Evidence map›Paper›PMID 27331590›Full record

ArticleJournal of acquired immune deficiency syndromes (1999)2016

Safety, Feasibility, and Acceptability of the PrePex Device for Adult Male Circumcision in Malawi.

Pamela K Kohler, Beth A Tippett Barr, Anderson Kangʼombe, Carola Hofstee, Franklin Kilembe, Sean Galagan, David Chilongozi, Dorothy Namate, Medson Machaya, Khuliena Kabwere and 4 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of acquired immune deficiency syndromes (1999), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. VMMC Devices-Introducing a New Innovation to a Public Health Intervention.Journal of acquired immune deficiency syndromes (1999) · 2016
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Pamela K Kohler*Department of Global Health, University of Washington, Seattle, WA; †Department of Psychosocial and Community Health, University of Washington, Seattle, WA; ‡Health Services, US Centers for Disease Control and Prevention, Lilongwe, Malawi; §Banja La Mtsogolo, Blantyre, Malawi; ‖Médecin Sans Frontières, Nsanje, Malawi; ¶International Training and Education Center for Health, Lilongwe, Malawi; #Malawi Ministry of Health, Lilongwe, Malawi; **US Centers for Disease Control and Prevention, Atlanta, Georgia; and ††Jhpiego, An affiliate of Johns Hopkins University, Washington, DC.
Beth A Tippett Barr
Anderson Kangʼombe
Carola Hofstee
Franklin Kilembe
Sean Galagan
David Chilongozi
Dorothy Namate
Medson Machaya
Khuliena Kabwere
Mwawi Mwale
Wezi Msunguma
Jason Reed
Frank Chimbwandira

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI Grace C. John-Stewart · 1988 to 2026
$104.9M
NIAID NIH HHS P30 AI027757
6 · The paper itself

Abstract

introductionNonsurgical adult male circumcision devices present an alternative to surgery where health resources are limited. This study aimed to assess the safety, feasibility, and acceptability of the PrePex device for adult male circumcision in Malawi.

methodsA prospective single-arm cohort study was conducted at 3 sites (1 urban static, 1 rural static, 1 rural tent) in Malawi. Adverse event (AE) outcomes were stratified to include/exclude pain, and confidence intervals (CIs) were corrected for clinic-level clustering.

resultsAmong 935 men screened, 131 (14.0%) were not eligible, 13 (1.4%) withdrew before placement, and 791 (84.6%) received the device. Moderate and severe AEs totaled 7.1% including pain [95% CI: 3.4-14.7] and 4.0% excluding pain (95% CI: 2.6 to 6.4). Severe AEs included pain (n = 3), insufficient skin removal (n = 4), and early removal (n = 4). Among early removals, 1 had immediate surgical circumcision, 1 had surgery after 48 hours of observation, 1 declined surgery, and 1 did not return to our site although presented at a nearby clinic. More than half of men (51.9%) reported odor; however, few (2.2%) stated they would not recommend the device to others because of odor. Median levels of reported pain (scale, 1-10) were 2 (interquartile range, 2-4) during application and removal, and 0 (interquartile range, 0-2) at all other time points.

conclusionsSevere AEs were rare and similar to other programs. Immediate provision of surgical services after displacement or early removal proved a challenge. Cases of insufficient skin removal were linked to poor technique, suggesting provider training requires reinforcement and supervision.

Indexed as

Patient Acceptance of Health CareAdolescentAdultCircumcision, MaleFeasibility StudiesHumansMalawiMaleMiddle AgedPain MeasurementPatient SatisfactionProspective StudiesYoung Adult

Identifiers

PMID27331590
PMCPMC4936431

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.