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P18.03 Rapid training and implementation of the pollock technique, a safe, rapid and effective newborn circumcision procedure, in a low-resource setting
  1. N Kojima1,
  2. CC Bristow2,
  3. N Pollock3,
  4. P Crouse4,
  5. H Theodore5,
  6. J Bonhomme5,
  7. CF Gaston5,
  8. JG Dévieux6,
  9. JW Pape5,7,
  10. JD Klausner2,8
  1. 1David Geffen School of Medicine, University of California Los Angeles, USA
  2. 2Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, USA
  3. 3Department of Medicine, University of British Columbia, Canada
  4. 4Intramed Medical Centre, Canada
  5. 5Les Centres GHESKIO, Haiti
  6. 6Robert Stempel School of Public Health, Florida International University, USA
  7. 7Division of Infectious Disease and International Medicine, Weill Medical College of Cornell University, USA
  8. 8Departments of Medicine, David Geffen School of Medicine, University of California Los Angeles, USA


Background Male circumcision is highly protective against urinary tract infections, inflammatory conditions of the penis, sexually transmitted infections, and urogenital cancers. We aimed to re-introduce newborn male circumcision through the creation of a training program in Port-au-Prince, Haiti—an area with a considerable burden of preventable urogenital infections, sexually transmitted infections, and low circumcision rate—after an earlier study reported that a majority of Haitian medical providers were in need of and wanted newborn circumcision training.

Methods The rapid, newborn circumcision training program was conducted in November 2014 at the GHESKIO Health Centres, a large, non-governmental clinic offering comprehensive paediatric and adult health services. Two Haitian obstetricians and seven nurses learned administrative, educational, and clinical newborn male circumcision procedures. Complications were monitored and surveys were given to the obstetricians, nurses, and parents of the newborns for assessment.

Results Upon training completion, one of two obstetricians achieved procedural competence. The team circumcised 92 newborns with minor bleeding observed in 1 infant; there were 0 moderate or severe complications. Obstetricians, nurses, and parents of the newborns reported that they were very satisfied with the program (100%, 92%, and 94%, respectively). Of the parents, 100% reported they would recommend the procedure to their friends and 100% reported that they were satisfied with the cosmetic result of the procedure. The nurse-collected survey indicated that 100% of the procedures followed the proper protocol. Since the rapid newborn circumcision training program concluded, the GHESKIO Health Centres have dedicated two days a week to perform newborn male circumcisions, averaging 14 patients per week

Conclusion Introduction of a newborn male circumcision training program was feasible, achieving an acceptable rate of procedural competency and high quality services. Permanent resources now exist in Haiti to train additional providers to perform newborn male circumcisions.

Funding UCLA Centre for AIDS Research (CFAR) NIH/NIAID AI028697, NIH/NICHD R21HD076685, Pollock Foundation, and Klausner Research and Education Fund.

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