Safety of over Twelve Hundred Infant Male Circumcisions Using the Mogen Clamp in Kenya 英文参考文献.docVIP

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Safety of over Twelve Hundred Infant Male Circumcisions Using the Mogen Clamp in Kenya 英文参考文献.doc

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Safety of over Twelve Hundred Infant Male Circumcisions Using the Mogen Clamp in Kenya 英文参考文献

SafetyofoverTwelveHundredInfantMaleCircumcisions UsingtheMogenClampinKenya MarisaR.Young1*,RobertC.Bailey1,2,ElijahOdoyo-June2,TracyE.Irwin3,WalterObiero2, DedanO.Ongong’a4,JacintaA.Badia5,KawangoAgot6,SherryK.Nordstrom3 1DepartmentofEpidemiologyandBiostatistics,UniversityofIllinoisatChicagoSchoolofPublicHealth,Chicago,Illinois,UnitedStatesofAmerica,2NyanzaReproductive Health Society, Kisumu, Kenya, 3Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States of America, 4Department of Surgery, Nyanza Provincial General Hospital, Kisumu, Kenya, 5CARE International, Kisii, Kenya, 6Impact Research and Development Organisation,Kisumu,Kenya Abstract Background: Several sub-Saharan African countries plan to scale-up infant male circumcision (IMC) for cost-efficient HIV prevention.LittledataexistaboutthesafetyofIMCinEastandsouthernAfrica.Wecalculatedadverseevent(AE)rateand risksforAEsassociatedwithintroductionofIMCservicesatfivegovernmenthealthfacilitiesinwesternKenya. Methods:AEdatawereanalyzedforIMCproceduresperformedbetweenSeptember,2009andNovember,2011.Healthy infants aged #2 months and weighing $2.5kg were eligible for IMC. Following parental consent, trained clinicians provided IMC services free of charge under local anesthesia using the Mogen clamp. Odds ratios and 95% confidence intervalswereusedtoexploreAEriskfactors. Findings:Atotalof1,239IMCprocedureswereperformed.Medianageofinfantswas4days(IQR=1,16).TheoverallAE rateamonginfantsreviewedpost-operativelywas2.7%(18/678;95%CI:1.4,3.9).TherewasonesevereAEinvolvingexcision ofasmallpieceofthelateralaspectoftheglanspenis.OtherAEsweremildormoderateandweretreatedconservatively. BabiesonemonthofageorolderweremorelikelytohaveanAE(OR3.20;95%CI:1.23,8.36).AEratedidnotdifferbynurse versusclinicalofficerornumberofpreviousproceduresperformed. Conclusion:IMCservicesprovidedinKenyanGovernmenthospitalsinthecontextofroutineIMCprogramminghaveAE ratescomparableto