A.R. Oddo

C. Zust

E. Ruedrich

E. VanderWal

L. Marugg

M.C. McCarthy

R. Sartori

Annals of Global Health

Directory of Open Access Journals

A n n a l s o f G l o b a l H e a l t h , V O L . 8 2 , N O . 3 , 2 0 1 6 New and Emerging Priorities for Global HealthM a yeJ u n e 2 0 1 6 : 5 3 2 – 5 7 4549Mobile Solution for Immunization (M-SIMU) study; a recentlycompleted 152 village randomized controlled trial that employsshort message system (SMS) reminders and mobile money incen-tives to improve pediatric immunization coverage and timelinessin rural western Kenya. Oftentimes, randomized controlled trialsand public health programs move forward without receiving inputfrom the community the intervention seeks to serve. Focus groupdiscussions (FGDs) prior to a trial’s implementation helps ensurethe interventions are contextualized to local customs and culture.Methods: FGD was conducted with three groups of mothersranging from eight to 12. The FGD participant’s opinions ontiming, frequency, and content of SMS reminders, amount of incen-tives, in addition to other perceived challenges and barriers, weresought and integrated into the M-SIMU trial.Findings: The FGD participants preferred that the SMS remindersfor M-SIMU to be offered in multiple languages, personalized withthe child’s name to maximize the likelihood that the message iscorrectly relayed to the intended recipient, sent to caregivers 3 daysand 1 day before their infant’s scheduled vaccination date, includethe study sponsor, and have local motivational sayings appended tothe end of the reminder. Also, the amount of incentives was suggestedto range from 50 to 300 Kenya Shillings (USD 0.5 to 3).Interpretation: The findings were incorporated in the M-SIMUstudy’s design and during the conduct of the study; efficacy of thedesign was evidential. Improvements in vaccine coverage and time-liness were reported by various health stakeholders in the study area,including Community Health Workers (CHWs), Village Reporters(VRs) and nurses. Such success could be associated with the involve-ment of the key stakeholders (mothers) in designing the randomizedcontrolled trial.Funding: This is part of the M-SIMU study that was funded bythe Bill and Melinda Gates Foundation.Abstract #: 2.041_NEPPreoperative incidence of penile abnormalities found duringvoluntary male medical circumcision in SwazilandA.R. Oddo1, E. Ruedrich1, C. Zust1, L. Marugg1, E. VanderWal2,H. VanderWal2, R. Sartori2, M.C. McCarthy1; 1Wright StateUniversity, Boonshoft School of Medicine, Dayton, Ohio, USA, 2TheLuke Commission, Miracle Campus, Box 41, Sidvokodvo, SwazilandBackground: Circumcision has proven to be an effective procedurein reducing the transmission of HIV in Africa. The Luke Commis-sion (TLC), a mobile hospital outreach, has acted upon this researchby performing thousands of male circumcisions throughout ruralSwaziland, the country with the highest rate of HIV in the world.As a result of limited healthcare access, penile abnormalities thatwould be diagnosed during genital health exams in developed coun-tries are often found and corrected during these procedures. Theobjective of the study was to evaluate the rates of penile abnormal-ities discovered and treated during voluntary male medical circum-cisions performed in Swaziland.Methods: We assessed the rates of the penile abnormalitiesthrough a retrospective analysis of all male patients who underwentvoluntary male medical circumcision performed by the LukeCommission during a period from June-August, 2014. The partic-ipants of the study consisted of uncircumcised males ages 4 to 65years old who lived in remote rural communities throughoutSwaziland and volunteered for the procedure. As part of the TLCprotocol, nursing staff perform a preoperative examination anddocument all findings in an electronic database. The penile abnor-malities documented and analyzed included: phimosis, paraphimo-sis, epispadias, hypospadias, ulcers, balanitis, torsion, and cases ofadherent foreskin attached to glans. This information is added toa database that records procedure date, date of birth/age and HIVstatus.Findings: Out of 929 total circumcisions, there were 726 patients(78%) with phimosis, 25 (3%) with hypospadias, 359 (39%) withadherent foreskin attached to glans, and no patients with paraphi-mosis, epispadias, ulcers, balanitis, or torsion; 771 patients (83%)had at least one penile abnormality, and 334 patients (36%) hadtwo or more conditions. Over 96% of those individuals with abnor-malities were ages 6e19. The 158 patients (17%) that had no penileabnormalities followed a similar age distribution as those patientswith abnormalities.Interpretation: These results display that a significant majority ofpatients had penile abnormalities that persisted well into theirteenage years. This data exemplifies the steps The Luke Commis-sion is taking alongside the Swaziland government towardsdecreasing HIV transmission and improving male sexual health.Funding: None.Abstract #: 2.042_NEPLived experience of persons with prostate cancer enrolled intopalliative care: A qualitative study at mobile hospice MbararaA.O. Olirus; Mbarara University of Science and Technology, UgandaBackground: About 1 in 6 men worldwide will be diagnosed withprostate cancer during their lifetime. In Uganda, prostate cancer iscurrently one of the most common cancers among men with anage-standardized incidence rate of 39.6 per 100,000. Its physical,emotional and social effects greatly impacts the lives of men.Although current palliative care management practices are aimedat improving the quality of life, little has been documented on thelived experiences of men with prostate cancer in Uganda. This studyexplored the experiences of men with prostate cancer enrolled intopalliative care in rural southwestern Uganda.Methods: An exploratory study was conducted among 8 prostatecancer patients enrolled into palliative care in Mbarara district,southwestern Uganda. Data was collected between March and April2015. Data obtained was analyzed using Colaizzi phenomenologicalapproach along key themes; family and social relationships, spirituallife, care and treatment before palliative care and care at hospice.Findings: The five key themes generated different subthemes withsome reported examples from participants. Family relationship:subthemes; Good family relationship, “I would not be surviving ifnot for this family of mine”; lost functionality, “I feel uncomfortablefor not being able to do anything as a man”; Feeling of hopelessness,“this disease made me lose my manhood!” Social relationships:subtheme; Good social support, “this sickness created for me very

Preoperative incidence of penile abnormalities found during voluntary male medical circumcision in Swaziland

Oddo, Anthony R.

Ruedrich, Elizabeth

Zust, Christopher

Marugg, Lindsey

VanderWal, Echo

Sartori, Rebekah

McCarthy, Mary C.

CORE

Wright State University CORE Scholar Department of Surgery Faculty Publications Surgery 2016 Preoperative Incidence of Penile Abnormalities Found During Voluntary Male Medical Circumcision in Swaziland Anthony R. Oddo Wright State University - Main Campus Elizabeth Ruedrich Wright State University - Main Campus Christopher Zust Lindsey Marugg Wright State University - Main Campus Echo VanderWal See next page for additional authors Follow this and additional works at: https://corescholar.libraries.wright.edu/surg  Part of the Surgery Commons Repository Citation Oddo, A. R., Ruedrich, E., Zust, C., Marugg, L., VanderWal, E., Sartori, R., & McCarthy, M. C. (2016). Preoperative Incidence of Penile Abnormalities Found During Voluntary Male Medical Circumcision in Swaziland. Annals of Global Health, 82 (3), 549. https://corescholar.libraries.wright.edu/surg/729 This Abstract is brought to you for free and open access by the Surgery at CORE Scholar. It has been accepted for inclusion in Department of Surgery Faculty Publications by an authorized administrator of CORE Scholar. For more information, please contact library-corescholar@wright.edu. Authors Anthony R. Oddo, Elizabeth Ruedrich, Christopher Zust, Lindsey Marugg, Echo VanderWal, Rebekah Sartori, and Mary C. McCarthy This abstract is available at CORE Scholar: https://corescholar.libraries.wright.edu/surg/729 Mobile Solution for Immunization (M-SIMU) study; a recentlycompleted 152 village randomized controlled trial that employsshort message system (SMS) reminders and mobile money incen-tives to improve pediatric immunization coverage and timelinessin rural western Kenya. Oftentimes, randomized controlled trialsand public health programs move forward without receiving inputfrom the community the intervention seeks to serve. Focus groupdiscussions (FGDs) prior to a trial’s implementation helps ensurethe interventions are contextualized to local customs and culture.Methods: FGD was conducted with three groups of mothersranging from eight to 12. The FGD participant’s opinions ontiming, frequency, and content of SMS reminders, amount of incen-tives, in addition to other perceived challenges and barriers, weresought and integrated into the M-SIMU trial.Findings: The FGD participants preferred that the SMS remindersfor M-SIMU to be offered in multiple languages, personalized withthe child’s name to maximize the likelihood that the message iscorrectly relayed to the intended recipient, sent to caregivers 3 daysand 1 day before their infant’s scheduled vaccination date, includethe study sponsor, and have local motivational sayings appended tothe end of the reminder. Also, the amount of incentives was suggestedto range from 50 to 300 Kenya Shillings (USD 0.5 to 3).Interpretation: The findings were incorporated in the M-SIMUstudy’s design and during the conduct of the study; efficacy of thedesign was evidential. Improvements in vaccine coverage and time-liness were reported by various health stakeholders in the study area,including Community Health Workers (CHWs), Village Reporters(VRs) and nurses. Such success could be associated with the involve-ment of the key stakeholders (mothers) in designing the randomizedcontrolled trial.Funding: This is part of the M-SIMU study that was funded bythe Bill and Melinda Gates Foundation.Abstract #: 2.041_NEPPreoperative incidence of penile abnormalities found duringvoluntary male medical circumcision in SwazilandA.R. Oddo1, E. Ruedrich1, C. Zust1, L. Marugg1, E. VanderWal2,H. VanderWal2, R. Sartori2, M.C. McCarthy1; 1Wright StateUniversity, Boonshoft School of Medicine, Dayton, Ohio, USA, 2TheLuke Commission, Miracle Campus, Box 41, Sidvokodvo, SwazilandBackground: Circumcision has proven to be an effective procedurein reducing the transmission of HIV in Africa. The Luke Commis-sion (TLC), a mobile hospital outreach, has acted upon this researchby performing thousands of male circumcisions throughout ruralSwaziland, the country with the highest rate of HIV in the world.As a result of limited healthcare access, penile abnormalities thatwould be diagnosed during genital health exams in developed coun-tries are often found and corrected during these procedures. Theobjective of the study was to evaluate the rates of penile abnormal-ities discovered and treated during voluntary male medical circum-cisions performed in Swaziland.Methods: We assessed the rates of the penile abnormalitiesthrough a retrospective analysis of all male patients who underwentvoluntary male medical circumcision performed by the LukeCommission during a period from June-August, 2014. The partic-ipants of the study consisted of uncircumcised males ages 4 to 65years old who lived in remote rural communities throughoutSwaziland and volunteered for the procedure. As part of the TLCprotocol, nursing staff perform a preoperative examination anddocument all findings in an electronic database. The penile abnor-malities documented and analyzed included: phimosis, paraphimo-sis, epispadias, hypospadias, ulcers, balanitis, torsion, and cases ofadherent foreskin attached to glans. This information is added toa database that records procedure date, date of birth/age and HIVstatus.Findings: Out of 929 total circumcisions, there were 726 patients(78%) with phimosis, 25 (3%) with hypospadias, 359 (39%) withadherent foreskin attached to glans, and no patients with paraphi-mosis, epispadias, ulcers, balanitis, or torsion; 771 patients (83%)had at least one penile abnormality, and 334 patients (36%) hadtwo or more conditions. Over 96% of those individuals with abnor-malities were ages 6e19. The 158 patients (17%) that had no penileabnormalities followed a similar age distribution as those patientswith abnormalities.Interpretation: These results display that a significant majority ofpatients had penile abnormalities that persisted well into theirteenage years. This data exemplifies the steps The Luke Commis-sion is taking alongside the Swaziland government towardsdecreasing HIV transmission and improving male sexual health.Funding: None.Abstract #: 2.042_NEPLived experience of persons with prostate cancer enrolled intopalliative care: A qualitative study at mobile hospice MbararaA.O. Olirus; Mbarara University of Science and Technology, UgandaBackground: About 1 in 6 men worldwide will be diagnosed withprostate cancer during their lifetime. In Uganda, prostate cancer iscurrently one of the most common cancers among men with anage-standardized incidence rate of 39.6 per 100,000. Its physical,emotional and social effects greatly impacts the lives of men.Although current palliative care management practices are aimedat improving the quality of life, little has been documented on thelived experiences of men with prostate cancer in Uganda. This studyexplored the experiences of men with prostate cancer enrolled intopalliative care in rural southwestern Uganda.Methods: An exploratory study was conducted among 8 prostatecancer patients enrolled into palliative care in Mbarara district,southwestern Uganda. Data was collected between March and April2015. Data obtained was analyzed using Colaizzi phenomenologicalapproach along key themes; family and social relationships, spirituallife, care and treatment before palliative care and care at hospice.Findings: The five key themes generated different subthemes withsome reported examples from participants. Family relationship:subthemes; Good family relationship, “I would not be surviving ifnot for this family of mine”; lost functionality, “I feel uncomfortablefor not being able to do anything as a man”; Feeling of hopelessness,“this disease made me lose my manhood!” Social relationships:subtheme; Good social support, “this sickness created for me veryA n n a l s o f G l o b a l H e a l t h , V O L . 8 2 , N O . 3 , 2 0 1 6 New and Emerging Priorities for Global HealthM a yeJ u n e 2 0 1 6 : 5 3 2 – 5 7 4549

English

Preoperative Incidence of Penile Abnormalities Found During Voluntary Male Medical Circumcision in Swaziland

https://corescholar.libraries.wright.edu/cgi/viewcontent.cgi?article=1731&amp;context=surg

Preoperative incidence of penile abnormalities found during voluntary male medical circumcision in Swaziland

Abstract

Similar works

Full text

Available Versions

Directory of Open Access Journals

CORE