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Implications of FGM as Portal for Microbial Infections: We need you to join the campaign to #endFGM #endcuttinggirls

Female genital mutilation has the ability to induce secondary infections resulting from microbial pathogens. Topping,  reported some microbial infections associated with female circumcision such as STIs, HIV/AIDS, reproductive tract infection, pelvic inflammatory diseases and chronic urinary tract infection. In the same vain, WHO  asserted that FGM increases the short and long term health risks to women and girls and is unacceptable from a human rights and health perspective. While in general there is an increased risk of adverse health outcomes with increased severity of FGM, WHO is opposed to all forms of FGM and is emphatically against the practice being carried out by health care providers (medicalization).

FGM and Complication of Sexually transmitted Infections (STIs)
Female circumcision has been reportedly linked lead to increased risk of acquiring sexually transmitted infections (STIs) and complications of pelvic inflammatory diseases (PID). STIs are an important public health problem worldwide as the global incidence of STIs is estimated by the WHO to begin excess of 125 million per year, mainly affecting developing countries. Elmusharaf et al. [8] reported that African countries demonstrated the most seroprevalence of chlamydial antibodies ranging from 8 to 91% with the highest occurrence of Neisseria gonnorrhoeae and Chlamydia trachomatis as the causative agents in most of sub-Saharan Africa.

Recurrent Urinary Tract Infections (UTIs)
Partial occlusion of the vagina and urethra means the normal flow of urine is deflected and the perineum remains constantly wet and susceptible to bacterial growth. Retrograde UTI's therefore commonly occur, affecting the bladder, uterus and kidneys. Damage to the lower urinary tract during the procedure can also result in urinary tract infections.

Pelvic Inflammatory Diseases (PID)
Pelvic inflammatory disease (PID), a common complication of sexually transmitted infections (STIs) is accompanied by abdominal pain and infertility and the etiologic agents were Neisseria gonnorrhoeae and Chlamydia trachomatis. FGM plays a significant impact in the progression of PID for the woman who has been infibulated there are added risks of infection band resulting infertility. It has been reported by Patrick, et al. that chronic pelvic disease was three times more prevalent in the infibulated women. Chronic retention of urine, menstrual flow, and repeated urinary tract infections with E. coli are the consequences of poor drainage, which results from a space from behind the vulva skin. This then becomes an excellent reservoir for the growth of pathogenic organisms such as the Escherichia coli Muteshi et al. reported a high incidence of candidiasis, which was more frequent with infibulation, and urine cultures. Shandoll [11] has suggested three main causes of PID in the infibulated woman, namely:

(1) Infection at the time of infibulation,

(2) Interference with drainage and

(3) Infection from splitting the infibulation.

FGM Increases Susceptibility to HIV/AIDS
FGM has said to play a critical role in facilitating HIV infection through various mechanisms as it predisposes women to HIV infection in the following ways: increased need for blood transfusion due to haemorrhage either when the procedures is performed at childbirth or result of vaginal tearing during defibulation and intercourse and the use of the same blade on another person [12]. This is because, the operation is mainly carried out by practitioners of traditional medicine and by traditional birth attendants using unsanitary knives and other unsterilized instruments in generally unhygienic conditions [7]. According to Hardy [13], during intercourse penetration, there are difficulties which often result in tissue damages, lesion and postcoital bleeding which tends to make the squamous vaginal epithelium similar in permeability to the columnar mucosa of the rectum, thus facilitating the possible transmission of HIV.

Other Health Implication of FGM
FGM does irreparable harm to the female reproductive organ and health as a whole which can result to death through severe bleeding, pain and trauma as well as overwhelming infections. It has dangerous health implications because of the unsanitary conditions in which it is generally practiced

The opening passages between the vagina and bladder or anus can result to Urogenital Vaginal Fistula such as Vesico-Vaginal Fistula (VVF): Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula (UGF). VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault and Recto Vaginal Fistula (RVF) A rectovaginal fistula is an abnormal connection between the lower portion of your large intestine your rectum — and your vagina. Bowel contents can leak through the fistula, allowing gas or stool to pass through your vagina.


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