Document Detail


Reliability of self reported form of female genital mutilation and WHO classification: cross sectional study.
MedLine Citation:
PMID:  16803943     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the reliability of self reported form of female genital mutilation (FGM) and to compare the extent of cutting verified by clinical examination with the corresponding World Health Organization classification.
DESIGN: Cross sectional study.
SETTINGS: One paediatric hospital and one gynaecological outpatient clinic in Khartoum, Sudan, 2003-4.
PARTICIPANTS: 255 girls aged 4-9 and 282 women aged 17-35.
MAIN OUTCOME MEASURES: The women's reports of FGMthe actual anatomical extent of the mutilation, and the corresponding types according to the WHO classification.
RESULTS: All girls and women reported to have undergone FGM had this verified by genital inspection. None of those who said they had not undergone FGM were found to have it. Many said to have undergone "sunna circumcision" (excision of prepuce and part or all of clitoris, equivalent to WHO type I) had a form of FGM extending beyond the clitoris (10/23 (43%) girls and 20/35 (57%) women). Of those who said they had undergone this form, nine girls (39%) and 19 women (54%) actually had WHO type III (infibulation and excision of part or all of external genitalia). The anatomical extent of forms classified as WHO type III varies widely. In 12/32 girls (38%) and 27/245 women (11%) classified as having WHO type III, the labia majora were not involved. Thus there is a substantial overlap, in an anatomical sense, between WHO types II and III.
CONCLUSION: The reliability of reported form of FGM is low. There is considerable under-reporting of the extent. The WHO classification fails to relate the defined forms to the severity of the operation. It is important to be aware of these aspects in the conduct and interpretation of epidemiological and clinical studies. WHO should revise its classification.
Authors:
Susan Elmusharaf; Nagla Elhadi; Lars Almroth
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2006-06-27
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  333     ISSN:  1756-1833     ISO Abbreviation:  BMJ     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-14     Completed Date:  2006-07-25     Revised Date:  2012-03-06    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  England    
Other Details:
Languages:  eng     Pagination:  124     Citation Subset:  AIM; IM    
Affiliation:
Division of International Health, Karolinska Institutet, SE 171 77 Stockholm, Sweden. Sozan.Elmusharaf@ki.se
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Circumcision, Female / classification,  psychology,  statistics & numerical data*
Cross-Sectional Studies
Female
Humans
Self Disclosure*
Sudan
Terminology as Topic
World Health Organization
Comments/Corrections
Comment In:
BMJ. 2006 Jul 15;333(7559):106-7   [PMID:  16840444 ]
BMJ. 2006 Jul 29;333(7561):259-60   [PMID:  16873868 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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