Randomised trial of early infant circumcision performed by clinical officers and registered nurse midwives using the Mogen clamp in Rakai, Uganda

Edward N. Kankaka, Teddy Murungi, Godfrey Kigozi, Frederick Makumbi, Dorean Nabukalu, Stephen Watya, Nehemiah Kighoma, Resty Nampijja, Daniel Kayiwa, Fred Nalugoda, David Serwadda, Maria Wawer, Ronald H. Gray

Research output: Contribution to journalArticle

Abstract

Objectives: To assess the safety and acceptability of early infant circumcision (EIC) provided by trained clinical officers (COs) and registered nurse midwives (RNMWs) in rural Uganda. Subjects and Methods: We conducted a randomised trial of EIC using the Mogen clamp provided by newly trained COs and RNMWs in four health centres in rural Rakai, Uganda. The trial was registered with clinicaltrials.gov # NCT02596282. In all, 501 healthy neonates aged 1–28 days with normal birth weight and gestational age were randomised to COs (n = 256) and RNMWs (n = 245) for EIC, and were followed-up at 1, 7 and 28 days. Results: In all, 701 mothers were directly invited to participate in the trial, 525 consented to circumcision (74.9%) and 23 were found ineligible on screening (4.4%). The procedure took an average of 10.5 min. Adherence to follow-up was >90% at all scheduled visits. The rates of moderate/severe adverse events were 2.4% for COs and 1.6% for RNMWs (P = 0.9). All wounds were healed by 28 days after circumcision. Maternal satisfaction with the procedure was 99.6% for infants circumcised by COs and 100% among infants circumcised by RNMWs. Conclusions: EIC was acceptable in this rural Ugandan population and can be safely performed by RNMWs who have direct contact with the mothers during pregnancy and delivery. EIC services should be made available to parents who are interested in the service.

Original languageEnglish (US)
Pages (from-to)164-170
Number of pages7
JournalBJU International
Volume119
Issue number1
DOIs
StatePublished - Jan 1 2017

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Keywords

  • Mogen clamp
  • Rakai
  • Uganda
  • early infant circumcision
  • non-physicians

ASJC Scopus subject areas

  • Urology

Cite this

Kankaka, E. N., Murungi, T., Kigozi, G., Makumbi, F., Nabukalu, D., Watya, S., Kighoma, N., Nampijja, R., Kayiwa, D., Nalugoda, F., Serwadda, D., Wawer, M., & Gray, R. H. (2017). Randomised trial of early infant circumcision performed by clinical officers and registered nurse midwives using the Mogen clamp in Rakai, Uganda. BJU International, 119(1), 164-170. https://doi.org/10.1111/bju.13589