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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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
背景：男性包皮环切术（MC）是预防艾滋病毒的一揽子干预措施的关键部分，撒哈拉以南非洲最大的健康挑战。
目的：估计2010-2023年期间撒哈拉以南非洲地区男性包皮环切术的患病率，并评估实现世卫组织目标的进展。
方法：我们对2010-2023年期间发表的研究进行了系统综述和荟萃分析。我们搜索了PubMed,Scopus,科克伦中部,谷歌学者，世卫组织和人口和健康调查关于撒哈拉以南非洲MC患病率的报告。MC患病率使用逆方差异质性模型合成，使用I2统计的异质性和使用漏斗图的发表偏倚。
结果：共纳入53项研究。研究期间的总体患病率为45.9％（95％CI32.3-59.8），东部的MC患病率较高(69.9%，95CI49.9-86.8）与南部非洲（33.3%，95CI21.7-46.2)。城市总体患病率较高(45.3%，95CI27.7-63.4）与农村地区相比（42.6%，95%26.5-59.5）。男性包皮环切患病率从2010-2015年的40.2%（95%CI25.0-56.3）上升到2016-2023年的56.2%（95%CI31.5-79.5）。三个国家的MC覆盖率超过了80%，即,埃塞俄比亚,肯尼亚和坦桑尼亚。
结论：总体而言，目前MC患病率低于50%，东非国家的患病率较高，南部非洲的患病率较低。大多数优先国家需要采取更多措施来扩大医疗男性包皮环切术计划。
目的：估计2010-2023年期间撒哈拉以南非洲地区男性包皮环切术的患病率，并评估实现世卫组织目标的进展。
方法：我们对2010-2023年期间发表的研究进行了系统综述和荟萃分析。我们搜索了PubMed,Scopus,科克伦中部,谷歌学者，世卫组织和人口和健康调查关于撒哈拉以南非洲MC患病率的报告。MC患病率使用逆方差异质性模型合成，使用I2统计的异质性和使用漏斗图的发表偏倚。
结果：共纳入53项研究。研究期间的总体患病率为45.9％（95％CI32.3-59.8），东部的MC患病率较高(69.9%，95CI49.9-86.8）与南部非洲（33.3%，95CI21.7-46.2)。城市总体患病率较高(45.3%，95CI27.7-63.4）与农村地区相比（42.6%，95%26.5-59.5）。男性包皮环切患病率从2010-2015年的40.2%（95%CI25.0-56.3）上升到2016-2023年的56.2%（95%CI31.5-79.5）。三个国家的MC覆盖率超过了80%，即,埃塞俄比亚,肯尼亚和坦桑尼亚。
结论：总体而言，目前MC患病率低于50%，东非国家的患病率较高，南部非洲的患病率较低。大多数优先国家需要采取更多措施来扩大医疗男性包皮环切术计划。
