IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0063134.html
   My bibliography  Save this article

Reach and Cost-Effectiveness of the PrePex Device for Safe Male Circumcision in Uganda

Author

Listed:
  • Kevin Duffy
  • Moses Galukande
  • Nick Wooding
  • Monica Dea
  • Alex Coutinho

Abstract

Introduction: Modelling, supported by the USAID Health Policy Initiative and UNAIDS, performed in 2011, indicated that Uganda would need to perform 4.2 million medical male circumcisions (MMCs) to reach 80% prevalence. Since 2010 Uganda has completed 380,000 circumcisions, and has set a national target of 1 million for 2013. Objective: To evaluate the relative reach and cost-effectiveness of PrePex compared to the current surgical SMC method and to determine the effect that this might have in helping to achieve the Uganda national SMC targets. Methods: A cross-sectional descriptive cost-analysis study conducted at International Hospital Kampala over ten weeks from August to October 2012. Data collected during the performance of 625 circumcisions using PrePex was compared to data previously collected from 10,000 circumcisions using a surgical circumcision method at the same site. Ethical approval was obtained. Results: The moderate adverse events (AE) ratio when using the PrePex device was 2% and no severe adverse events were encountered, which is comparable to the surgical method, thus the AE rate has no effect on the reach or cost-effectiveness of PrePex. The unit cost to perform one circumcision using PrePex is $30.55, 35% ($7.90) higher than the current surgical method, but the PrePex method improves operator efficiency by 60%, meaning that a team can perform 24 completed circumcisions compared to 15 by the surgical method. The cost-effectiveness of PrePex, comparing the cost of performing circumcisions to the future cost savings of potentially averted HIV infections, is just 2% less than the current surgical method, at a device cost price of $20. Conclusion: PrePex is a viable SMC tool for scale-up with unrivalled potential for superior reach, however national targets can only be met with effective demand creation and availability of trained human resource.

Suggested Citation

  • Kevin Duffy & Moses Galukande & Nick Wooding & Monica Dea & Alex Coutinho, 2013. "Reach and Cost-Effectiveness of the PrePex Device for Safe Male Circumcision in Uganda," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-6, May.
    • Handle: RePEc:plo:pone00:0063134
    DOI: 10.1371/journal.pone.0063134
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0063134
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0063134&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0063134?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. James G Kahn & Elliot Marseille & Bertran Auvert, 2006. "Cost-Effectiveness of Male Circumcision for HIV Prevention in a South African Setting," PLOS Medicine, Public Library of Science, vol. 3(12), pages 1-10, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Emmanuel Njeuhmeli & Katharine Kripke & Karin Hatzold & Jason Reed & Dianna Edgil & Juan Jaramillo & Delivette Castor & Steven Forsythe & Sinokuthemba Xaba & Owen Mugurungi, 2014. "Cost Analysis of Integrating the PrePex Medical Device into a Voluntary Medical Male Circumcision Program in Zimbabwe," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-7, May.
    2. Michel Tchuenche & Eurica Palmer & Vibhuti Haté & Ananthy Thambinayagam & Dayanund Loykissoonlal & Emmanuel Njeuhmeli & Steven Forsythe, 2016. "The Cost of Voluntary Medical Male Circumcision in South Africa," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-17, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Steffen Flessa, 2009. "Cost effectiveness of antiretrovirals — long term or short term?," Applied Health Economics and Health Policy, Springer, vol. 7(4), pages 225-227, December.
    2. Elliot Marseille & James Kahn & Christian Pitter & Rebecca Bunnell & William Epalatai & Emmanuel Jawe & Willy Were & Jonathan Mermin, 2009. "The cost effectiveness of home-based provision of antiretroviral therapy in rural Uganda," Applied Health Economics and Health Policy, Springer, vol. 7(4), pages 229-243, December.
    3. Bruce Larson & Allan Tindikahwa & George Mwidu & Hannah Kibuuka & Fred Magala, 2015. "How Much Does It Cost to Improve Access to Voluntary Medical Male Circumcision among High-Risk, Low-Income Communities in Uganda?," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-11, March.
    4. James G Kahn & Nicholas Muraguri & Brian Harris & Eric Lugada & Thomas Clasen & Mark Grabowsky & Jonathan Mermin & Shahnaaz Shariff, 2012. "Integrated HIV Testing, Malaria, and Diarrhea Prevention Campaign in Kenya: Modeled Health Impact and Cost-Effectiveness," PLOS ONE, Public Library of Science, vol. 7(2), pages 1-9, February.
    5. Michel Tchuenche & Eurica Palmer & Vibhuti Haté & Ananthy Thambinayagam & Dayanund Loykissoonlal & Emmanuel Njeuhmeli & Steven Forsythe, 2016. "The Cost of Voluntary Medical Male Circumcision in South Africa," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-17, October.
    6. Michel Tchuenche & Vibhuti Haté & Dacia McPherson & Eurica Palmer & Ananthy Thambinayagam & Dayanund Loykissoonlal & Emmanuel Njeuhmeli & Steven Forsythe, 2016. "Estimating Client Out-of-Pocket Costs for Accessing Voluntary Medical Male Circumcision in South Africa," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-10, October.
    7. Jessica B McGillen & John Stover & Daniel J Klein & Sinokuthemba Xaba & Getrude Ncube & Mutsa Mhangara & Geraldine N Chipendo & Isaac Taramusi & Leo Beacroft & Timothy B Hallett & Patrick Odawo & Rumb, 2018. "The emerging health impact of voluntary medical male circumcision in Zimbabwe: An evaluation using three epidemiological models," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-17, July.
    8. Olalekan A Uthman & Taiwo Aderemi Popoola & Mubashir M B Uthman & Olatunde Aremu, 2010. "Economic Evaluations of Adult Male Circumcision for Prevention of Heterosexual Acquisition of HIV in Men in Sub-Saharan Africa: A Systematic Review," PLOS ONE, Public Library of Science, vol. 5(3), pages 1-7, March.
    9. Dickens S Omondi Aduda & Collins Ouma & Rosebella Onyango & Mathews Onyango & Jane Bertrand, 2015. "Voluntary Medical Male Circumcision Scale-Up in Nyanza, Kenya: Evaluating Technical Efficiency and Productivity of Service Delivery," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-17, February.
    10. Paul Gavaza & Karen Rascati & Abiola Oladapo & Star Khoza, 2012. "The State of Health Economic Research in South Africa," PharmacoEconomics, Springer, vol. 30(10), pages 925-940, October.
    11. Bertran Auvert & Elliot Marseille & Eline L Korenromp & James Lloyd-Smith & Remi Sitta & Dirk Taljaard & Carel Pretorius & Brian Williams & James G Kahn, 2008. "Estimating the Resources Needed and Savings Anticipated from Roll-Out of Adult Male Circumcision in Sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 3(8), pages 1-8, August.
    12. Margaret Brandeau & Gregory Zaric, 2009. "Optimal investment in HIV prevention programs: more is not always better," Health Care Management Science, Springer, vol. 12(1), pages 27-37, March.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0063134. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.