Shangring versus the mogen clamp for early infant male circumcision (eimc): a cost-comparative analysis in kenya, tanzania and uganda

You have accessJournal of UrologyCME1 Apr 2023MP49-08 SHANGRING VERSUS THE MOGEN CLAMP FOR EARLY INFANT MALE CIRCUMCISION (EIMC): A COST-COMPARATIVE ANALYSIS IN KENYA, TANZANIA AND UGANDA Mary O. Strasser, Lina Posada, Nahid Punjani, Spyridon Basourakos, Godfrey Kigozi, Quentin Awori, Alice Christensen, Mark Barone, Karla Ballman, Marc Goldstein, Alvin Mushlin, Philip Li, and Richard K. Lee Mary O. StrasserMary O. Strasser More articles by this author , Lina PosadaLina Posada More articles by this author , Nahid PunjaniNahid Punjani More articles by this author , Spyridon BasourakosSpyridon Basourakos More articles by this author , Godfrey KigoziGodfrey Kigozi More articles by this author , Quentin AworiQuentin Awori More articles by this author , Alice ChristensenAlice Christensen More articles by this author , Mark BaroneMark Barone More articles by this author , Karla BallmanKarla Ballman More articles by this author , Marc GoldsteinMarc Goldstein More articles by this author , Alvin MushlinAlvin Mushlin More articles by this author , Philip LiPhilip Li More articles by this author , and Richard K. LeeRichard K. Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003297.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The World Health Organization (WHO) has recommended voluntary medical male circumcision (VMMC) as a prevention strategy for countries with low rates of circumcision and high rates of the heterosexually-transmitted human immunodeficiency virus (HIV). Early infant male circumcision (EIMC) is being considered due to its simplicity, rapid wound healing, and similar or more long-term benefits to adolescents and adults. However, data regarding the safety, efficacy, and cost of EIMC are limited. Thus, we sought to perform a comprehensive cost assessment of the ShangRing (SR) versus the standard of care (Mogen Clamp, MoC) as the EIMC device for future scale-up and a cost-effective HIV prevention strategy in this patient population. METHODS: As a secondary endpoint to an EIMC randomized controlled trial (RCT) of infants aged 0-60 days in Kenya, Tanzania , and Uganda, receiving SR versus MoC, utilization and cost data were analyzed. This included baseline facility costs, direct costs such as equipment, supply, and personnel costs, as well as indirect costs such as facility maintenance and capital cost for equipment. The Decision Makers Program Planning Tool (DMPPT) v1.0, developed by the USAID Health Policy Initiative in collaboration with UNAIDS, was utilized to perform a direct cost comparison of these two devices. This analysis tool derives a single unit cost of a procedure based on the baseline facility share, direct and indirect costs. All expenses adn costs related to this RCT are are reported in USD. RESULTS: A total of 1378 infant males underwent EIMC, of which 689 had SR , and 689 had MoC. No significant complications required additional cost or intervention at either study site. The overall cost of a single EIMC in Kenya, Uganda , and Tanzania were $61.30, $47.14 and $64.59, respectively for the SR ; and $56.38, $50.43, and $58.57, respectively, for the MoC. For both EIMC devices, the costs were mainly driven by direct costs. CONCLUSIONS: SR is a safe and low-cost alternative for EIMC in VMMC in Sub-Saharan Africa. Moreover, with scale-up utilizing lower-level personnel, the SR cost may be further reduced. Therefore, the SR is an attractive alternative for future EIMC initiatives in sub-Saharan Africa to further reduce the HIV burden in these regions. Source of Funding: The Bill and Melinda Gates Foundation © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e680 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mary O. Strasser More articles by this author Lina Posada More articles by this author Nahid Punjani More articles by this author Spyridon Basourakos More articles by this author Godfrey Kigozi More articles by this author Quentin Awori More articles by this author Alice Christensen More articles by this author Mark Barone More articles by this author Karla Ballman More articles by this author Marc Goldstein More articles by this author Alvin Mushlin More articles by this author Philip Li More articles by this author Richard K. Lee More articles by this author Expand All Advertisement PDF downloadLoading ...