Estimates of the prevalence of male circumcision in sub-Saharan Africa from 2010–2023—A systematic review and meta-analysis
Abstract
Background
Male circumcision (MC) is a key part of the package of interventions to prevent HIV, the biggest health challenge in sub-Saharan Africa.
Objective
To estimate the male circumcision prevalence and to evaluate the progress towards meeting WHO targets in sub-Saharan Africa during the period 2010–2023.
Methods
We carried out a systematic review and meta-analysis of studies published during the period 2010–2023. We searched PubMed, Scopus, Cochrane CENTRAL, Google Scholar, WHO and the Demographic and Health Survey for reports on MC prevalence in sub-Saharan Africa. MC prevalence was synthesized using inverse-variance heterogeneity models, heterogeneity using I2 statistics and publication bias using funnel plots.
Results
A total of 53 studies were included. The overall prevalence during the study period was 45.9% (95% CI 32.3–59.8), with a higher MC prevalence in Eastern (69.9%, 95%CI 49.9–86.8) compared to Southern African (33.3%, 95%CI 21.7–46.2). The overall prevalence was higher in urban (45.3%, 95%CI 27.7–63.4) compared to rural settings (42.6%, 95% 26.5–59.5). Male circumcision prevalence increased from 40.2% (95% CI 25.0–56.3) during 2010–2015 to 56.2% (95% CI 31.5–79.5) during 2016–2023. Three countries exceeded 80% MC coverage, namely, Ethiopia, Kenya and Tanzania.
Conclusion
Overall, the current MC prevalence is below 50%, with higher prevalence in Eastern African countries and substantially lower prevalence in Southern Africa. Most of the priority countries need to do more to scale up medical male circumcision programs.
Authors
Elsayed B, Elmarasi M, Madzime RJ, Mapahla L, ElBadway MMS, Chivese T
Year
2024
Topics
- Epidemiology and Determinants of Health
- Epidemiology
- Population(s)
- General HIV- population
- Prevention, Engagement and Care Cascade
- Prevention
- Prevention
- Biomedical interventions
