Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study
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 Nd...
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| creator | Mutanekelwa, Imukusi Siziya, Seter Daka, Victor Kabelenga, Elijah Mfune, Ruth L Chileshe, Misheck Mulenga, David Nyirenda, Herbert Tato Nyirenda, Christopher Mudenda, Steward Mukanga, Bright Bowa, Kasonde |
| description | 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. 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 [greater than or equal to]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. 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. 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. |
| doi_str_mv | 10.1371/journal.pone.0256955 |
| format | Article |
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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. 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 [greater than or equal to]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. 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. 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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0256955</identifier><identifier>PMID: 34478471</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adverse events ; AIDS ; Chi-square test ; Circumcision ; Complications ; Complications and side effects ; Cross-sectional studies ; Demographics ; Demography ; Distribution ; Hematoma ; HIV ; Holidays & special occasions ; Human immunodeficiency virus ; Males ; Medicine and Health Sciences ; People and Places ; Public health ; Research and Analysis Methods ; Safety ; Sociodemographics ; Statistical tests ; Statistics ; Surgery ; Teaching hospitals ; Veterinary colleges ; Veterinary medicine ; Wound healing</subject><ispartof>PloS one, 2021-09, Vol.16 (9), p.e0256955-e0256955</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Mutanekelwa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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There is a need to explore other high priority national/regional areas of VMMC program safety/quality, such as adherence to follow-up visits.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adverse events</subject><subject>AIDS</subject><subject>Chi-square test</subject><subject>Circumcision</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Cross-sectional studies</subject><subject>Demographics</subject><subject>Demography</subject><subject>Distribution</subject><subject>Hematoma</subject><subject>HIV</subject><subject>Holidays & special occasions</subject><subject>Human immunodeficiency virus</subject><subject>Males</subject><subject>Medicine and Health Sciences</subject><subject>People and Places</subject><subject>Public health</subject><subject>Research and Analysis Methods</subject><subject>Safety</subject><subject>Sociodemographics</subject><subject>Statistical 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and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study</title><author>Mutanekelwa, Imukusi ; Siziya, Seter ; Daka, Victor ; Kabelenga, Elijah ; Mfune, Ruth L ; Chileshe, Misheck ; Mulenga, David ; Nyirenda, Herbert Tato ; Nyirenda, Christopher ; Mudenda, Steward ; Mukanga, Bright ; Bowa, Kasonde</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-8ae3287d44732ae62e5cf65cde539c04138ab3a7db252333b61b10624bbba2b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adverse events</topic><topic>AIDS</topic><topic>Chi-square test</topic><topic>Circumcision</topic><topic>Complications</topic><topic>Complications and side effects</topic><topic>Cross-sectional 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Seter</au><au>Daka, Victor</au><au>Kabelenga, Elijah</au><au>Mfune, Ruth L</au><au>Chileshe, Misheck</au><au>Mulenga, David</au><au>Nyirenda, Herbert Tato</au><au>Nyirenda, Christopher</au><au>Mudenda, Steward</au><au>Mukanga, Bright</au><au>Bowa, Kasonde</au><au>Lee, Richard Kao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study</atitle><jtitle>PloS one</jtitle><date>2021-09-03</date><risdate>2021</risdate><volume>16</volume><issue>9</issue><spage>e0256955</spage><epage>e0256955</epage><pages>e0256955-e0256955</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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. 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 [greater than or equal to]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. 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. 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.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34478471</pmid><doi>10.1371/journal.pone.0256955</doi><tpages>e0256955</tpages><orcidid>https://orcid.org/0000-0001-9490-5609</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2021-09, Vol.16 (9), p.e0256955-e0256955 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2569042513 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Adverse events AIDS Chi-square test Circumcision Complications Complications and side effects Cross-sectional studies Demographics Demography Distribution Hematoma HIV Holidays & special occasions Human immunodeficiency virus Males Medicine and Health Sciences People and Places Public health Research and Analysis Methods Safety Sociodemographics Statistical tests Statistics Surgery Teaching hospitals Veterinary colleges Veterinary medicine Wound healing |
| title | Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T03%3A23%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prevalence%20and%20correlates%20of%20voluntary%20medical%20male%20circumcision%20adverse%20events%20among%20adult%20males%20in%20the%20Copperbelt%20Province%20of%20Zambia:%20A%20cross-sectional%20study&rft.jtitle=PloS%20one&rft.au=Mutanekelwa,%20Imukusi&rft.date=2021-09-03&rft.volume=16&rft.issue=9&rft.spage=e0256955&rft.epage=e0256955&rft.pages=e0256955-e0256955&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0256955&rft_dat=%3Cgale_plos_%3EA674199261%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2569042513&rft_id=info:pmid/34478471&rft_galeid=A674199261&rft_doaj_id=oai_doaj_org_article_86a0820bc2fb49f58f57cb5ef7f5eb16&rfr_iscdi=true |