Demis Kebede Solomon, Agmas Kindu, Kefale Demewoz, Kassaw Amare, Aytenew Tigabu Munye
Department of Maternity and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department Pediatrics and Child Health, Debre Tabor Comprehensive Specialized Hospital, Debre Tabor, Ethiopia.
PLoS One. 2025 Jan 28;20(1):e0316755. doi: 10.1371/journal.pone.0316755. eCollection 2025.
Traditional childhood uvulectomy (TCU) is an unregulated cultural practice associated with significant health risks, including infections, anemia, aspiration, and oral or pharyngeal injuries. The reuse of unsafe tools such as blades, needles, or thread loops exacerbates the spread of infectious diseases like HIV and hepatitis B. Despite its clinical significance, the pooled prevalence and associated factors of TCU have not been adequately examined through systematic reviews or meta-analyses.
This review and meta-analysis aimed to estimate the pooled prevalence and associated factors of TCU in some African countries.
This systematic review and meta-analysis adhered to the PRISMA 2020 guidelines. A comprehensive search was performed across multiple databases, including MEDLINE, ScienceDirect, Google Scholar, and African Journals Online, to identify relevant studies. A weighted inverse-variance random-effects model was employed to estimate the pooled prevalence and associated predictors of TCU. Heterogeneity among the included studies was assessed using a forest plot, I2 statistics, and Egger's test, ensuring the robustness and reliability of the findings. Missing data was handled by random effect model and sensitivity analysis. Data extraction was conducted fromNovember 6 to December 23, 2023.
Included studies focused on children aged birth to under 15 years, examining TCU defined as the partial or complete removal of the uvula by traditional healers.
Eleven primary studies comprising 7,231 children from some countries in Africa were included.
Pooled estimate of TCU in some African countries was 40.98% (95% CI: 25.04-56.92; I2 = 99.61, P = 0.001). Mothers residing in rural areas were 2.45 times more likely to have a child experienced TCU compared to those in urban areas (AOR = 2.45; 95% CI: 1.59-3.32). Similarly, Mothers with a history of having a previous child who undergo TCU were 8.44 times more likely to seek the procedure for their other children compared to mothers without such a history (AOR = 8.44; 95% CI: 6.27-10.61). However, caution is warranted when interpreting these findings due to the significant heterogeneity reported across the included studies, which may influence the generalizability of the results.
Nearly two-fifths of children in some African countries experienced TCU, which was influenced by maternal history and rural residency. While most procedures did not result in hospitalization, significant health risks remain. These findings underscore the urgent need for targeted interventions within maternal and child health programs to address TCU and mitigate its associated morbidity in the affected countries across Africa.
PROSPERO I.D.: CRD42024498699.
传统儿童悬雍垂切除术（TCU）是一种不受监管的文化习俗，存在重大健康风险，包括感染、贫血、误吸以及口腔或咽部损伤。刀片、针头或线环等不安全工具的重复使用加剧了艾滋病毒和乙型肝炎等传染病的传播。尽管其具有临床意义，但尚未通过系统评价或荟萃分析对TCU的合并患病率及相关因素进行充分研究。
本综述和荟萃分析旨在估计一些非洲国家TCU的合并患病率及相关因素。
本系统综述和荟萃分析遵循PRISMA 2020指南。在多个数据库中进行全面检索，包括MEDLINE、ScienceDirect、谷歌学术和非洲在线期刊，以识别相关研究。采用加权逆方差随机效应模型估计TCU的合并患病率及相关预测因素。使用森林图、I²统计量和Egger检验评估纳入研究之间的异质性，以确保研究结果的稳健性和可靠性。采用随机效应模型和敏感性分析处理缺失数据。数据提取于2023年11月6日至12月23日进行。
纳入的研究聚焦于出生至15岁以下的儿童，研究将TCU定义为传统治疗师对悬雍垂进行部分或完全切除。
纳入了11项主要研究，共涉及来自非洲一些国家的7231名儿童。
一些非洲国家TCU的合并估计患病率为40.98%（95%置信区间：25.04 - 56.92；I² = 99.61，P = 0.001）。与城市地区的母亲相比，农村地区的母亲让孩子接受TCU的可能性高2.45倍（调整后比值比[AOR] = 2.45；95%置信区间：1.59 - 3.32）。同样，有过孩子接受TCU经历的母亲，让其他孩子接受该手术的可能性比没有这种经历的母亲高8.44倍（AOR = 8.44；95%置信区间：6.27 - 10.61）。然而，由于纳入研究中报告的显著异质性可能会影响结果的普遍性，因此在解释这些发现时需谨慎。
在一些非洲国家，近五分之二的儿童接受了TCU，这受到母亲的经历和农村居住情况的影响。虽然大多数手术未导致住院，但重大健康风险依然存在。这些发现强调了在母婴健康项目中进行有针对性干预的迫切需求，以解决TCU问题并减轻其在非洲受影响国家的相关发病率。
国际前瞻性系统评价注册库（PROSPERO）编号：CRD42024498699。
