Bleeding disorder ‘may be linked to circumcision deaths’

The hereditary bleeding disorder haemophilia could be a reason for the deaths in some circumcision rituals, blood disease awareness foundation Igazi has said.

“Mild or moderate cases of haemophilia often only come to light after an injury, dental work, or surgery,” nurse Henry Steenkamp said.

Steenkamp is working with the organisation on an education and outreach programme, the foundation said.

“As a result, initiates who may have a less severe form of the condition – and who may not previously have experienced an uncontrolled bleed – may not be aware of the fact that they are at risk following a traditional circumcision.”

According to the Traditional Circumcision Act, initiates must be over 16, consent to the procedure, and undergo mandatory routine testing before retreating to the rural areas where rituals are performed.

The routine tests include a full blood count, HIV screening, viral studies, and chest X-rays to determine whether they have tuberculosis.

However, the tests do not include a partial thromboplastin time (PTT) test. This is used to evaluate the blood’s ability to clot and is used to diagnose haemophilia.

“If we could get the PTT test included as part of the routine screening procedure we could identify high-risk individuals, and be in a stronger position to assist both initiates and traditional authorities to manage the risk of excessive bleeding following circumcision,” Steenkamp said.

He said in cases where initiates were tested and high-risk individuals were managed, there had not been a single death. This made a good argument for including the test in the routine check-up.

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