Browsing by Author "Otwombe, Kennedy"

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    Outcomes of male circumcision performed by medical doctors and non–doctor health workers in central Uganda
    (Research Square, 2020) Kibansha Matumaini, Hope; Batte, Anthony; Otwombe, Kennedy; Lebotsa, Emily; Luboga, Sam
    Task shifting for male circumcision is still a challenge. The aim of this study was to evaluate the outcomes of circumcision conducted by doctors compared to non-doctors in Kampala, Uganda Results: In this prospective cohort study, we observed and followed 274 males at 3 health facilities in Kampala, Uganda. Each participant was observed during the circumcision procedure, monitored for 2 hours post-surgery and assessed at 24hours, 3 days and after one week for adverse events. The mean age of the circumcised men was 24.82 (6.36) years. Of the circumcisions, 19.3% (53/274) were carried out by doctors while 80.7% (221/274) by non-doctor health workers. About 5.47% (15/274) experienced adverse events and the proportions by cadre were similar; medical doctors (5.66% [3/53]) and non-doctor health workers (5.43% [12/221]), p=0.99. Seven patients had evidence of pus discharge (all had been operated by non-doctors), only 2 patients had bleeding at 2 hours (one by medical doctor and one by nondoctor), 4 patients had evidence of excessive skin removal (2 by medical doctor vs 2 by non-doctors). There was no reported urethral injury or glans amputation. These results indicate that non-doctor health workers can offer circumcision services safely with low adverse event rates.
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    Outcomes of voluntary medical male circumcision performed by medical doctors and non‑doctor health workers in central Uganda
    (African Journal of Urology, 2021) Kibansha Matumaini, Hope; Batte, Anthony; Otwombe, Kennedy; Lebotsa, Emily; Luboga, Sam
    Voluntary medical male circumcision (VMMC) reduces the risk of HIV transmission. Task shifting of VMMCs to non-doctor health workers is recommended to enhance scale-up of VMMC programs. This study evaluated outcomes of circumcision conducted by doctors compared to non-doctors in central Uganda. Methods: In this prospective observational study, we observed and followed 274 males at 3 health facilities in Kampala, Uganda. Each participant was observed during the circumcision procedure, monitored for 2 h post-surgery and assessed at 24 h, 3 days and after one week for adverse events. Results: The median age of the circumcised men was 24.00(IQR, 20.00–28.00) years. Of the VMMCs, 19.3% (53/274) were carried out by doctors while 80.7% (221/274) by non-doctors. Following VMMC, 5.47% (15/274) men experienced adverse events and proportions of adverse events by cadre were similar; doctors (5.66% [3/53]) and non-doctor health workers (5.43% [12/221]), p = 0.99. Seven participants had pus discharge (all had been operated by non-doctors), 2 participants had bleeding at 2 h (one by doctor and one by non-doctor), and 4 participants had excessive skin removal (2 by doctors vs 2 by non-doctors). There was no reported urethral injury or glans amputation. Conclusion: Our study found no statistically significant difference in the incidence of adverse events among VMMCs conducted by doctors compared to non-doctor health workers. Our study showed no incidence of serious adverse events such as death, urethral injury or glans amputation following VMMCs. Our results add to the existing literature to guide task shifting in the context of VMMCs.