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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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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. |
format | Online Article Text |
id | pubmed-4583405 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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