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Reliability of self reported form of female genital mutilation and WHO classification: cross sectional study

Elmusharaf, Susan ; Elhadi, Nagla ; Almroth, Lars

BMJ, 2006-07, Vol.333 (7559), p.124-127 [Periódico revisado por pares]

London: British Medical Journal Publishing Group

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  • Título:
    Reliability of self reported form of female genital mutilation and WHO classification: cross sectional study
  • Autor: Elmusharaf, Susan ; Elhadi, Nagla ; Almroth, Lars
  • Assuntos: Adolescent ; Adult ; Anatomy ; Biological and medical sciences ; Child ; Child, Preschool ; Circumcision, Female - classification ; Circumcision, Female - psychology ; Circumcision, Female - statistics & numerical data ; Clitoris ; Cross sectional studies ; Female ; Female circumcision ; Female genital mutilation ; General aspects ; Genital mutilation ; Genitalia ; Girls ; Gynecology ; Humans ; Inspection reports ; Medical sciences ; Medicin och hälsovetenskap ; Pediatrics ; Prepuce ; Self Disclosure ; Sudan ; Teaching hospitals ; Terminology as Topic ; Women ; Womens health ; World Health Organization
  • É parte de: BMJ, 2006-07, Vol.333 (7559), p.124-127
  • Notas: istex:276A966459C7B8773FC904D70347F0108DD65AAE
    Correspondence to: S Elmusharaf
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    PMID:16803943
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    ArticleID:bmj.38873.649074.55
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    content type line 23
    Correspondence to: S Elmusharaf Sozan.Elmusharaf@ki.se
    Abdelrahim Obeid, Mohamed A A El Sheikh, Saad M El Fadil, Staffan Bergström, Alia Satti, Hibba A Bedri, Tayseer Idris, M Sir K Hashim, Gaafar I Suliman, and Staffan Bergström participated in planning and data collection.
    Funding: Swedish International Development Agency, Sida/SAREC, the Regional Research Council of Northeast Skåne, Sweden, and the Department of Paediatrics, Centralsjukhuset, Kristianstad, Sweden.
    Contributors: SE had the original idea for the study, coordinated the planning and implementation of the study, performed most of the analyses, was responsible for writing the manuscript, and is guarantor. NE participated in planning, data collection, and analysis and interpretation of results and revised the final version of the manuscript. LA participated in the planning and continuous supervision of the study, supervised the analysis of the data and writing of the manuscript, and is guarantor.
    Ethical approval: The University of Khartoum, the Children's Emergency Hospital, Khartoum, Sudan, and the Karolinska Institute, Sweden, approved the study.
    Competing interests: None declared.
  • Descrição: Abstract 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.
  • Editor: London: British Medical Journal Publishing Group
  • Idioma: Inglês
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