BY PHYLLIS MABANJE GOVERNMENT will soon introduce a less painful and blood-free circumcision method as it steps up efforts to circumcise three million males by 2015.
The Ministry of Health and Child Welfare in conjunction with the Zimbabwe Community Health Intervention Research Project is already conducting pre-trials of the Prepex method in some parts of the country.
National coordinator for male circumcision in the Health ministry, Sinokuthemba Xaba said the response to the Prepex trials had been overwhelming.
“So far, we have only carried out studies to ascertain the safety, feasibility and acceptability of the Prepex device, as a device-based method of carrying out adult male circumcision in Zimbabwe. The studies so far have been successful.”
Prepex is a non-surgical circumcision device which uses rubber bands. It was developed by Circ MedTech, an Israeli company founded in 2009.
A plastic ring is inserted inside the foreskin and a rubber ring is placed on the outer foreskin, on top of the inner ring.
The outer ring clamps on the inner ring stopping the flow of blood to that part of the foreskin that is to be removed. Within a week the foreskin dies from a lack of oxygen and either falls off on its own or is easily cut off; no anesthesia or sutures are required.
What makes it a better alternative than its surgical counterpart is that it can be performed in a non-sterile setting.
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This makes it more ideal for most impoverished African countries with limited facilities and personnel to perform the procedure.
Xaba said plans were at an advanced stage to roll out the programme expected to start next year.
“We are currently making efforts and mobilising resources for ensuring the roll-out of the Prepex device in Zimbabwe,” he said.
“This entails putting in place a comprehensive logistical strategy of procuring the devices and also ensuring that we can distribute them to all the centres that will be providing male circumcision services.”
The resources would also be used in the training of doctors and nurses on use of the Prepex device for medical male circumcision.
“Ministry of Health and Child Welfare is ensuring that it takes all the necessary steps to ensure that the device will be rolled out comprehensively, so that every Zimbabwean who would want to be circumcised using the Prepex can have the service available at a health facility close to them.”
Xaba said they will engage different communication strategies, including mass media and community-based communication strategies to ensure that people have adequate and factual information on Prepex.
“This information will not only be targeted to men, but also to women, so that they have adequate information on the benefits of male circumcision and how it can benefit them as women as well,” said Xaba.
Commenting on whether Prepex was better than the surgical method, Xaba said there were no benefits of one method versus the other. “However, the Prepex device brings in an opportunity for people to have options that they can choose from.
“Furthermore, there are still some people, due to certain conditions, who won’t be able to be circumcised using the Prepex and hence, the surgical procedure will be there and they can be circumcised by it. In this regard, we are happy that there are options for the provision of male circumcision services.”
He said there was also a chance of Prepex devices being used by primary care nurses in rural health centres. This will enable men in remote areas where there are no doctors and nurses to access male circumcision services.
Researchers have also described the Prepex method as safe, acceptable to patients and staff, and easier to deploy at a large scale in multiple locations and settings.
To date, clinical trials have been held in several African countries including South Africa, Uganda, Kenya, Rwanda and now Zimbabwe.
But it has been established that not all males are suitable candidates, as some have tight foreskins (phimosis), which makes it difficult to insert the inner plastic ring. Researchers said such men were not suitable for the procedure and should use the surgical method.
