Elmusharaf S, Elkhidir I, Hoffmann S, Almroth L
Department of Public Health, Division of International Health (IHCAR), Karolinska Institutet, Stockholm, Sweden.
BJOG. 2006 Apr;113(4):469-74. doi: 10.1111/j.1471-0528.2006.00896.x.
To assess whether the extent of female genital mutilation (FGM) influences the risk of acquiring sexually transmitted infections (STIs).
Hospital-based case-control study.
Two obstetric/gynaecological outpatient clinics in Khartoum, Sudan, 2003-2004.
A total of 222 women aged 17-35 years coming to antenatal and gynaecological clinics.
Women recruited for the study were divided into cases with seropositivity for Neisseria gonorrhoeae (gonococcal antibody test), Chlamydia trachomatis (enzyme immunoassay) or Treponema pallidum (Treponema pallidum haemagglutination assay) (n= 26) and controls without antibodies to these species (n= 196). Socio-demographic data were obtained and physical examination including genital examination was performed in order to classify the form of FGM. Cases and controls were compared using logistic regression to adjust for covariates.
Extent of FGM and seropositivity for C. trachomatis, N. gonorrhoeae or T. pallidum.
Of the cases, 85% had undergone the most severe form of FGM involving labia majora compared with 78% of controls (n.s.). Thus, there was no association between serological evidence of STIs and extent of FGM. The only factor that differed significantly between the groups was the education level, cases with STIs having significantly shorter education (P= 0.03) than controls.
There is a little difference between cases and controls in regard to FGM. Having in mind the relatively small sample size, the results still indicate that FGM seems neither to be a risk factor for nor protective against acquiring STIs. This is important as argument against traditional beliefs that FGM protects against pre/extramarital sex.
评估女性生殖器切割(FGM)的程度是否会影响获得性传播感染(STIs)的风险。
基于医院的病例对照研究。
2003年至2004年,苏丹喀土穆的两家产科/妇科门诊诊所。
共有222名年龄在17至35岁之间的女性前往产前和妇科诊所就诊。
招募参加研究的女性被分为淋病奈瑟菌(淋病抗体检测)、沙眼衣原体(酶免疫测定)或梅毒螺旋体(梅毒螺旋体血凝试验)血清学阳性的病例组(n = 26)和没有这些病原体抗体的对照组(n = 196)。获取社会人口统计学数据并进行包括生殖器检查在内的体格检查,以便对女性生殖器切割的形式进行分类。使用逻辑回归对病例组和对照组进行比较,以调整协变量。
女性生殖器切割的程度以及沙眼衣原体、淋病奈瑟菌或梅毒螺旋体的血清学阳性情况。
在病例组中,85%的女性接受了涉及大阴唇的最严重形式的女性生殖器切割,而对照组为78%(无统计学差异)。因此,性传播感染的血清学证据与女性生殖器切割的程度之间没有关联。两组之间唯一有显著差异的因素是教育水平,患有性传播感染的病例组的教育年限明显短于对照组(P = 0.03)。
在女性生殖器切割方面,病例组和对照组之间差异不大。考虑到样本量相对较小,结果仍表明女性生殖器切割似乎既不是获得性传播感染的危险因素,也不是预防因素。这一点很重要,因为它与女性生殖器切割可预防婚前/婚外性行为的传统观念相悖。