Outcomes of voluntary medical male circumcision performed by medical doctors and non-doctor health workers in central Uganda
Bibliographic record
Abstract
Abstract Background Voluntary medical male circumcision (VMMC) reduces the risk of HIV transmission. Task shifting of VMMCs to non-doctor health workers is recommended to enhance scale-up of VMMC programs. This study evaluated outcomes of circumcision conducted by doctors compared to non-doctors in central Uganda. Methods In this prospective observational study, we observed and followed 274 males at 3 health facilities in Kampala, Uganda. Each participant was observed during the circumcision procedure, monitored for 2 h post-surgery and assessed at 24 h, 3 days and after one week for adverse events. Results The median age of the circumcised men was 24.00(IQR, 20.00–28.00) years. Of the VMMCs, 19.3% (53/274) were carried out by doctors while 80.7% (221/274) by non-doctors. Following VMMC, 5.47% (15/274) men experienced adverse events and proportions of adverse events by cadre were similar; doctors (5.66% [3/53]) and non-doctor health workers (5.43% [12/221]), p = 0.99. Seven participants had pus discharge (all had been operated by non-doctors), 2 participants had bleeding at 2 h (one by doctor and one by non-doctor), and 4 participants had excessive skin removal (2 by doctors vs 2 by non-doctors). There was no reported urethral injury or glans amputation. Conclusion Our study found no statistically significant difference in the incidence of adverse events among VMMCs conducted by doctors compared to non-doctor health workers. Our study showed no incidence of serious adverse events such as death, urethral injury or glans amputation following VMMCs. Our results add to the existing literature to guide task shifting in the context of VMMCs.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".