Yes most Nigerians are circumcised.

Circumcision practice around the world has various implications and has generated a lot of debate about the pros and cons of the practice. Nigeria is one of the countries where male and female circumcision practice still occurs however, there has been claim of reduction in female genital cutting. Congregational or 'group' circumcision prevails in some communities as a means of upholding traditions and commemoration of festive period. Objective:To determine the pattern of circumcision practice and identify factors affecting the practice in Ilorin community. Materials and Methods: The study was a descriptive, cross sectional study conducted among parents of under-5 children of both the sexes using pre-tested, semi-structured questionnaires, which were administered to the respondents by trained research assistants over a six-week period. Clinical examination of genital area in index child of each respondent was done by a pediatric surgeon, who was the principal investigator. Results: Three hundred and ninety three (93%) respondents completed the questionnaire and the same number of index children's external genitalia was examined by the pediatric surgeon. The mean age of respondents was 33.2±9.3 years, and the main source of family income was private enterprises and civil services. The circumcision status of fathers was 100%, mothers, 65.6%, and overall female-child circumcision rate was 46.7%. Though, most of the index children were delivered at health centers (72.3%), the circumcisions were performed at almost equal frequencies by traditional circumcisionists (39.8%) and doctors (39.2%), with more than half of the circumcision being done outside the hospital. The mean age at circumcision was 22 ±0.69 months, with 73.9% of girls as against 91.7% boys being circumcised by the age of five years. Family choice was the main determinant of the age at circumcision and the circumcisionist. Female circumcision was done by traditional circumcisionist, nurses, and doctors in 1 in 4, 1 in 5, and 1 in 10 cases of circumcision, respectively. Traditional open (classical) circumcision technique was mostly used (40.4%), followed by Plastibel TM (ring type) (32.6%), and 'group' circumcision was practiced among 41.2% of respondents. Post-circumcision complications were seen in 116 (33.7%) of circumcised children examined. Conclusion: Circumcision practice in Ilorin is still higher among the traditional circumcisionists, despite of high hospital delivery. Female circumcision and 'group' circumcision were also being practiced, using mainly the traditional open circumcision technique. The high rate of circumcision complications indicate the need for proper enlightenment and retraining of health care providers and traditional circumcisionists on the safe methods available. The government should involve the religion and opinion leaders in the community to assist in the prevention of negative and harmful traditional practices including female circumcision.

Abdur-Rahman LO, Musa OI, Oshagbemi GK. Community-based study of circumcision practices in Nigeria. Ann Trop Med Public Health 2012;5:231-5

Abdur-Rahman LO, Musa OI, Oshagbemi GK. Community-based study of circumcision practices in Nigeria. Ann Trop Med Public Health [serial online] 2012 [cited 2014 Jan 4];5:231-5. Available from: http://www.atmph.org/text.asp?2012/5/3/231/98625

Introduction

Circumcision has been widely practiced from the immemorial time, around the world, for different reasons and at different stages of life. Health promotion and health protection are medical reasons given in the developed world for circumcision. In many developing countries, such as Africa and Asia, cultural, religious, and aesthetic reasons are given. [1] About one-third of the world's male population has been circumcized. [2] Many reports have reappraised the indications for circumcision, and others have highlighted the alternatives of circumcision. [3] Circumcision is currently claimed to give protection against HIV infection, and wide male circumcision is advocated. [4],[5]

In sub-Saharan Africa, female circumcision, and especially infibulation or pharaonic circumcision is performed, despite of the complications associated with it. In a national survey across the 36 states of Nigeria, the prevalence of female genital cutting (FGC) was highest in: Ekiti (89%), Edo (88%), Ondo and Kwara (83%), Ebonyi (76%), and Bayelsa (72%) with a national prevalence rate of 40%. [6]

Traditionally, circumcision for the male is regarded as an educational institution which prepares them for courtship, negotiating marriage, and other social responsibilities; while for the female, it is a mean of curbing promiscuity. [7],[8]

The settings and practitioners of circumcision vary in different communities and countries. 'Group circumcision' during festive periods is a common practice in Nigeria. Complications arising from circumcision are often concealed for life either due to death of the victims or fear of being made an outcast by the society. [9]

This study aimed at documenting the pattern of circumcision practice and identifies factors affecting the practice in Ilorin community in the northern part of Nigeria.

Materials and Methods

The study was carried out between January 15 th and February 29 th 2008 in Ilorin, an ancient and political capital of Kwara state. It is the gate way between the southern and northern part of Nigeria, and currently in the North-central geopolitical zone. The people are mainly Yorubas and muslims, but there is a mix of other tribes and religion because of its location. The 2006 census, which is the most recent, put the population at 786,429, with an estimated annual population growth rate of 2.5%. [10]

The economy of the area is mostly pre-industrial, with the major occupation of the people being peasant farming and cloth weaving. The educated citizens are employed in the civil service, and a sizable number of the population is engaged in commerce, and small scale industrial enterprises.

The study was a descriptive, cross sectional study conducted among mothers of under-5 children of both the sexes using pre-tested, semi-structured questionnaires, which were administered to the respondents by trained research assistants. The pediatric surgeon conducted the clinical examination of genital area in the index child of each respondent. A multi-staged sampling technique was used to select the household, and index child was randomly selected among the circumcised children in the household. The sample size was calculated with Fisher's formula, and by allowing for a 10% attrition rate, a total sample size of 422 was estimated.

Multistage sampling technique was used to select the subjects from households in compounds of various wards. Due consent was obtained from the household head and respondents after explaining the objectives of the study and confidentiality of findings was ensured. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software version 11.0 and Microsoft Excel for Windows 2007.