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Meta-Analysis
. 2024 Mar 13;19(3):e0298387.
doi: 10.1371/journal.pone.0298387. eCollection 2024.

Estimates of the prevalence of male circumcision in sub-Saharan Africa from 2010-2023-A systematic review and meta-analysis

Basant Elsayed  1 , Mohamed Elmarasi  1 , Ruvarashe J Madzime  2 , Lovemore Mapahla  2 , Menatalla M S ElBadway  1 , Tawanda Chivese  1
Affiliations
Meta-Analysis

Estimates of the prevalence of male circumcision in sub-Saharan Africa from 2010-2023-A systematic review and meta-analysis

Basant Elsayed et al. PLoS One. .

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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow chart.
The figure shows the search process. Abbreviations: MC–male circumcision.
Fig 2
Fig 2. Forest plot showing the overall prevalence of male circumcision during 2010–2023.
The forest plot includes data from nationally representative studies only.
Fig 3
Fig 3. Changes in the prevalence of male circumcision in Eastern African countries during the period 2010–2023.
The graph shows the changes in the prevalence of male circumcision in Eastern African countries during the period 2010–2023.
Fig 4
Fig 4. Changes in the prevalence of male circumcision in Southern African countries during the period 2010–2023.
The graph shows the changes in the prevalence of male circumcision in Southern African countries during the period 2010–2023.
Fig 5
Fig 5. Maps showing changes in the prevalence of male circumcision in Eastern African countries during 2010–2015 and 2016–2023.
Maps showing the prevalence of male circumcision during 2010–2015 and 2016–2023 among sub-Saharan Africa countries.
See this image and copyright information in PMC

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