ArticleBulletin of the World Health Organization2021
Implementation of an infant male circumcision programme, Pakistan.
Article in Bulletin of the World Health Organization, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 14 citations in OpenAlex.
- Newborn screening and referral for congenital anomalies by lay health workers in Pakistan: a mixed-methods study to evaluate the effectiveness of a co-created educational intervention.BMC medical education · 2025Article
- Attitude towards donation of the excised foreskin after circumcision surgery for research: A study from Madinah, Saudi Arabia.PloS one · 2023Article
- A comprehensive comparison of the early and late complications of surgical circumcision in neonates and children: A cohort study.Health science reports · 2022Article
- Efficacy of Dexmedetomidine Anesthesia plus Dorsal Penile Nerve Block in Pediatric Circumcision.Evidence-based complementary and alternative medicine : eCAM · 2022Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo retrospectively review outcomes of a health provider-led infant circumcision programme in Pakistan.
methodsBased on World Health Organization guidelines, we trained surgical technicians and midwives to perform circumcisions using the Plastibell device at two Indus Health Network facilities. Programme tools include a training manual for health providers, information brochures for families, an enrolment form and standardized forms for documenting details of the procedure and outcomes. Infants aged 1-92 days were eligible for the study. Health workers contacted families on days 1 and 7 after the procedure to record any adverse events. We compared the characteristics of infants experiencing adverse events with infants facing no complications using multivariate logistic regression.
findingsBetween August 2016 and August 2018, 2822 circumcised male infants with mean age 22.8 days were eligible for the study. Of these, 2617 infants (92.7%) were followed up by telephone interviews of caretakers. Older infants were more likely to experience adverse events than infants circumcised between 1-30 days of age: 31-60 days: adjusted odds ratio, aOR: 2.03; 95% confidence interval, CI: 1.31-3.15; 61-92 days: aOR: 2.14; 95% CI: 1.13-4.05. Minor adverse events (100 infants; 3.8%) included failure of the bell to shed (90 infants) and minimal bleeding (10 infants). Major adverse events (eight infants; 0.3%) included bleeding that required intervention (four infants), infection (three infants) and skin tear (one infant).
conclusionStandardized training protocols and close monitoring enabled nonphysician health providers to perform safe circumcisions on infants aged three months or younger.
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