Health service provider education and/or training in infant male circumcision to improve short- and long-term morbidity outcomes: protocol for systematic review

Thomas K. Gyan, Natalie A. Strobel, Kimberley E. McAuley, C. Shannon, S. Newton, C. Tawiah-Agyemang, S. Amenga-Etego, S. Owusu-Agyei, David A. Forbes, Karen M. Edmond

    Research output: Contribution to journalArticle

    1 Citation (Scopus)

    Abstract

    Background: There has been an expansion of circumcision services in Africa as part of a long-term HIV prevention strategy. However, the effect of infant male circumcision on morbidity and mortality still remains unclear. Acute morbidities associated with circumcision include pain, bleeding, swelling, infection, tetanus or inadequate skin removal. Scale-up of circumcision services could lead to a rise in these associated morbidities that could have significant impact on health service delivery and the safety of infants. Multidisciplinary training programmes have been developed to improve skills of health service providers, but very little is known about the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. This review aims to evaluate the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. Methods/design: The review will include studies comparing health service providers who have received education and/or training to improve their skills for infant male circumcision with those who have not received education and/or training. Randomised controlled trials (RCTs) and cluster RCTs will be included. The outcomes of interest are short-term morbidities of the male infant including pain, infection, tetanus, bleeding, excess skin removal, glans amputation and fistula. Long-term morbidities include urinary tract infection (UTI), HIV infection and abnormalities of urination. Databases such as MEDLINE (OVID), PsycINFO (OVID), EMBASE (OVID), CINAHL, Cochrane Library (including CENTRAL and DARE), WHO databases and reference list of papers will be searched for relevant articles. Study selection, data extraction and synthesis and risk of bias assessment using the Cochrane risk of bias assessment tool will be conducted. We will calculate the pooled estimates of the difference in means and risk ratios using random effects models. If insufficient data are available, we will present results descriptively. Discussion: This review appears to be the first to be conducted in this area. The findings will have important implications for infant male circumcision programmes and policy. Systematic review registration: PROSPERO CRD42015029345 © 2016 Gyan et al.
    Original languageEnglish
    Number of pages6
    JournalSystematic Reviews
    Volume5
    Issue number1
    DOIs
    Publication statusPublished - 2016

    Fingerprint

    Male Circumcision
    Health Services
    Morbidity
    Education
    Tetanus
    Randomized Controlled Trials
    Databases
    Hemorrhage
    Pain
    Skin
    Urination
    Infection
    Amputation
    Urinary Tract Infections
    MEDLINE
    Libraries
    Fistula
    HIV Infections
    Odds Ratio
    HIV

    Cite this

    @article{e3c90748398b4b6bb621a49b3507613b,
    title = "Health service provider education and/or training in infant male circumcision to improve short- and long-term morbidity outcomes: protocol for systematic review",
    abstract = "Background: There has been an expansion of circumcision services in Africa as part of a long-term HIV prevention strategy. However, the effect of infant male circumcision on morbidity and mortality still remains unclear. Acute morbidities associated with circumcision include pain, bleeding, swelling, infection, tetanus or inadequate skin removal. Scale-up of circumcision services could lead to a rise in these associated morbidities that could have significant impact on health service delivery and the safety of infants. Multidisciplinary training programmes have been developed to improve skills of health service providers, but very little is known about the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. This review aims to evaluate the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. Methods/design: The review will include studies comparing health service providers who have received education and/or training to improve their skills for infant male circumcision with those who have not received education and/or training. Randomised controlled trials (RCTs) and cluster RCTs will be included. The outcomes of interest are short-term morbidities of the male infant including pain, infection, tetanus, bleeding, excess skin removal, glans amputation and fistula. Long-term morbidities include urinary tract infection (UTI), HIV infection and abnormalities of urination. Databases such as MEDLINE (OVID), PsycINFO (OVID), EMBASE (OVID), CINAHL, Cochrane Library (including CENTRAL and DARE), WHO databases and reference list of papers will be searched for relevant articles. Study selection, data extraction and synthesis and risk of bias assessment using the Cochrane risk of bias assessment tool will be conducted. We will calculate the pooled estimates of the difference in means and risk ratios using random effects models. If insufficient data are available, we will present results descriptively. Discussion: This review appears to be the first to be conducted in this area. The findings will have important implications for infant male circumcision programmes and policy. Systematic review registration: PROSPERO CRD42015029345 {\circledC} 2016 Gyan et al.",
    author = "Gyan, {Thomas K.} and Strobel, {Natalie A.} and McAuley, {Kimberley E.} and C. Shannon and S. Newton and C. Tawiah-Agyemang and S. Amenga-Etego and S. Owusu-Agyei and Forbes, {David A.} and Edmond, {Karen M.}",
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    Health service provider education and/or training in infant male circumcision to improve short- and long-term morbidity outcomes: protocol for systematic review. / Gyan, Thomas K.; Strobel, Natalie A.; McAuley, Kimberley E.; Shannon, C.; Newton, S.; Tawiah-Agyemang, C.; Amenga-Etego, S.; Owusu-Agyei, S.; Forbes, David A.; Edmond, Karen M.

    In: Systematic Reviews, Vol. 5, No. 1, 2016.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Health service provider education and/or training in infant male circumcision to improve short- and long-term morbidity outcomes: protocol for systematic review

    AU - Gyan, Thomas K.

    AU - Strobel, Natalie A.

    AU - McAuley, Kimberley E.

    AU - Shannon, C.

    AU - Newton, S.

    AU - Tawiah-Agyemang, C.

    AU - Amenga-Etego, S.

    AU - Owusu-Agyei, S.

    AU - Forbes, David A.

    AU - Edmond, Karen M.

    PY - 2016

    Y1 - 2016

    N2 - Background: There has been an expansion of circumcision services in Africa as part of a long-term HIV prevention strategy. However, the effect of infant male circumcision on morbidity and mortality still remains unclear. Acute morbidities associated with circumcision include pain, bleeding, swelling, infection, tetanus or inadequate skin removal. Scale-up of circumcision services could lead to a rise in these associated morbidities that could have significant impact on health service delivery and the safety of infants. Multidisciplinary training programmes have been developed to improve skills of health service providers, but very little is known about the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. This review aims to evaluate the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. Methods/design: The review will include studies comparing health service providers who have received education and/or training to improve their skills for infant male circumcision with those who have not received education and/or training. Randomised controlled trials (RCTs) and cluster RCTs will be included. The outcomes of interest are short-term morbidities of the male infant including pain, infection, tetanus, bleeding, excess skin removal, glans amputation and fistula. Long-term morbidities include urinary tract infection (UTI), HIV infection and abnormalities of urination. Databases such as MEDLINE (OVID), PsycINFO (OVID), EMBASE (OVID), CINAHL, Cochrane Library (including CENTRAL and DARE), WHO databases and reference list of papers will be searched for relevant articles. Study selection, data extraction and synthesis and risk of bias assessment using the Cochrane risk of bias assessment tool will be conducted. We will calculate the pooled estimates of the difference in means and risk ratios using random effects models. If insufficient data are available, we will present results descriptively. Discussion: This review appears to be the first to be conducted in this area. The findings will have important implications for infant male circumcision programmes and policy. Systematic review registration: PROSPERO CRD42015029345 © 2016 Gyan et al.

    AB - Background: There has been an expansion of circumcision services in Africa as part of a long-term HIV prevention strategy. However, the effect of infant male circumcision on morbidity and mortality still remains unclear. Acute morbidities associated with circumcision include pain, bleeding, swelling, infection, tetanus or inadequate skin removal. Scale-up of circumcision services could lead to a rise in these associated morbidities that could have significant impact on health service delivery and the safety of infants. Multidisciplinary training programmes have been developed to improve skills of health service providers, but very little is known about the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. This review aims to evaluate the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. Methods/design: The review will include studies comparing health service providers who have received education and/or training to improve their skills for infant male circumcision with those who have not received education and/or training. Randomised controlled trials (RCTs) and cluster RCTs will be included. The outcomes of interest are short-term morbidities of the male infant including pain, infection, tetanus, bleeding, excess skin removal, glans amputation and fistula. Long-term morbidities include urinary tract infection (UTI), HIV infection and abnormalities of urination. Databases such as MEDLINE (OVID), PsycINFO (OVID), EMBASE (OVID), CINAHL, Cochrane Library (including CENTRAL and DARE), WHO databases and reference list of papers will be searched for relevant articles. Study selection, data extraction and synthesis and risk of bias assessment using the Cochrane risk of bias assessment tool will be conducted. We will calculate the pooled estimates of the difference in means and risk ratios using random effects models. If insufficient data are available, we will present results descriptively. Discussion: This review appears to be the first to be conducted in this area. The findings will have important implications for infant male circumcision programmes and policy. Systematic review registration: PROSPERO CRD42015029345 © 2016 Gyan et al.

    U2 - 10.1186/s13643-016-0216-6

    DO - 10.1186/s13643-016-0216-6

    M3 - Article

    VL - 5

    JO - Systematic Reviews

    JF - Systematic Reviews

    SN - 2046-4053

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