Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study.

<h4>Background</h4>Voluntary Medical Male Circumcision (VMMC) is a key intervention in HIV/AIDS. Improving VMMC program uptake in Zambia requires careful monitoring of adverse events (AE) to inform program quality and safety. We investigate the prevalence of VMMC AE and their associated...

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Autores principales:	Imukusi Mutanekelwa, Seter Siziya, Victor Daka, Elijah Kabelenga, Ruth L Mfune, Misheck Chileshe, David Mulenga, Herbert Tato Nyirenda, Christopher Nyirenda, Steward Mudenda, Bright Mukanga, Kasonde Bowa
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/86a0820bc2fb49f58f57cb5ef7f5eb16
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spelling	oai:doaj.org-article:86a0820bc2fb49f58f57cb5ef7f5eb162021-12-02T20:14:49ZPrevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study.1932-620310.1371/journal.pone.0256955https://doaj.org/article/86a0820bc2fb49f58f57cb5ef7f5eb162021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256955https://doaj.org/toc/1932-6203<h4>Background</h4>Voluntary Medical Male Circumcision (VMMC) is a key intervention in HIV/AIDS. Improving VMMC program uptake in Zambia requires careful monitoring of adverse events (AE) to inform program quality and safety. We investigate the prevalence of VMMC AE and their associated factors among adult males in Ndola, Copperbelt Province, Zambia.<h4>Methods</h4>We performed a cross-sectional study using secondary clinical data collected in 2015 using two validated World Health Organisation/Ministry of Health reporting forms. We reviewed demographics and VMMC surgical details from 391 randomly sampled adult males aged ≥18 years at Ndola Teaching Hospital, a specialised VMMC fixed site in Zambia. Non-parametric tests (Fisher's exact test or Chi-square depending on assumptions being met) and logistic regression were conducted to determine the relationships between associated factors and VMMC AE.<h4>Results</h4>The overall VMMC AE prevalence was 3.1% (95% CI 1.60%- 5.30%) and most AEs occurred postoperatively. In decreasing order, the commonly reported VMMC AE included; bleeding (47.1%), swelling (29.4%), haematoma (17.6%), and delayed wound healing (5.9%). There was an inversely proportional relationship between VMMC volume (as measured by the number of surgeries conducted per VMMC provider) and AEs. Compared to the highest VMMC volume of 63.2% (247/391) as reference, as VMMC volume reduced to 35.0% (137/391) and then 1.8% (7/391), the likelihood of AEs increased by five times (aOR 5.08; 95% CI 1.33-19.49; p = 0.018) and then sixteen times (aOR 16.13; 95% CI 1.42-183.30; p = 0.025) respectively.<h4>Conclusions</h4>Our study found a low prevalence of VMMC AEs in Ndola city, Copperbelt Province of Zambia guaranteeing the safety of the VMMC program. We recommend more surgically proficient staff to continue rendering this service. There is a need to explore other high priority national/regional areas of VMMC program safety/quality, such as adherence to follow-up visits.Imukusi MutanekelwaSeter SiziyaVictor DakaElijah KabelengaRuth L MfuneMisheck ChilesheDavid MulengaHerbert Tato NyirendaChristopher NyirendaSteward MudendaBright MukangaKasonde BowaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0256955 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Imukusi Mutanekelwa Seter Siziya Victor Daka Elijah Kabelenga Ruth L Mfune Misheck Chileshe David Mulenga Herbert Tato Nyirenda Christopher Nyirenda Steward Mudenda Bright Mukanga Kasonde Bowa Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study.
description	<h4>Background</h4>Voluntary Medical Male Circumcision (VMMC) is a key intervention in HIV/AIDS. Improving VMMC program uptake in Zambia requires careful monitoring of adverse events (AE) to inform program quality and safety. We investigate the prevalence of VMMC AE and their associated factors among adult males in Ndola, Copperbelt Province, Zambia.<h4>Methods</h4>We performed a cross-sectional study using secondary clinical data collected in 2015 using two validated World Health Organisation/Ministry of Health reporting forms. We reviewed demographics and VMMC surgical details from 391 randomly sampled adult males aged ≥18 years at Ndola Teaching Hospital, a specialised VMMC fixed site in Zambia. Non-parametric tests (Fisher's exact test or Chi-square depending on assumptions being met) and logistic regression were conducted to determine the relationships between associated factors and VMMC AE.<h4>Results</h4>The overall VMMC AE prevalence was 3.1% (95% CI 1.60%- 5.30%) and most AEs occurred postoperatively. In decreasing order, the commonly reported VMMC AE included; bleeding (47.1%), swelling (29.4%), haematoma (17.6%), and delayed wound healing (5.9%). There was an inversely proportional relationship between VMMC volume (as measured by the number of surgeries conducted per VMMC provider) and AEs. Compared to the highest VMMC volume of 63.2% (247/391) as reference, as VMMC volume reduced to 35.0% (137/391) and then 1.8% (7/391), the likelihood of AEs increased by five times (aOR 5.08; 95% CI 1.33-19.49; p = 0.018) and then sixteen times (aOR 16.13; 95% CI 1.42-183.30; p = 0.025) respectively.<h4>Conclusions</h4>Our study found a low prevalence of VMMC AEs in Ndola city, Copperbelt Province of Zambia guaranteeing the safety of the VMMC program. We recommend more surgically proficient staff to continue rendering this service. There is a need to explore other high priority national/regional areas of VMMC program safety/quality, such as adherence to follow-up visits.
format	article
author	Imukusi Mutanekelwa Seter Siziya Victor Daka Elijah Kabelenga Ruth L Mfune Misheck Chileshe David Mulenga Herbert Tato Nyirenda Christopher Nyirenda Steward Mudenda Bright Mukanga Kasonde Bowa
author_facet	Imukusi Mutanekelwa Seter Siziya Victor Daka Elijah Kabelenga Ruth L Mfune Misheck Chileshe David Mulenga Herbert Tato Nyirenda Christopher Nyirenda Steward Mudenda Bright Mukanga Kasonde Bowa
author_sort	Imukusi Mutanekelwa
title	Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study.
title_short	Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study.
title_full	Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study.
title_fullStr	Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study.
title_full_unstemmed	Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study.
title_sort	prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the copperbelt province of zambia: a cross-sectional study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/86a0820bc2fb49f58f57cb5ef7f5eb16
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Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study.

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