{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:14:06Z","timestamp":1784265246261,"version":"3.55.0"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec028\">\n<jats:title>Background<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec029\">\n<jats:title>Objective<\/jats:title>\n<jats:p>This review and meta-analysis aimed to estimate the pooled prevalence and associated factors of TCU in some African countries.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec030\">\n<jats:title>Methods<\/jats:title>\n<jats:p>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, I<jats:sup>2<\/jats:sup> statistics, and Egger\u2019s 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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec031\">\n<jats:title>Eligibility criteria<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec032\">\n<jats:title>Participants<\/jats:title>\n<jats:p>Eleven primary studies comprising 7,231 children from some countries in Africa were included.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec033\">\n<jats:title>Results<\/jats:title>\n<jats:p>Pooled estimate of TCU in some African countries was 40.98% (95% CI: 25.04\u201356.92; I<jats:sup>2<\/jats:sup> = 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\u20133.32). 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\u201310.61). 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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec034\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec035\">\n<jats:title>Prospero I.D.<\/jats:title>\n<jats:p>CRD42024498699.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0316755","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T18:53:21Z","timestamp":1738090401000},"page":"e0316755","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pooled prevalence and associated factors of traditional uvulectom among children in Africa: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0537-7571","authenticated-orcid":true,"given":"Solomon","family":"Demis Kebede","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kindu","family":"Agmas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demewoz","family":"Kefale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amare","family":"Kassaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tigabu Munye","family":"Aytenew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"issue":"8","key":"pone.0316755.ref001","doi-asserted-by":"crossref","first-page":"244","DOI":"10.51594\/ijarss.v5i8.574","article-title":"Determinants of reproductive health seeking behaviour among women of reproductive age in Ajaokuta village, Kogi State","volume":"5","author":"AS Haruna","year":"2023","journal-title":"Int J Appl Res Soc Sci"},{"issue":"7","key":"pone.0316755.ref002","doi-asserted-by":"crossref","first-page":"e0234866","DOI":"10.1371\/journal.pone.0234866","article-title":"The burden of traditional neonatal uvulectomy among admissions to neonatal intensive care units, North Central Ethiopia, 2019: A triangulated crossectional study","volume":"15","author":"W Alebachew Bayih","year":"2020","journal-title":"PLoS One"},{"issue":"12","key":"pone.0316755.ref003","doi-asserted-by":"crossref","first-page":"e0279362","DOI":"10.1371\/journal.pone.0279362","article-title":"Practice and associated factors of traditional uvulectomy among caregivers having children less than 5 years old in South Gondar Zone, Amhara Region, Ethiopia, 2020","volume":"17","author":"BW Yirdaw","year":"2022","journal-title":"PLoS One"},{"issue":"4","key":"pone.0316755.ref004","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.4314\/ahs.v14i4.36","article-title":"Health seeking behaviour and challenges in utilising health facilities in Wakiso district, Uganda","volume":"14","author":"D Musoke","year":"2014","journal-title":"Afr Health Sci"},{"key":"pone.0316755.ref005","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1742-4755-11-46","article-title":"A cross sectional study on factors associated with harmful traditional practices among children less than 5 years in Axum town, north Ethiopia, 2013","volume":"11","author":"K Gebrekirstos","year":"2014","journal-title":"Reproductive Health"},{"issue":"8","key":"pone.0316755.ref006","doi-asserted-by":"crossref","first-page":"450","DOI":"10.36472\/msd.v9i8.779","article-title":"Traditional Uvulectomy: A common and potentially life-threatening practice in a developing country","volume":"9","author":"IK Ndu","year":"2022","journal-title":"Med Sci Discov"},{"key":"pone.0316755.ref007","first-page":"704924","article-title":"The traditionally amputated uvula amongst nigerians: still an ongoing practice","author":"AA Adoga","year":"2011","journal-title":"ISRN Otolaryngol"},{"issue":"1","key":"pone.0316755.ref008","first-page":"1","article-title":"Prevalence and associated factors to uvula cutting on under five children in Amhara region, debre birhan town, 2016\/2017","volume":"5","author":"K Kebede","year":"2017","journal-title":"International Journal of Pediatrics and Child Health"},{"issue":"7","key":"pone.0316755.ref009","doi-asserted-by":"crossref","first-page":"e0305175","DOI":"10.1371\/journal.pone.0305175","article-title":"Prevalence of traditional uvulectomy and its associated factors among parents who had less than 6 months of infants in Gondar City, north-west Ethiopia: Mixed study design","volume":"19","author":"LY Bazezew","year":"2024","journal-title":"PLoS One"},{"issue":"1","key":"pone.0316755.ref010","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s12906-020-03185-y","article-title":"Factors that promote and sustain the use of traditional, complementary and integrative medicine services at LEKMA hospital, Ghana, 2017: an observational study","volume":"21","author":"A Kenu","year":"2021","journal-title":"BMC Complement Med Ther"},{"issue":"1","key":"pone.0316755.ref011","first-page":"22","article-title":"Morbidity and mortality associated with traditional uvulectomy among neonates in a tertiary health facility in Kano, Nigeria","volume":"3","author":"ZL Farouk","year":"2023","journal-title":"Nigerian J Perinat Neonat Care"},{"issue":"4","key":"pone.0316755.ref012","first-page":"530","article-title":"Early initiation of and exclusive breastfeeding in large-scale community-based programmes in Bolivia and Madagascar","volume":"24","author":"EJ Baker","year":"2006","journal-title":"J Health Popul Nutr"},{"issue":"6","key":"pone.0316755.ref013","doi-asserted-by":"crossref","first-page":"e0002078","DOI":"10.1371\/journal.pgph.0002078","article-title":"Uvula infections and traditional uvulectomy: Beliefs and practices in Luwero district, central Uganda","volume":"3","author":"SPS Kibira","year":"2023","journal-title":"PLOS Glob Public Health"},{"issue":"5","key":"pone.0316755.ref014","doi-asserted-by":"crossref","first-page":"08","DOI":"10.9790\/0853-0950813","article-title":"Harmful Cultural Practices: Parents Perceived Effects of Traditional Uvulectomy On The under-five-children In Jigawa State, Nigeria","volume":"9","author":"BL Ajibade","year":"2013","journal-title":"IOSR-JDMS"},{"issue":"1","key":"pone.0316755.ref015","first-page":"52","article-title":"Factors influencing health-seeking behaviour among civil servants in Ibadan, Nigeria","volume":"16","author":"OO Latunji","year":"2018","journal-title":"Ann Ib Postgrad Med"},{"issue":"2","key":"pone.0316755.ref016","first-page":"176","article-title":"Traditional uvulectomy, a common practice in South Kivu in the Democratic Republic of Congo","volume":"28","author":"R Mbusa Kambale","year":"2018","journal-title":"Med Sante Trop"},{"issue":"1","key":"pone.0316755.ref017","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1093\/pubmed\/fdh207","article-title":"Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers","volume":"27","author":"BT Shaikh","year":"2005","journal-title":"J Public Health (Oxf)"},{"key":"pone.0316755.ref018","doi-asserted-by":"crossref","DOI":"10.1016\/B978-0-12-802104-0.00002-0","article-title":"Traditional medicine","author":"CT Che","year":"2017","journal-title":"Pharmacognosy"},{"key":"pone.0316755.ref019","doi-asserted-by":"crossref","first-page":"111835","DOI":"10.1016\/j.ijporl.2023.111835","article-title":"The burdens, associated factors, and reasons for traditional uvulectomy in Ethiopia: A systematic review and meta-analysis","volume":"176","author":"T Getachew","year":"2024","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"4","key":"pone.0316755.ref020","doi-asserted-by":"crossref","first-page":"902","DOI":"10.4269\/ajtmh.15-0874","article-title":"Seroprevalence of hepatitis B infection in Nigeria: a national survey","volume":"95","author":"AT Olayinka","year":"2016","journal-title":"Am J Trop Med Hyg"},{"issue":"2","key":"pone.0316755.ref021","doi-asserted-by":"crossref","DOI":"10.21276\/aimdr.2018.4.2.DE6","article-title":"Beliefs about traditional uvulectomy and teething: awareness and perception among adults in Tanzanian rural setting","volume":"4","author":"SS Owibingire","year":"2018","journal-title":"Ann Int Med Dental Res"},{"key":"pone.0316755.ref022","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.ijporl.2016.07.011","article-title":"Profile of pediatric traditional uvulectomy in North-West Nigeria: the need for caution and education","volume":"88","author":"SO Adebola","year":"2016","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"1","key":"pone.0316755.ref023","first-page":"16","article-title":"Traditional uvulectomy among the neonates: experience in a Nigerian tertiary health institution.","volume":"13","author":"M Abdullahi","year":"2016","journal-title":"Borno Med J"},{"issue":"2","key":"pone.0316755.ref024","doi-asserted-by":"crossref","first-page":"25","DOI":"10.21276\/aimdr.2018.4.2.DE6","article-title":"Beliefs about traditional uvulectomy and teething: awareness and perception among adults in Tanzanian rural setting","volume":"4","author":"SS Owibingire","year":"2018","journal-title":"Ann Int Med Dent Res"},{"issue":"3","key":"pone.0316755.ref025","first-page":"467","article-title":"Assessing the risk of bias of quantitative analytical studies: introducing the vision for critical appraisal within JBI systematic reviews","volume":"21","author":"Z Munn","year":"2023","journal-title":"JBI Evid Synth"},{"issue":"1 Suppl","key":"pone.0316755.ref026","first-page":"S1-30","article-title":"Clinical practice guideline: tonsillectomy in children","volume":"144","author":"RF Baugh","year":"2011","journal-title":"Otolaryngol Head Neck Surg"},{"key":"pone.0316755.ref027","first-page":"169795","article-title":"Magnitude and reasons for harmful traditional practices among children less than 5 years of age in Axum Town, North Ethiopia, 2013","author":"K Gebrekirstos","year":"2014","journal-title":"Int J Pediatr"},{"issue":"6","key":"pone.0316755.ref028","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1007\/s10461-010-9681-4","article-title":"Bloody traditional procedures performed during infancy in the oropharyngeal area among HIV+ children: implication from the perspective of mother-to-child transmission of HIV","volume":"14","author":"YB Mitke","year":"2010","journal-title":"AIDS Behav"},{"key":"pone.0316755.ref029","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.ijporl.2016.07.011","article-title":"Profile of pediatric traditional uvulectomy in North-West Nigeria: the need for caution and education","volume":"88","author":"SO Adebola","year":"2016","journal-title":"Int J Pediatric Otorhinolaryngol"},{"issue":"8","key":"pone.0316755.ref030","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/0277-9536(94)90379-4","article-title":"Traditional uvulectomy in Niger: a public health problem?","volume":"39","author":"A Prual","year":"1994","journal-title":"Soc Sci Med"},{"issue":"2","key":"pone.0316755.ref031","doi-asserted-by":"crossref","first-page":"25","DOI":"10.21276\/aimdr.2018.4.2.DE6","article-title":"Beliefs about traditional uvulectomy and teething: awareness and perception among adults in Tanzanian rural setting","volume":"4","author":"SS Owibingire","year":"2018","journal-title":"Ann Int Med Dent Res"},{"key":"pone.0316755.ref032","first-page":"8307591","article-title":"Factors influencing compliance and health seeking behaviour for hypertension in Mukono and Buikwe in Uganda: a qualitative study","author":"G Musinguzi","year":"2018","journal-title":"Int J Hypertens"},{"issue":"19","key":"pone.0316755.ref033","doi-asserted-by":"crossref","first-page":"e38978","DOI":"10.1016\/j.heliyon.2024.e38978","article-title":"The complications of traditional uvulectomy and concurrent occurrences of cultural malpractices in Ethiopia: A systematic review and meta-analysis","volume":"10","author":"T Getachew","year":"2024","journal-title":"Heliyon"},{"issue":"1","key":"pone.0316755.ref034","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s13002-022-00533-9","article-title":"The folk illness kimeo and \u201ctraditional\u201d uvulectomy: an ethnomedical study of care seeking for children with cough and weakness in Dar es Salaam","volume":"18","author":"S Lange","year":"2022","journal-title":"J Ethnobiol Ethnomed"},{"key":"pone.0316755.ref035","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/1475-9276-11-31","article-title":"Differences in health care seeking behaviour between rural and urban communities in South Africa","volume":"11","author":"M van der Hoeven","year":"2012","journal-title":"Int J Equity Health"},{"issue":"1","key":"pone.0316755.ref036","doi-asserted-by":"crossref","DOI":"10.1177\/21582440231153038","article-title":"Factors associated with the use of traditional medicine in Wolaita Zone, Southern Ethiopia","volume":"13","author":"FM Legesse","year":"2023","journal-title":"Sage Open"}],"updated-by":[{"DOI":"10.1371\/journal.pone.0329891","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000}}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0316755","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T18:53:42Z","timestamp":1738090422000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0316755"}},"subtitle":[],"editor":[{"given":"Kahsu","family":"Gebrekidan,","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,28]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0316755","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,28]]}}}