A controlled trial of three methods for neonatal circumcision in Lusaka, Zambia
Published Date:Jan 1 2013
Source:J Acquir Immune Defic Syndr. 62(1):e1-e6.
Funding:D43 TW001035/TW/FIC NIH HHS/United States
U2G PS002793/PS/NCHHSTP CDC HHS/United States
Neonatal male circumcision (NMC) is not routinely practiced in Zambia, but it promising long-term HIV prevention strategy. We studied the feasibility and safety of three different NMC methods
Patients and Methods
We enrolled healthy newborns in a controlled trial of the Mogen, Gomco, and Plastibell devices. Doctors, nurses, and clinical officers were trained to perform Mogen, Gomco, and Plastibell techniques. Each provider performed at least 10 circumcisions using each device. Neonates were reviewed at one week and six weeks post circumcision for adverse events.
Between October 2009 and March 2011, 17 providers (5 physicians, 9 nurse-midwives, and 3 clinical officers) without prior NMC experience were trained, and 640 circumcisions performed. The median infant birth weight was 3.2kg (IQR 2.9–3.5 kg) and median age at the time of procedure was 11 days (IQR:7–18 days); 149 babies (23.3%) were HIV-exposed. The overall adverse event rate was 4.9% (n=31/630), and the moderate-severe AE rate was 4.1% (n=26/630). Write in what this was. Rates did not significantly differ by method. Most providers (65%) preferred the Mogen clamp over the Gomco and Plastibell.
Doctors, nurses, and clinical officers can be trained to safely provide NMC in a programmatic setting. The three studied techniques had comparable safety profiles. Mogen clamp was the preferred device for most providers.
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