ORIGINAL ARTICLE   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2018 December;177(12):707-14

DOI: 10.23736/S0393-3660.17.03678-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Determinants of male child circumcision in Jordan: a cohort study

Eman F. BADRAN ¹ ✉, Luay AL NOURI ¹, Abeer ALASSAF ¹, Rola S. SAQAN ², Rasha ODEH ¹

¹ Department of Pediatrics, School of Medicine, University of Jordan, Amman, Jordan; ² Department of Pediatrics, Faculty of Medicine Jordan University of Science and Technology, Irbid, Jordan

BACKGROUND: Circumcision is common in Jordan. Most healthcare professionals who perform this procedure do it without a medical reason and receive no structured training program (except for surgeons). Previous studies have reported that personal or cultural beliefs strongly influence parents’ decision overall. Therefore, this study investigated the determinants of male child circumcision in Jordan.
METHODS: This prospective cohort study was conducted at a hospital from January-December 2011. Healthy male children <12 years and >36 weeks gestational age with birth weight >2.5 kg were included. Eight-hundred ten male Muslim children participated. Of these, 573 (66.6%) were circumcised, mostly during the neonatal period (70.5%).
RESULTS: Average age of circumcision was two months. Most procedures were performed by a pediatrician 258/537 (48%). Analgesia/anesthesia during circumcision was not promoted enough. All effects of the circumcision were considered minor (1.9%). Families’ cultural beliefs, the father having a higher education, and a pediatrician conducting the procedure at low-cost clinic primarily determined the completion of circumcision during the neonatal period. Families’ religious beliefs and fathers’ memories of pain during their own circumcision did not seemingly affect fathers’ choices concerning circumcision age. Physicians only played a minor role in advising the family before the procedure.
CONCLUSIONS: Male, neonatal circumcision rate is high in Jordan with low complication rates. Parental cultural beliefs influenced the time of circumcision. Physicians, specifically pediatricians who typically perform the circumcisions, should inform parents about the procedure during the prenatal visit and first universal screening follow-up visit with newborns.

KEY WORDS: Child - Cohort studies - Jordan - Circumcision, male - Infant, newborn