title: Non-surgical adult male circumcision using the PrePex device: task-shifting from physicians to nurses.
abstract: The Republic of Rwanda is implementing a program of voluntary male circumcision (MC) to reduce HIV transmission but lacks the infrastructure for conventional surgical MC on a nationwide scale. Nonsurgical MC using the PrePex device was first assessed in 5 subjects on an inpatient basis. Subsequent procedures were on an outpatient basis. Physicians performed 100 outpatient procedures (Phase 1 of this study) and trained nurses in the technique; the nurses then independently performed 47 procedures (Phase 2). All subjects achieved complete circumcision and healing within 6 weeks. There were no cases of infection or bleeding. In Phase 1, one case of transient moderate diffuse edema occurred. In Phase 2, no adverse events were reported. Thus, outcomes of MC performed by nurses using the PrePex device were not inferior to outcomes achieved by physicians, suggesting that task-shifting MC by this method from physicians to nurses is feasible in Rwanda.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mutabazi
authors.forename: Jean P
authors.initials: JP
authors.lastname: Bitega
authors.forename: Leon M
authors.initials: LM
authors.lastname: Ngeruka
authors.forename: Theobald
authors.initials: T
authors.lastname: Hategekimana
authors.forename: Steven A
authors.initials: SA
authors.lastname: Kaplan
authors.forename: Corine
authors.initials: C
authors.lastname: Karema
authors.forename: Agnes
authors.initials: A
authors.lastname: Binagwaho
mesh_terms: D000293:Adolescent; D000328:Adult; D002944:Circumcision, Male / Q000295:instrumentation* / Q000451:nursing*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009732:Nursing Care; D010147:Pain Measurement; D012432:Rwanda; D013525:Surgical Instruments; D016896:Treatment Outcome; D014945:Wound Healing