Bulletin of the World Health Organization

Traditional male circumcision in eastern and southern Africa: a systematic review of prevalence and complications

Andrea Wilcken, Thomas Keil & Bruce Dick

Volume 88, Number 12, December 2010, 907-914

Table 1. Studies on the prevalence and/or age of traditional male circumcision in eastern and southern Africa, as identified through a systematic review of the literature

First author Publication year Study setting Study design Data collection method Study population
Prevalence of MC
Of circumcised males, % circumcised by traditional provider Age at MC (in years)
Tribe/residence Male study participants (No.) Age in years % 95% CIa
National Institute for Medical Research, United Republic of Tanzania16 2009 United Republic of Tanzania, rural and urban areas, three regions. Only districts where most men are circumcised traditionally were considered (i.e. Mara region, Tarime district) Cohort Interview and clinical assessment of circumcision status 77% Mkurya 170 18–24 (29%)
25–34 (45%)
35–44 (26%)
99 98–100 63 By 18 (86.5%), by 21.5 (99.0%)
Peltzer17 2008 South Africa, OR Tambo district, Eastern Cape, 17 initiation schools Intervention Interview 7 days post TMC; clinical examination 2, 4, 7 and 14 days post TMC Xhosa 192 18.7 (mean) NA (MC was inclusion criterion for assessing complications after MC) 100 18.7 ± 1.9 (mean ± SD)
Bailey18 2008 Kenya, Bungoma district, Western province, 87% rural residence Cohort Direct observation at 3, 8 and 30 days post TMC (n = 24); interview and direct observation 62 days (median) post MC (n = 298); interview 46 days (median) post MC (n = 709) Babukusu 1007 12–16 (“majority”) NA (MC was inclusion criterion for assessing complications after MC) 44 15 (median), 14.7 (mean)
Shaffer11 2007 Kenya, Southern Rift Valley, rural population Cross-sectional Questionnaire (self-completed) Kalenjin, Kisii, Luhya, Luo 1378 31.1 ± 8.8 (mean ± SD) 80 78–82 74 12.7 ± 3.5 (mean ± SD)
DHS15 2006–07 Namibia, nationally representative survey Cross-sectional Interview Rural and urban 5576 15–49 21 20–22 25 < 13 (84%), 13–19 (9%)
Lagarde14 2003 South Africa, North Central, Westonaria, Gauteng township Cross-sectional Interview Sotho, Tswana, Xhosa and Zulu 482 19–29 22 19–26 65 17 (median); 16–18 (IQR)
Rain-Taljaard12 2003 South Africa, North Central, Gauteng township, mining area, urban Cross-sectional Interview Sotho, Tswana, Xhosa and Zulu 723 14–24 10 8–12 58 20 (median); 17–24 (IQR)
Bailey13 1999 Uganda, Mbale district, industrial borough Cross-sectional Interview Mainly Bagisu 365 30.9 (mean) 52 47–57 90 18 (median, non-Muslims), 13 (median, Muslims)

CI, confidence interval; DHS, Demographic and Health Survey; IQR, interquartile range; MC, male circumcision; NA, not available; SD, standard deviation; TMC, traditional male circumcision.

a 95% CIs were calculated by the authors of the present review using the Wilson method.22

[an error occurred while processing this directive]