{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:42:25Z","timestamp":1792042945351,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2001,12,21]],"date-time":"2001-12-21T00:00:00Z","timestamp":1008892800000},"content-version":"vor","delay-in-days":142,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2001,8]]},"abstract":"<jats:p>This paper examines the association between traditional practices of female genital cutting (FGC) and adult women\u2019s reproductive morbidity in rural Gambia. In 1999, we conducted a cross\u2010sectional community survey of 1348 women aged 15\u201354\u2003years, to estimate the prevalence of reproductive morbidity on the basis of women\u2019s reports, a gynaecological examination and laboratory analysis of specimens. Descriptive statistics and logistic regression were used to compare the prevalence of each morbidity between cut and uncut women adjusting for possible confounders. A total of 1157 women consented to gynaecological examination and 58% had signs of genital cutting. There was a high level of agreement between reported circumcision status and that found on examination (97% agreement). The majority of operations consisted of clitoridectomy and excision of the labia minora (WHO classification type II) and were performed between the ages of 4 and 7\u2003years. The practice of genital cutting was highly associated with ethnic group for two of the three main ethnic groups, making the effects of ethnic group and cutting difficult to distinguish. Women who had undergone FGC had a significantly higher prevalence of bacterial vaginosis (BV) [adjusted odds ratio (OR)=1.66; 95% confidence interval (CI) 1.25\u20132.18] and a substantially higher prevalence of herpes simplex virus 2 (HSV2) [adjusted OR=4.71; 95% CI 3.46\u20136.42]. The higher prevalence of HSV2 suggests that cut women may be at increased risk of HIV infection. Commonly cited negative consequences of FGC such as damage to the perineum or anus, vulval tumours (such as Bartholin\u2019s cysts and excessive keloid formation), painful sex, infertility, prolapse and other reproductive tract infections (RTIs) were not significantly more common in cut women. The relationship between FGC and long\u2010term reproductive morbidity remains unclear, especially in settings where type II cutting predominates. Efforts to eradicate the practice should incorporate a human rights approach rather than rely solely on the damaging health consequences.<\/jats:p>","DOI":"10.1046\/j.1365-3156.2001.00749.x","type":"journal-article","created":{"date-parts":[[2003,3,12]],"date-time":"2003-03-12T21:37:58Z","timestamp":1047505078000},"page":"643-653","source":"Crossref","is-referenced-by-count":145,"title":["The long\u2010term reproductive health consequences of female genital cutting in rural Gambia: a community\u2010based survey"],"prefix":"10.1111","volume":"6","author":[{"given":"Linda","family":"Morison","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Scherf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Ekpo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Paine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beryl","family":"West","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalind","family":"Coleman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gijs","family":"Walraven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2001,12,21]]},"reference":[{"key":"e_1_2_7_2_2","first-page":"227","article-title":"Current status of female circumcision among Nigerian Igbos","volume":"16","author":"Adinma J","year":"1997","journal-title":"West African Journal of Medicine"},{"key":"e_1_2_7_3_2","unstructured":"BallardR(1998)The effect of antiviral treatment of HSV\u20102 lesions on the cervical shedding of HIV. Presented at a WHO\/UNAIDS consultation October 14\u201316 1998.STD Interventions for Preventing HIV: What is the Evidence?WHO\/UNAIDS Geneva."},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.2307\/2137631"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002243420802"},{"key":"e_1_2_7_6_2","unstructured":"CarrD(1997)Female Genital Cutting: Findings from the Demographic and Health Surveys Program. Macro International Inc. Calverton MD USA."},{"key":"e_1_2_7_7_2","unstructured":"Egyptian Fertility Care Society(1996)Clinic\u2010Based Investigation of the Typology and Self\u2010Reporting of FGM in Egypt. 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The Gambia Women\u2019s Bureau Banjul The Gambia."},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.2001.00692.x"},{"key":"e_1_2_7_21_2","unstructured":"ToubiaN(1993)Female Genital Mutilation: A Call for Global Action. Women Ink New York."},{"key":"e_1_2_7_22_2","doi-asserted-by":"crossref","unstructured":"ToubiaN(1996)Female Genital Mutilation: A Call for Global Action (in Arabic). Task Force on Female Genital Mutilation Cairo.","DOI":"10.2307\/2138052"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04333-6"},{"key":"e_1_2_7_24_2","first-page":"603","article-title":"Maternal mortality in rural Gambia: levels, causes and contributing factors","volume":"78","author":"Walraven G","year":"2000","journal-title":"Bulletin of the World Health Organization"},{"key":"e_1_2_7_25_2","unstructured":"WeissHA Buv\u00e9A RobinsonNJet\u2003al. (2001)The epidemiology of HSV\u20102 infection and its association with HIV infection in four urban African populations.AIDS15suppl 5 (in press)."},{"key":"e_1_2_7_26_2","unstructured":"WHO(1995)Female Genital Mutilation: Report of a WHO Technical Working Group. Geneva 17\u201319 July 1995. 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