedCrossRef
14.
Chalmers B, Hashi KO (2000) 432 Somali women’s birth experiences in Canada after earlier female genital mutilation. Birth 27:227–234PubMedCrossRef
15.
El Dareer A (1983) Complications of female circumcision in the Sudan. Trop Doct 13:131–133PubMed
16.
Momoh C, Ladhani S, Lochrie DP, Rymer J (2001) Female genital mutilation: analysis of the first twelve months of a Southeast London specialist clinic. BJOG 108:186–191PubMed
17.
Osifo DO, Evbuomwan I (2009) Female genital mutilation among Edo people: the complications and pattern of presentation at a pediatric surgery unit, Benin City. Afr J Reprod Health 13:17–25PubMed
18.
Shandall AA (1967) Circumcision and infibulation of females: a general consideration of the problem and a clinical study of the complications in Sudanese women. Sudan Med J 5:178–212PubMed
19.
Almroth L, Bedri H, El Musharaf S et al (2005) Urogenital complications among girls with genital mutilation: a hospital-based study in Khartoum. Afr J Reprod Health 9:118–124PubMedCrossRef
20.
el-Defrawi MH, Lotfy G, Dandash KF, Refaat AH, Eyada M (2001) Female genital mutilation and its psychosexual impact. J Sex Marital Ther 27:465–473PubMedCrossRef
21.
Knight R, Hotchin A, Bayly C, Grover S (1999) Female genital mutilation—experience of The Royal Women’s Hospital, Melbourne. Aust N Z J Obstet Gynaecol 39:50–54PubMedCrossRef
22.
Arbesman M, Kahler L, Buck GM (1993) Assessment of the impact of female circumcision on the gynecological, genitourinary and obstetrical health problems of women from Somalia: literature review and case series. Women Health 20:27–42PubMedCrossRef
23.
Hassan A (1995) Sudanese women’s struggle to eliminate harmful practices. Plan Parent Chall 2:17–8, 21–2
24.
Klouman E, Manongi R, Klepp KI (2005) Self-reported and observed female genital cutting in rural Tanzania: associated demographic factors, HIV and sexually transmitted infections. Trop Med Int Health 10:105–115PubMedCrossRef
25.
Msuya SE, Mbizvo E, Hussain A, Sundby J, Sam NE, Stray-Pedersen B (2002) Female genital cutting in Kilimanjaro, Tanzania: changing attitudes? Trop Med Int Health 7:159–165PubMedCrossRef
26.
Okonofu FE, Larsen U, Oronsaye F, Snow RC, Slanger TE (2002) The association between female genital cutting and correlates of sexual and gynaecological morbidity in Edo State, Nigeria. BJOG 109:1089–1096PubMedCrossRef
27.
Brewer DD, Potterat JJ, Roberts JM Jr, Brody S (2007) Male and female circumcision associated with prevalent HIV infection in virgins and adolescents in Kenya, Lesotho, and Tanzania. Ann Epidemiol 17:217–226PubMed
28.
Maslovskaya O, Brown JJ, Padmadas SS (2009) Disentangling the complex association between female genital cutting and HIV among Kenyan women. J Biosoc Sci 41:815–830PubMedCrossRef
29.
Yount KM, Abraham BK (2007) Female genital cutting and HIV/AIDS among Kenyan women. Stud Fam Plann 38:73–88PubMedCrossRef
30.
Elmusharaf S, Elkhidir I, Hoffmann S, Almroth L (2006) A case-control study on the association between female genital mutilation and sexually transmitted infections in Sudan. BJOG 113:469–474PubMedCrossRef
31.
Morison L, Scherf C, Ekpo G et al (2001) The long-term reproductive health consequences of female genital cutting in rural Gambia: a community-based survey. Trop Med Int Health 6:643–653PubMedCrossRef
32.
Hamoudi A, Shier M (2010) Late complications of childhood female genital mutilation. J Obstet Gynaecol Can 32:587–589PubMed
33.
Jaeger F, Caflisch M, Hohlfeld P (2009) Female genital mutilation and its prevention: a challenge for paediatricians. Eur J Pediatr 168:27–33PubMedCrossRef
34.
Utz-Billing I, Kentenich H (2008) Female genital mutilation: an injury, physical and mental harm. J Psychosom Obstet Gynaecol 29:225–229PubMedCrossRef
35.
Leye EPR, Nienhuis G, Claeys P, Temmerman M (2006) Health care in Europe for women with genital mutilation. Health Care Women Int 27:362–378PubMedCrossRef
36.
Johansen RE (2006) Care for infibulated women giving birth in Norway: an anthropological analysis of health workers’ management of a medically and culturally unfamiliar issue. Med Anthropol Q 20:516–544PubMedCrossRef
37.
38.
Nour NM (2004) Female genital cutting: clinical and cultural guidelines. Obstet Gynecol Surv 59:272–279PubMedCrossRef
39.
Obermeyer CM (2005) The consequences of female circumcision for health and sexuality: an update on the evidence. Cult Health Sex 7:443–461PubMedCrossRef
40.
Egwuatu VE, Agugua NE (1981) Complications of female circumcision in Nigerian Igbos. Br J Obstet Gynaecol 88:1090–1093PubMedCrossRef
41.
42.
European Study Group on Heterosexual Transmission of HIV (1992) Comparison of female to male and male to female transmission of HIV in 563 stable couples. BMJ 304:809–813
43.
Merli C (2010) Male and female genital cutting among Southern Thailand’s Muslims: rituals, biomedical practice and local discourses. Cult Health Sex 12:725–738PubMedCrossRef
44.
Banks E, Meirik O, Farley T, Akande O, Bathija H, Ali M (2006) Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries. Lancet 367:1835–1841PubMedCrossRef
45.
Behrendt A, Moritz S (2005) Posttraumatic stress disorder and memory problems after female genital mutilation. Am J Psychiatry 162:1000–1002PubMedCrossRef
46.
Boyle EH (2002) Female genital cutting: cultural conflict in the global community. Johns Hopkins University Press, Baltimore
47.
Snow RC, Slanger TE, Okonofua FE, Oronsaye F, Wacker J (2002) Female genital cutting in southern urban and peri-urban Nigeria: self-reported validity, social determinants and secular decline. Trop Med Int Health 7:91–100PubMedCrossRef
48.
FGM Joint Statement W, UNICEF and UNFPA, (1997, Page 4
49.
50.
51.
52.
US Department of State (2009) CRoHRPf-I, 25 February, sect. 5—attachment 1
Metadata
Title
Female genital mutilation and infections: a systematic review of the clinical evidence
Authors
Christos Iavazzo
Thalia A. Sardi
Ioannis D. Gkegkes
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 6/2013
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-012-2708-5

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