Safety of over Twelve Hundred Infant Male Circumcisions
Using the Mogen Clamp in Kenya
Marisa R. Young
Robert C. Bailey
Elijah Odoyo-June
Tracy E. Irwin
Walter Obiero
Dedan O. Ongong’a
Jacinta A. Badia
Kawango Agot
Sherry K. Nordstrom
10027/10342
https://indigo.uic.edu/articles/journal_contribution/Safety_of_over_Twelve_Hundred_Infant_Male_Circumcisions_Using_the_Mogen_Clamp_in_Kenya/10755557
Background: Several sub-Saharan African countries plan to scale-up infant male circumcision (IMC) for cost-efficient HIV
prevention. Little data exist about the safety of IMC in East and southern Africa. We calculated adverse event (AE) rate and
risks for AEs associated with introduction of IMC services at five government health facilities in western Kenya.
Methods: AE data were analyzed for IMC procedures performed between September, 2009 and November, 2011. Healthy
infants aged ≤2 months and weighing ≥2.5 kg were eligible for IMC. Following parental consent, trained clinicians
provided IMC services free of charge under local anesthesia using the Mogen clamp. Odds ratios and 95% confidence
intervals were used to explore AE risk factors.
Findings: A total of 1,239 IMC procedures were performed. Median age of infants was 4 days (IQR = 1, 16). The overall AE
rate among infants reviewed post-operatively was 2.7% (18/678; 95%CI: 1.4, 3.9). There was one severe AE involving excision
of a small piece of the lateral aspect of the glans penis. Other AEs were mild or moderate and were treated conservatively.
Babies one month of age or older were more likely to have an AE (OR 3.20; 95%CI: 1.23, 8.36). AE rate did not differ by nurse
versus clinical officer or number of previous procedures performed.
Conclusion: IMC services provided in Kenyan Government hospitals in the context of routine IMC programming have AE
rates comparable to those in developed countries. The optimal time for IMC is within the first month of life.
2013-10-31 00:00:00
untagged