Outcomes of voluntary medical male circumcision performed by medical doctors and non‑doctor health workers in central Uganda
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
African Journal of Urology
Abstract
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.
Description
Keywords
Male circumcision, Africa, Uganda, Task shifting
Citation
Matumaini, H. K., Batte, A., Otwombe, K., Lebotsa, E., & Luboga, S. (2021). Outcomes of voluntary medical male circumcision performed by medical doctors and non-doctor health workers in central Uganda. African Journal of Urology, 27(1), 1-5. https://doi.org/10.1186/s12301-021-00156-8