Tag Archives: Infection

Invasion of the host organism by microorganisms that can cause pathological conditions or diseases.

Female genital circumcision/mutilation: implications for female urogynaecological health.

Int Urogynecol J. 2013 Jul 16. [Epub ahead of print]

Female genital circumcision/mutilation: implications for female urogynaecological health.

Teufel K, Dörfler DM.

Hospital of St. Poelten, St. Poelten, Austria, katharinateufel@gmx.at.


“Female genital circumcision” or “female genital mutilation”, as it is called more often, is an operation that is primarily carried out in Africa. Owing to migration, physicians are increasingly confronted with this issue in Western countries as well. A range of negative effects may result from this operation and this article aims to address consequences for female pelvic health. Special emphasis is placed on urogynaecological health consequences; in particular, on “voiding difficulties”, “recurrent urinary tract infections” and “vesicovaginal fistula”. All of these occur mostly in infibulated women, i.e. in women whose genitalia are sealed by the most severe form of circumcision. Some of the problems that may emerge as a result of the operation can be resolved by defibulation (i.e. surgical reopening of the sealed vulva). Female genital circumcision is a sensitive topic even in the area of research and reliable data are therefore scarce.

This article can be purchased in this LINK

Female genital mutilation and infections: a systematic review of the clinical evidence.

Arch Gynecol Obstet. 2013 Jan 12. [Epub ahead of print]

Female genital mutilation and infections: a systematic review of the clinical evidence.

Iavazzo C, Sardi TA, Gkegkes ID.

Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, Marousi, 151 23, Athens, Greece, christosiavazzo@hotmail.com.

AIM: Female genital mutilation (FGM) is a common practice especially performed in women with no anaesthesia or antibiotics and in absence of aseptic conditions. The aim of this systematic review is to explore and analyze for first time in the current literature, the clinical evidence related to the presence of infections in the practice of FGM.

METHOD: A systematic search of PubMed and Scopus was performed. A combination of the terms “female circumcision”, “genital mutilation”, “genital cutting” and “infection” were used. Studies reporting data on the infections related to patients with FGM were included.

RESULTS: A total of 22,052 patients included, in the study, from African countries. The age ranged from 10 days to 20 years. The procedure was done by physicians, paramedical staff, and other specialties. Type I FGM was performed in 3,115 women while 5,894, 4,049 and 93 women underwent Type II, Type III and unknown type of FGM, respectively. Different types of infections were identified including UTIs, genitourinary tract infections, abscess formation and septicemia or even HIV infection. Moreover, most infections were identified in Type III FGM. The isolated pathogens in the different type of infections, were HIV, Clostridium tetani, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Candida albicans, Trichomonas vaginalis, HSV-2, Pseudomonas pyocyanea, Staphylococcus aureus. The univariate risk of infection ranged from 0.47 to 5.2.

CONCLUSION: A variety of infections can occur after FGM. The management of these complications in a low-income economy can be a great burden for the families.

This article can be purchased in this LINK.

Female Genital Cutting and HIV Transmission: Is There an Association?

American Journal of Reproductive Immunology. Article first published online: 13 OCT 2012. DOI: 10.1111/aji.12028

Female Genital Cutting and HIV Transmission: Is There an Association?

Diouf K, Nour N


Female Genital Cutting (FGC) refers to the practice of surgically removing all or part of the female external genitalia for non-medical purposes. It is a common practice in many countries in Africa, the Middle East, and to a lesser extent, Asia. Over 130 million women worldwide have undergone this procedure, and over 2 million women and girls are subject to it every year. Various complications have been described, including infection, hemorrhage, genitourinary and obstetric complications, as well as psychological sequelae. Since the beginning of the HIV epidemic, a few reports have also described a potentially elevated risk of HIV transmission among women with FGC. In this report, we aim to review the evidence and identify unanswered questions and research gaps regarding a potential association between FGC and HIV transmission.

This article can be purchased in this LINK

Hepatitis C virus infection among paediatric patients attending University of Assiut Hospital, Egypt

Eastern Mediterranean Health Journal. 2010 April; 16 (4)

Hepatitis C virus infection among paediatric patients attending University of Assiut Hospital, Egypt 

Kalil KA, Farghally HS, Hassanein KM, Abd-Elsayed AA, Hassanein FE


Few studies have evaluated the epidemiology and risk factors of hepatitis C virus (HCV) infection in children in Egypt. This study of 465 children attending Assiut University Hospital measured the rates of anti-HCV positivity by 3rd-generation ELISA test and of HCV-RNA positivity by PCR, with analysis of some relevant risk factors. The rate of HCV-RNA positivity among ELISA-positive cases (n = 121) was 72.2% overall: 100% in the subgroup with hepatitis, 70.8% in those with a history of multiple transfusions and 58.3% in those without hepatitis or multiple transfusions. History of blood transfusions, frequent injections, hospitalization or surgical procedures were significant risk factors for anti-HCV positivity by ELISA.

This article can be viewed online in this LINK.

Necrotizing fasciitis complicating female genital mutilation: case report

Eastern Mediterranean Health Journal. 2010 May: 16 (5)

Case report: Necrotizing fasciitis complicating female genital mutilation: case report 

Abdalla A. M, Abdelazeim A. M

Faculty of Medicine & Health Sciences, University of Kassala, Kassala, Sudan (Correspondence to: Abdalla A. Mohammed: dohmaa@yahoo.co.uk)


Necrotizing fasciitis is a deep-seated infection of the subcutaneous tissue that results in the progressive destruction of fascia and fat; it easily spreads across the fascial plane within the subcutaneous tissue [1]. It begins locally at the site of the trauma, which may be severe, minor or even non-apparent. The affected skin becomes very painful without any grossly visible change. With progression of the disease, tissues become swollen, often within hours. Skin colour may progress to violet and blisters may form, with subsequent necrosis of subcutaneous tissues.

Necrotizing fasciitis is caused by many types of bacteria such as group A streptococcus, Vibrio vulnificus, Clostridium perfringens, Bacteroides fragilis, commonly known as “flesh-eating bacteria”; Group A streptococcus is the most common cause [2]. The disease has also been referred to as haemolytic streptococcal gangrene, Meleney ulcer, acute dermal gangrene, hospital gangrene, suppurative fasciitis, and synergistic necrotizing cellulitis. Fournier gangrene is a form of necrotizing fasciitis that is localized to the scrotum and perineal area.

Patients with necrotizing fasciitis typically have a high fever and appear very ill. Very severe cases progress within hours and the mortality rate is as high as 40% [3,4].

Here we report a rare case of necrotizing fasciitis complicating female genital mutilation (FGM)…..

This article can be viewed online in this LINK

Female genital cutting and HIV/AIDS among Kenyan women.

Stud Fam Plann. 2007 Jun;38(2):73-88.

Female genital cutting and HIV/AIDS among Kenyan women.

Yount KM, Abraham BK.

Department of Sociology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 724, Atlanta, GA 30322, USA. kyount@sph.emory.edu


Female genital cutting (FGC) and HIV/AIDS are both highly prevalent in sub-Saharan Africa, and researchers have speculated that the association may be more than coincidental. Data from 3167 women aged 15-49 who participated in the 2003 Kenya Demographic and Health Survey (KDHS) are used to test the direct and indirect associations of FGC with HIV. Our adjusted models suggest that FGC is not associated directly with HIV, but is associated indirectly through several pathways. Cut women are 1.72 times more likely than uncut women to have older partners, and women with older partners are 2.65 times more likely than women with younger partners to test positive for HIV Cut women have 1.94 times higher odds than uncut women of initiating sexual intercourse before they are 20, and women who experience their sexual debut before age 20 have 1.73 times higher odds than those whose sexual debut comes later of testing positive for HIV. Cut women have 27 percent lower odds of having at least one extra-union partner, and women with an extra-union partner have 2.63 times higher odds of testing positive for HIV. Therefore, in Kenya, FGC may be an early life-course event that indirectly alters women’s odds of becoming infected with HIV through protective and harmful practices in adulthood.

This article can be purchased in this LINK

Disentangling the complex association between female genital cutting and HIV among Kenyan women.

J Biosoc Sci. 2009 Nov;41(6):815-30. Epub 2009 Jul 16.

Disentangling the complex association between female genital cutting and HIV among Kenyan women.

Maslovskaya O, Brown JJ, Padmadas SS.

Division of Social Statistics, School of Social Sciences, University of Southampton, UK.


Female genital cutting (FGC) is a widespread cultural practice in Africa and the Middle East, with a number of potential adverse health consequences for women. It was hypothesized by Kun (1997) that FGC increases the risk of HIV transmission through a number of different mechanisms. Using the 2003 data from the Kenyan Demographic and Health Survey (KDHS), this study investigates the potential association between FGC and HIV. The 2003 KDHS provides a unique opportunity to link the HIV test results with a large number of demographic, social, economic and behavioural characteristics of women, including women’s FGC status. It is hypothesized that FGC increases the risk of HIV infection if HIV/AIDS is present in the community. A multilevel binary logistic regression technique is used to model the HIV status of women, controlling for selected individual characteristics of women and interaction effects. The results demonstrate evidence of a statistically significant association between FGC and HIV, after controlling for the hierarchical structure of the data, potential confounding factors and interaction effects. The results show that women who had had FGC and a younger or the same-age first-union partner have higher odds of being HIV positive than women with a younger or same-age first-union partner but without FGC; whereas women who had had FGC and an older first-union partner have lower odds of being HIV positive than women with an older first-union partner but without FGC. The findings suggest the behavioural pathway of association between FGC and HIV as well as an underlying complex interplay of bio-behavioural and social variables being important in disentangling the association between FGC and HIV.

This article can be purchased in this LINK

Male and female circumcision associated with prevalent HIV infection in virgins and adolescents in Kenya, Lesotho and Tanzania

Ann Epidemiol. 2007 Mar;17(3):217.26.

Male and female circumcision associated with prevalent HIV infection in virgins and adolescents in Kenya, Lesotho and Tanzania

Brewer DD, Potterat JJ, Roberts Jr, Brody S

Interdisciplinary Scientific Research, Seattle, WA 98115, USA. Via www.interscientific.net/contact.html



Remarkable proportions of self-reported virgins and adolescents in eastern and southern Africa are infected with HIV, yet non-sexual routes of transmission have not been systematically investigated in such persons. Many observers in this region have recognized the potential for HIV transmission through unhygienic circumcision procedures. We assessed the relation between male and female circumcision (genital cutting) and prevalent HIV infection in Kenyan, Lesothoan, and Tanzanian virgins and adolescents.


We analyzed data from recent cross-sectional national probability sample surveys of adolescents and adults in households, focusing on populations in which circumcision was common and usually occurred in puberty or later.


Circumcised male and female virgins were substantially more likely to be HIV infected than uncircumcised virgins (Kenyan females: 3.2% vs. 1.4%, odds ratio [OR] = 2.38; Kenyan males: 1.8% vs. 0%, OR undefined; Lesothoan males: 6.1% vs. 1.9%, OR 3.36; Tanzanian males: 2.9% vs. 1.0%, OR 2.99; weighted mean phi correlation = 0.07, 95% confidence interval, 0.03 to 0.11). Among adolescents, regardless of sexual experience, circumcision was just as strongly associated with prevalent HIV infection. However, uncircumcised adults were more likely to be HIV positive than circumcised adults. Self-reported sexual experience was independently related to HIV infection in adolescent Kenyan females, but was unrelated to HIV infection in adolescent Kenyan, Lesothoan, and Tanzanian males.


HIV transmission may occur through circumcision-related blood exposures in eastern and southern Africa.

This article can be purchased in this LINK