Published in PLOS One on 2026-07-16, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Jaber Hamad Jaber Amin, Mohamedelmustafa Yahya Mohamed Eldouma, Sakshi Kumari, Ahmed Alshafei Elmahi Ahmed, Alshafee Mohammed Jebreel Sulyman, Amna A. Eltayeb, Asjad Zainalabdeen Ahmed, Huyam Elsir Fadlelseed Babiker, Tanzeel Mohamedain Abuelgasim Abdalla, Dania A. Elsiddig, Majdy Jailany Alamin Abdelgadir, Nooralsham Abdalla Adam Yousif, Israa Osman Ali Alhassan, Zainab Salih Ahmed Adam, Ahmed Yahia Mahadi Babiker, Mohammed Hammad Jaber Amin, Leina Elomeiri
Source: PLOS One • DOI 10.1371/journal.pone.0328341
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Traditional uvulectomy (TU) is the removal of the uvula, either partially or totally, by the traditional healer. It is prevalent in sub-Saharan Africa, driven by cultural beliefs and perceived therapeutic benefits, despite the risks of complications such as bleeding, infections, and death, and limited data exist. Our study aimed to assess the prevalence and practice of traditional uvulectomy among Sudanese children and adolescents, along with maternal perceptions, and identify associated risk factors.
A descriptive community-based cross-sectional study was conducted between January and April 2025 across more than ten states on mothers of children and adolescents (≤18 years). Data were collected via face-to-face interviews using a validated structured questionnaire to assess the socio-demographics, TU perception regarding TU, practice pattern, and reported complications. A convenience sampling technique was used. Statistical analyses were performed using R software, with p < 0.05 considered statistically significant.
A total of 1,135 mothers of children and adolescents (≤18 years) were interviewed face-to-face. The overall prevalence of TU was 15%, with higher rates among children <6 years (16%) and adolescents aged 12–18 years (17%). Maternal belief in TU varied significantly by child age (p < 0.001). Commonly cited reasons included breastfeeding difficulties (18%), cultural tradition (16%), and failure to thrive (13%). Mothers (45%) and grandmothers (41%) were the primary decision-makers, while traditional healers performed 55% of procedures, frequently using unsterilized instruments. Reported complications included fever (35%), feeding difficulties (21%), and bleeding (13%). TU practice was significantly associated with younger maternal age, lower educational attainment, higher parity, and strong adherence to tribal traditions (all p < 0.001).
Traditional uvulectomy remains prevalent in Sudan due to deeply rooted cultural beliefs, intergenerational influence, and gaps in healthcare access. Targeted, culturally sensitive interventions engaging tribal leaders, grandmothers, and traditional healers, alongside improved health education and service accessibility, are essential to reduce associated child health risks.
Introduction
Traditional uvulectomy (TU) refers to the partial or complete removal of the uvula, typically performed by traditional healers. The uvula is a small, fleshy structure suspended from the posterior margin of the soft palate between the palatine tonsils. It plays an important role in speech articulation, lubrication of the oropharyngeal mucosa, immune defense through antibody-rich secretions, and coordination with the soft palate to prevent nasopharyngeal regurgitation and aspiration during swallowing [1–3]. Developmentally, the uvula forms through fusion of the soft palate during the 11th week of gestation and is supplied by branches of the ascending pharyngeal and palatine arteries, with innervation from the glossopharyngeal and lesser palatine nerves [4–6].
In many low- and middle-income settings, traditional healers are trusted providers of healthcare, offering culturally accepted remedies and procedures that are transmitted across generations [7,8]. Although uvulectomy is rarely performed within formal healthcare settings, except as part of specific surgical interventions such as uvulopalatoplasty or adenotonsillectomy, it remains widely practiced as a traditional procedure [9,10]. TU is prevalent across sub-Saharan Africa, including Nigeria, Kenya, Sierra Leone, Tanzania, Ethiopia, South Africa, and Sudan [11–17], and has also been reported in Israel, Saudi Arabia, and other Middle Eastern countries [11,18,19]. Cultural beliefs, family traditions, and socioeconomic constraints strongly perpetuate the practice; for instance, previous studies report that up to one-third of mothers endorse TU, with family tradition cited as a major motivating factor [17]. Low educational attainment, limited access to healthcare services, and broader structural inequities further reinforce reliance on traditional practices [20,21].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Jaber Hamad Jaber Amin, Mohamedelmustafa Yahya Mohamed Eldouma, Sakshi Kumari, Ahmed Alshafei Elmahi Ahmed, Alshafee Mohammed Jebreel Sulyman, Amna A. Eltayeb, Asjad Zainalabdeen Ahmed, Huyam Elsir Fadlelseed Babiker, Tanzeel Mohamedain Abuelgasim Abdalla, Dania A. Elsiddig, Majdy Jailany Alamin Abdelgadir, Nooralsham Abdalla Adam Yousif, Israa Osman Ali Alhassan, Zainab Salih Ahmed Adam, Ahmed Yahia Mahadi Babiker, Mohammed Hammad Jaber Amin, Leina Elomeiri. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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