The influence of socioeconomic factors on choice of infant male circumcision provider in rural Ghana; a community level population based study

Male circumcision uptake and its predictors among sexually active men aged 15-59 years living in the highest HIV prevalence region of Ethiopia: evidence from 2016 Ethiopia demographic and health survey

Background

Pieces of evidence showed that the Gambella region of Ethiopia has remained HIV hotspot area for successive years. However, the magnitude of male circumcision uptake and its associated factors are not well studied in this region. Hence, the aim of the current study is to assess the magnitude of male circumcision uptake and its predictors among sexually active men in the region using the 2016 Ethiopian Demographic and Health Survey Data.

Method

Data on 868 sexually active men residing in the Gambella region were extracted from the 2016 Ethiopian Demographic and health Survey. Descriptive statistics and logistic regression were respectively used to summarize descriptive data and measure the statistical associations. Adjusted odds ratio and confidence intervals were respectively used to measure statistical associations between variables and their statistical significances.

Results

The current study revealed that the overall prevalence of male circumcision uptake in the Gambella region was 61.2% (95% CI: 57.96,64.44). The results of multivariable logistic regression revealed that being Muslim (AOR = 9.54, 95% CI: 6.765.13.88), being Orthodox Christian (AOR = 8.5, 95%CI: 5.00–14.45), being from Poor household (AOR = 0.11, 95%CI: 0.06, 0.22), being from medium-income household (AOR = .33, 95%CI: 0.15, 0.73), listening to radio (AOR = .29, 95%CI: .16, .54), having comprehensive HIV knowledge (AOR = .44, 95%CI: .27, .71) and ever been tested for HIV (AOR = .27, 95%CI: .16,.46) were independently associated with male circumcision uptake.

Conclusion

Despite all efforts made by different stakeholders to promote the provision of male circumcision in the Gambella region, its magnitude of uptake is still unacceptably low. The federal HIV prevention and Control Office and other stakeholders working on HIV prevention and control should give due emphasis to promoting HIV-related knowledge through community-based education and through religious leaders. Integrating and streamlining HIV-related education in the academic curricula, and expanding mass media coverage should also be given due consideration by the federal government and other stakeholders. The stakeholders should also give emphasis to strengthening and empowering poor sexually active men residing in the Gambella region.

Perioperative management of circumcision in children: Is there a difference between African and European hospitals?

CONTEXT

The circumcision is the most frequent procedure in paediatric surgery worldwide, performed for medical and ritual purposes. In developing countries, because of the difficult accessibility to healthcare, even a common procedure could be unsafe.

AIMS

The aim of the article is to compare the perioperative and anaesthesiological management of circumcision in children between two Italian and two sub-Saharan African hospitals.

MATERIALS AND METHODS

Medical records of paediatric circumcision from January 2014 to December 2016 have been reviewed. The involved hospitals were: Padua (Italy), Ferrara (Italy), Sao José em Bor (Guinea Bissau) and Yaoundé (Cameroun).

RESULTS

In Padua, 77 circumcisions were performed, 19 of these (24.6%) were ritual. In 75 children (97.4%), locoregional anaesthesia (LRA) together with sedation was used; only one complication (1.3%) occurred. In Ferrara, 200 interventions were done, 140 (70%) ritual; general anaesthesia was administered to 183 (93.5%) patients. There were five complications (2.5%). In Bissau, 53 procedures were performed, 21 (39.6%) ritual; in 34 children (64.1%), LRA with sedation was preferred. Two complications (3.8%) were reported. In Yaoundé, 60 children were circumcised, 15 (25%) for ritual purposes; in 51 (85%), only LRA was performed; there was only one (1.7%) complication. In the African hospital, no post-operative analgesia was administered.

CONCLUSION

Despite the different anaesthesiological techniques, the study shows no difference in rate of complications for the in-hospital setting. Training of the local medical team in pain management and post-operative care should be emphasised.