Female Genital Mutilation (FGM): Social Factors and Urinary Tract Infection
Background: Female Genital Mutilation (FGM) including circumcision is often practiced by lay practitioners with a few or no adequate medical information. Frequently, the procedure takes place under unclean and unhealthy conditions and without anesthesia or disinfected and sterilized tools.
Objectives: The aim of this study is to assess the rate of urinary tract infections among circumcised and non-circumcised girls 5-10 years age, to identify bacteria causing UTIs and to determine the social factors and complications of FGM.
Methods: This is a community-based cross-sectional analysis conducted at Khartoum State, Alsahafa town, included girls aging 5-10 years in kindergartens and primary schools. Data were collected, after obtaining informed consent from parents and guardians, by direct interview using pre-tested questionnaire. Urine samples were collected from 450 candidates (225 samples from each circumcised and non-circumcised group) for laboratory investigations. Data were analyzed by (SPSS) version 21.
Results: The study showed that the decision of girls’ circumcision was made by mother 87 (38.67%), grandmother 50 (22.2%). Most parents of circumcised group 180 (80.0%) were aware about the complications of Female Genital Mutilation (FGM). The purpose of circumcision was due to traditional reason in 123 (54.67%), for religious reasons in 80 (35.56%), for marriage purposes in 15 (6.67%), and for virginity saving 7 (3.11%). Circumcision was performed by midwives in 205 (91.1%), doctors in 13 (5.7%) and nurses in 7 (3.11%). Complications after circumcision were: 33 (14.67%) of circumcised girls had severe pain, 15 (6.67%) had hemorrhage, 12 (5.33%) had sepsis and 9 (4.0%) had urine retention. Hospitalization after complications (blood transfusion, sepsis and urine retention) was reported to be 4 (1.78%). Significant growth of samples collected was from the circumcised 82 (18.2%). The most frequent organisms to be identified were Escherichia coli, followed by Staphylococcus aureus.
Conclusion: Circumcision was performed across all social groups and the major reasons were traditional reason followed by religious reason. The study indicated that FGM was associated with urinary tract infections. The most dominate isolates were E. coli and S. aureus.