tailieunhanh - The long-term reproductive health consequences of female genital cutting in rural Gambia: a community-based survey

W e recommend amendments clarifying the ethics committee’ s func- tions in relation to approving extensions to the applicable period of storage of gametes and embryos. The bill would ensure that the ethics committee made decisions about approving, changing, or cancelling extensions to storage periods in much the same way as it would make decisions on activities listed as requiring approval under the Act. Proposed new sections 10A to 10D and 28(1)(aaa) of the Act relate to the ethics committee’ s functions in dealing with storage issues. These amendments would require the ethics committee’ s decisions about approving storage periods to be made in accordance with the guidelines and advice. | Tropical Medicine and International Health volume 6 no 8 pp 643-653 august 2001 The long-term reproductive health consequences of female genital cutting in rural Gambia a community-based survey Linda Morison1 Caroline Scherf2 Gloria Ekpo3 Katie Paine3 Beryl West3 Rosalind Coleman3 and Gijs Walraven3 1 MRC Tropical Epidemiology Group Department of Infectious and Tropical Diseases London School of Hygiene and Tropical Medicine London UK 2 Department of Obstetrics and Gynaecology University of Wales Cardiff UK 3 Medical Research Council Laboratories Farafenni and Fajara The Gambia Summary This paper examines the association between traditional practices of female genital cutting FGC and adult women s reproductive morbidity in rural Gambia. In 1999 we conducted a cross-sectional community survey of 1348 women aged 15 54 years to estimate the prevalence of reproductive morbidity on the basis of women s 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 classi cation type II and were performed between the ages of 4 and 7 years. 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 dif cult to distinguish. Women who had undergone FGC had a signi cantly higher prevalence of bacterial vaginosis BV adjusted odds ratio OR 95 con dence interval CI and a substantially higher prevalence of herpes simplex virus 2 HSV2 adjusted OR 95 CI . The higher prevalence