13 June 2012

Rwanda: WHO Official Commends Rwanda's Circumcision Efforts

WHO Regional Director for Africa Dr. Luis Gomes Sambo declared he is happy with the significant progress made by Rwanda in the health system, especially at community level.

This statement was made during his visit to Kanombe military hospital to see firsthand the use of the Prepex device used for male circumcision.

The device, the experimental use of which in Rwanda started two years ago, has proved to be easier to use and takes less time compared to surgical circumcision. "In our research, the advantages of the device proved to be many," remarked Lt. Col. Dr. Jean Paul Bitega, who headed the team conducting the research. "It requires no injection, no suture, no sterile environment and even nurses can use it after training."

There are five times less side-effects from the device than surgical circumcision and the healing period is of three weeks. Alexis Mugabe, who had received the treatment, said the procedure was quick and painless. "It took about two minutes and I felt no pain at all," he said, adding that he was confident he would go back to work the following day without problem.

Mugabe, who is one of the 2,304 males in all circumcised so far using the Prepex device, declared that he had put off circumcision as he was not looking forward to the surgery. "But when I heard of this new method, I came to do it and I'm glad for once the ring is removed in 7 days, it will take only 3 weeks to heal completely," he said.

As Sambo pointed out, the recommendation that circumcision be part of the HIV prevention program was made in 2007, and a tool that is likely to improve the way circumcisions are performed is welcome. "This device seems to be promising, especially for sub Saharan Africa which is the most affected by HIV/AIDS," he said pointing out that the region has 23 million people with HIV and a very high prevalence as there are 2 million new infections per year.

"What was needed is a devise that is easy to use and requires no anesthesia," said Dr. Emil Asamoah-Odei, the HIV/AIDs regional adviser for Africa. "With qualified doctors and surgeons scarce, the fact that the device can be used by nurses would be a plus."

Rwanda used the device on 10,000 people in February of this year as part of ongoing research to establish the safety of the device ,and follow up by the WHO is still ongoing.

"Its safety needs to be ensured before we can say that it is safe to replicate the method in other countries of the continent," explained Asamoah-Odei adding that a meeting to decide this will take place after results are available from other studies on the device that are currently taking place in Zimbabwe.

Rwanda, as the first country to ever use and test the device, was commended for leading in this and it was suggested that now that adults are mostly covered in the research, it would be good to start looking at providing the device for other age groups namely adolescents and children.

Dr. Sambo is on a four day working visiting to learn more about Rwanda's programs and assess progress on the ground with the view of sharing some success stories with the rest of the continent.

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