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Randomised trial of early infant circumcision performed by clinical officers and registered nurse midwives using the Mogen clamp in Rakai, Uganda
Author(s) -
Kankaka Edward N.,
Murungi Teddy,
Kigozi Godfrey,
Makumbi Frederick,
Nabukalu Dorean,
Watya Stephen,
Kighoma Nehemiah,
Nampijja Resty,
Kayiwa Daniel,
Nalugoda Fred,
Serwadda David,
Wawer Maria,
Gray Ronald H.
Publication year - 2017
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13589
Subject(s) - medicine , male circumcision , nursing , obstetrics , family medicine , population , health services , environmental health
Objectives To assess the safety and acceptability of early infant circumcision ( EIC ) provided by trained clinical officers ( CO s) and registered nurse midwives ( RNMW s) in rural Uganda. Subjects and Methods We conducted a randomised trial of EIC using the Mogen clamp provided by newly trained CO s and RNMW s in four health centres in rural Rakai, Uganda. The trial was registered with clinicaltrials.gov # NCT 02596282. In all, 501 healthy neonates aged 1–28 days with normal birth weight and gestational age were randomised to CO s ( n = 256) and RNMW s ( n = 245) for EIC , and were followed‐up at 1, 7 and 28 days. Results In all, 701 mothers were directly invited to participate in the trial, 525 consented to circumcision (74.9%) and 23 were found ineligible on screening (4.4%). The procedure took an average of 10.5 min. Adherence to follow‐up was >90% at all scheduled visits. The rates of moderate/severe adverse events were 2.4% for CO s and 1.6% for RNMW s ( P = 0.9). All wounds were healed by 28 days after circumcision. Maternal satisfaction with the procedure was 99.6% for infants circumcised by CO s and 100% among infants circumcised by RNMW s. Conclusions EIC was acceptable in this rural Ugandan population and can be safely performed by RNMW s who have direct contact with the mothers during pregnancy and delivery. EIC services should be made available to parents who are interested in the service.