title: Single-arm evaluation of the AccuCirc device for early infant male circumcision in Botswana.
abstract: : Existing devices for early infant male circumcision (EIMC) have inherent limitations. We evaluated the newly developed AccuCirc device by circumcising 151 clinically well, full-term male infants with birth weight ≥2.5 kg within the first 10 days of life from a convenience sample in 2 hospitals in Botswana. No major adverse events were observed. There was 1 local infection, 5 cases of minor bleeding, and 1 case of moderate bleeding. In 3 cases, the device made only partial incisions that were completed immediately by the provider without complications. Parental satisfaction was high: >96% of mothers stated that they would circumcise a future son. The pre-assembled, sterile AccuCirc kit has the potential to overcome obstacles related to supply chain management and on-site instrument disinfection that can pose challenges in resource-limited settings. In our study, the AccuCirc was safe and it should be considered for programmatic EIMC in resource-limited settings.
authors.affiliation: *Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA; †Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA; ‡Botswana-Harvard School of Public Health AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana; §Department of Epidemiology, Harvard School of Public Health, Boston, MA; ‖Northern Inter-Tribal Health Authority, Prince Albert, Saskatchewan, Canada; ¶Botswana Ministry of Health, Gaborne, Botswana; #Departments of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, MA; and; **Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Rebeca M
authors.initials: RM
authors.lastname: Plank
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Wirth
authors.forename: Nnamdi O
authors.initials: NO
authors.lastname: Ndubuka
authors.forename: Rasak
authors.initials: R
authors.lastname: Abdullahi
authors.forename: Maggie
authors.initials: M
authors.lastname: Nkgau
authors.forename: Chiapo
authors.initials: C
authors.lastname: Lesetedi
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Powis
authors.forename: Mompati
authors.initials: M
authors.lastname: Mmalane
authors.forename: Joseph
authors.initials: J
authors.lastname: Makhema
authors.forename: Roger
authors.initials: R
authors.lastname: Shapiro
authors.forename: Shahin
authors.initials: S
authors.lastname: Lockman
mesh_terms: D001902:Botswana; D002944:Circumcision, Male / Q000009:adverse effects* / Q000379:methods*; D004864:Equipment and Supplies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010342:Patient Acceptance of Health Care; D013530:Surgical Wound Infection / Q000453:epidemiology; D016896:Treatment Outcome