Surgical Outcomes of Newly Trained ShangRing Circumcision Providers
Autor: | Zude Zyambo, Philip S. Li, Richard K. Lee, Marc Goldstein, Robert Zulu, Raymond O. Simba, Mark A. Barone, Quentin Awori, Stephanie Combes, Catherine Hart, Kawango Agot, Jaim Jou Lai, Paul J. Feldblum |
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Rok vydání: | 2016 |
Předmět: |
Male
0301 basic medicine medicine.medical_specialty Health Personnel Human immunodeficiency virus (HIV) MEDLINE Zambia HIV Infections outcomes medicine.disease_cause ShangRing 03 medical and health sciences 0302 clinical medicine Patient satisfaction male circumcision medicine Humans Pharmacology (medical) Prospective Studies 030212 general & internal medicine skill Pain score circumcision device training business.industry Incidence (epidemiology) Cosmesis 030112 virology Surgery Treatment Outcome Infectious Diseases Circumcision Male Patient Satisfaction Male circumcision Family medicine Supplement Article Observational study business |
Zdroj: | Journal of Acquired Immune Deficiency Syndromes (1999) |
ISSN: | 1525-4135 |
Popis: | Background Devices can potentially accelerate scale-up of voluntary medical male circumcision in sub-Saharan Africa. Studies have demonstrated advantages of the ShangRing device over conventional circumcision. With the need to train providers rapidly for scale-up, concerns arise about the transferability of techniques and the expertise of new trainees. Methods We compared outcomes of ShangRing circumcisions conducted in Kenya by experienced providers (experience with more than 100 ShangRing circumcisions) and newly trained providers (trained in Kenya by the experienced providers before the study began). During training, trainees performed at least 7 ShangRing circumcisions and 3 removals. Newly trained providers received intermittent clinical mentoring initially during the study but otherwise conducted circumcisions on their own. Results Four hundred six and 115 ShangRing procedures were performed by the new trainees and the experienced providers, respectively. The mean duration of circumcisions was 6.2 minutes for both trained and experienced provider groups (P = 0.45), whereas the mean pain score (on an 11-point scale) was 2.5 and 3.2, respectively (P = 0.65). There was no difference in the proportion of participants healed by the day 42 visit (P = 0.13) nor in the incidence of moderate and severe adverse events observed (P = 0.16). Participants in both groups were equally satisfied with final wound cosmesis. Discussion Results demonstrate that the ShangRing circumcision technique is easy to learn and master. Newly trained providers can safely conduct ShangRing circumcisions in routine service settings. The ShangRing can facilitate rapid rollout of voluntary medical male circumcision for HIV prevention in sub-Saharan Africa. |
Databáze: | OpenAIRE |
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