Evidence map›Paper›PMID 27509246›Full record

ArticleJournal of acquired immune deficiency syndromes (1999)2016

Trends in the Marginal Cost of Male Circumcision in Rural Rakai Uganda.

Yira N Alfonso, David Bishai, Agnes Nantongo, Rebecca Kakembo, Sarah Kobusinge, Seema Kacker, Godfrey Kigozi, Ronald Gray

Abstract read
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 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

8 authors.

Yira N Alfonso*Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; †Rakai Health Sciences Program, Kalisizo, Uganda; ‡School of Medicine, Johns Hopkins University, Baltimore, MD; and §Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
David Bishai
Agnes Nantongo
Rebecca Kakembo
Sarah Kobusinge
Seema Kacker
Godfrey Kigozi
Ronald Gray

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007309 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI COX, ANDREA L · 1985 to 2019
$43.2M
Medical Scientist Training ProgramT32GM136577 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI ANDREA L COX · 2020 to 2026
$13.4M
Enhanced Provision of Male Circumcision for HIV Prevention, Rakai, UgandaU01AI100031 · NIAID · JOHNS HOPKINS UNIVERSITY · PI GRAY, RONALD H · 2012 to 2014
$3.2M
Male Circumcision and Use of Foreskin Tissues for HIV Prevention in UgandaD43TW009578 · FIC · JOHNS HOPKINS UNIVERSITY · PI GRAY, RONALD H · 2013 to 2017
$1.3M
FIC NIH HHS D43 TW009578NIAID NIH HHS U01 AI100031NIGMS NIH HHS T32 GM007309NIGMS NIH HHS T32 GM136577
6 · The paper itself

Abstract

introductionMale circumcision (MC) is an effective intervention to reduce HIV acquisition in men in Africa. We conducted a cost analysis using longitudinal data on expenditures on services and community mobilization to estimate the marginal cost of MC over time and understand cost drivers during scale-up.

methodsWe used a time series with monthly records from 2008 to 2013, for a total of 72 monthly observations, from the Rakai MC Program in Uganda. Generalized linear models were used to estimate the marginal cost of an MC procedure.

resultsThe marginal cost per MC in a mobile camp was $23 (P < 0.01) and in static facilities was $35 (P < 0.1). Major cost drivers included supplies in mobile camps with increasing numbers of surgeries, savings due to task shifting from physicians to clinical officers, and increased efficiency as personnel became more experienced.

conclusionsAs scale-up continues, marginal costs may increase because of mobilization needed for less motivated late adopters, but improved efficiency could contain costs.

Indexed as

AdolescentAdultAfricaAgedCircumcision, MaleHealth Care CostsHumansLongitudinal StudiesMaleMiddle AgedRural PopulationUgandaYoung Adult

Identifiers

PMID27509246
PMCPMC5110383

What OpenQuestion holds

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Registered trials

None linked

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.