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Piloting PrePex for Adult and Adolescent Male Circumcision in South Africa – Pain Is an Issue

BACKGROUND: The World Health Organisation and the Joint United Nations Programme on HIV/AIDS have recommended the scale-up of Medical Male Circumcision (MMC) in countries with high HIV and low MMC prevalence. PrePex device circumcision is proposed as an alternate method for scaling up MMC. OBJECTIVE...

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Autores principales: Lebina, Limakatso, Taruberekera, Noah, Milovanovic, Minja, Hatzold, Karin, Mhazo, Miriam, Nhlapo, Cynthia, Tshabangu, Nkeko, Manentsa, Mmatsie, Kazangarare, Victoria, Makola, Millicent, Billy, Scott, Martinson, Neil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583405/
https://www.ncbi.nlm.nih.gov/pubmed/26405786
http://dx.doi.org/10.1371/journal.pone.0138755
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author Lebina, Limakatso
Taruberekera, Noah
Milovanovic, Minja
Hatzold, Karin
Mhazo, Miriam
Nhlapo, Cynthia
Tshabangu, Nkeko
Manentsa, Mmatsie
Kazangarare, Victoria
Makola, Millicent
Billy, Scott
Martinson, Neil
author_facet Lebina, Limakatso
Taruberekera, Noah
Milovanovic, Minja
Hatzold, Karin
Mhazo, Miriam
Nhlapo, Cynthia
Tshabangu, Nkeko
Manentsa, Mmatsie
Kazangarare, Victoria
Makola, Millicent
Billy, Scott
Martinson, Neil
author_sort Lebina, Limakatso
collection PubMed
description BACKGROUND: The World Health Organisation and the Joint United Nations Programme on HIV/AIDS have recommended the scale-up of Medical Male Circumcision (MMC) in countries with high HIV and low MMC prevalence. PrePex device circumcision is proposed as an alternate method for scaling up MMC. OBJECTIVE: Evaluate safety and feasibility of PrePex in South Africa. DESIGN: A multisite prospective cohort PrePex study in adults and adolescents at three MMC clinics. Participants were followed-up 8 times, up to 56 days after PrePex placement. RESULTS: In total, 398 PrePex circumcisions were performed (315 adults and 83 adolescents) their median ages were 26 (IQR: 22–30) and 16 years (IQR: 15–17), respectively. The median time for device placement across both groups was 6 minutes (IQR: 5–9) with the leading PrePex sizes being B (30%) and C (35%) for adults (18–45 years), and A (31%) and B (38%) for adolescents (14–17 years). Additional sizes (size 12–20) were rarely used, even in the younger age group. Pain of device application was minimal but that of removal was severe. However, described pain abated rapidly and almost no pain was reported 1 hour after removal. The Adverse Events rate were experienced by 2.7% (11/398) of all participants, three of which were serious (2 displacements and 1 self-removal requiring prompt surgery). None of the Adverse Events required hospitalization. The majority of participants returned to work within a day of device placement. CONCLUSION: Our study shows that PrePex is a safe MMC method, for males 14 years and above. PrePex circumcision had a similar adverse event rate to that reported for surgical MMC, but device removal caused high levels of pain, which subsided rapidly.
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spelling pubmed-45834052015-10-02 Piloting PrePex for Adult and Adolescent Male Circumcision in South Africa – Pain Is an Issue Lebina, Limakatso Taruberekera, Noah Milovanovic, Minja Hatzold, Karin Mhazo, Miriam Nhlapo, Cynthia Tshabangu, Nkeko Manentsa, Mmatsie Kazangarare, Victoria Makola, Millicent Billy, Scott Martinson, Neil PLoS One Research Article BACKGROUND: The World Health Organisation and the Joint United Nations Programme on HIV/AIDS have recommended the scale-up of Medical Male Circumcision (MMC) in countries with high HIV and low MMC prevalence. PrePex device circumcision is proposed as an alternate method for scaling up MMC. OBJECTIVE: Evaluate safety and feasibility of PrePex in South Africa. DESIGN: A multisite prospective cohort PrePex study in adults and adolescents at three MMC clinics. Participants were followed-up 8 times, up to 56 days after PrePex placement. RESULTS: In total, 398 PrePex circumcisions were performed (315 adults and 83 adolescents) their median ages were 26 (IQR: 22–30) and 16 years (IQR: 15–17), respectively. The median time for device placement across both groups was 6 minutes (IQR: 5–9) with the leading PrePex sizes being B (30%) and C (35%) for adults (18–45 years), and A (31%) and B (38%) for adolescents (14–17 years). Additional sizes (size 12–20) were rarely used, even in the younger age group. Pain of device application was minimal but that of removal was severe. However, described pain abated rapidly and almost no pain was reported 1 hour after removal. The Adverse Events rate were experienced by 2.7% (11/398) of all participants, three of which were serious (2 displacements and 1 self-removal requiring prompt surgery). None of the Adverse Events required hospitalization. The majority of participants returned to work within a day of device placement. CONCLUSION: Our study shows that PrePex is a safe MMC method, for males 14 years and above. PrePex circumcision had a similar adverse event rate to that reported for surgical MMC, but device removal caused high levels of pain, which subsided rapidly. Public Library of Science 2015-09-25 /pmc/articles/PMC4583405/ /pubmed/26405786 http://dx.doi.org/10.1371/journal.pone.0138755 Text en © 2015 Lebina et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Lebina, Limakatso
Taruberekera, Noah
Milovanovic, Minja
Hatzold, Karin
Mhazo, Miriam
Nhlapo, Cynthia
Tshabangu, Nkeko
Manentsa, Mmatsie
Kazangarare, Victoria
Makola, Millicent
Billy, Scott
Martinson, Neil
Piloting PrePex for Adult and Adolescent Male Circumcision in South Africa – Pain Is an Issue
title Piloting PrePex for Adult and Adolescent Male Circumcision in South Africa – Pain Is an Issue
title_full Piloting PrePex for Adult and Adolescent Male Circumcision in South Africa – Pain Is an Issue
title_fullStr Piloting PrePex for Adult and Adolescent Male Circumcision in South Africa – Pain Is an Issue
title_full_unstemmed Piloting PrePex for Adult and Adolescent Male Circumcision in South Africa – Pain Is an Issue
title_short Piloting PrePex for Adult and Adolescent Male Circumcision in South Africa – Pain Is an Issue
title_sort piloting prepex for adult and adolescent male circumcision in south africa – pain is an issue
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583405/
https://www.ncbi.nlm.nih.gov/pubmed/26405786
http://dx.doi.org/10.1371/journal.pone.0138755
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