Deformity Clinical Trial
Official title:
Evaluation of the Acceptability and Safety of the ShangRing Device for Male Circumcision in Shinyanga, Tanzania
Verified date | February 2024 |
Source | IntraHealth International |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational [Patient Registry] |
The goal of this observational study was to evaluate the safety and acceptability of the ShangRing device for male circumcision among men in Shinyanga, Tanzania. The main question aims to answer both provider acceptability (practicality of device use and placement and removal times) and client acceptability (comfort during placement and removal, experience while wearing the ring, and penile appearance after healing). Participants voluntarily underwent male circumcision using the ShangRing device and before being discharged, were interviewed about their experience. Participants were also interviewed at device removal day (day 7), during a follow-up phone call (day 10), a sample were selected to participate in in-depth interviews (day28), and finally all men were asked to return for a follow-up visit (day 49).
Status | Completed |
Enrollment | 575 |
Est. completion date | July 30, 2019 |
Est. primary completion date | June 11, 2019 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Male |
Age group | 13 Years and older |
Eligibility | Inclusion Criteria: - Be an uncircumcised male aged 13 years or older - Be seeking medical circumcision at one of the study sites - Consent to an HIV test, unless they were known to be HIV-positive - Agree to be circumcised using the ShangRing device - Have their penis fit into one of the ShangRing ring sizes available during the study - Be able to understand the evaluation procedures and requirements - Agree to abstain from sexual intercourse and masturbation for six weeks after ring removal, for a total of seven weeks - Live within 30 kilometers of the facility in Shinyanga Region, Tanzania - Be willing to provide valid contact information (i.e., telephone number, address of residence, place of employment, and other locator information) and be willing to receive communications and/or follow-up visits - Have an activated mobile phone or access to a mobile phone - Agree to return for a follow-up visit to assess healing at day 49 (42 days post-removal) - Agree to a ten-day post-placement (three days post-removal) telephone call to assess and detect symptoms of AEs - Be able to communicate in English and/or Kiswahili - Be capable and willing to provide written informed consent (18 years and older) or written informed consent from a parent guardian (13-17 years) to participate for both HIV testing services and VMMC services Exclusion Criteria: - A cognitive impairment that prevented the client from providing consent - Any health condition (reported or observed) that was a contraindication to surgical VMMC in the national program or that ShangRing providers deemed a contraindication. These may include diabetes, peripheral vascular disease, cancer, bleeding disorders, and/or current moderate or severe infectious illness. - A current sexually transmitted infection (STI) other than HIV (clients with STIs were advised to return for circumcision once the STI was treated); and/or other conditions, which in the opinion of the site supervisor, prevented the client from undergoing a circumcision with the ShangRing device. |
Country | Name | City | State |
---|---|---|---|
Tanzania | Kahama District Hospital | Shinyanga | |
Tanzania | Ushetu Health Centre | Shinyanga |
Lead Sponsor | Collaborator |
---|---|
IntraHealth International | Centers for Disease Control and Prevention, Jhpiego, Ministry of Health, Tanzania, President Office Regional Administration and Local Government, Tanzania, World Health Organization |
Tanzania,
Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005 Nov;2(11):e298. doi: 10.1371/journal.pmed.0020298. Epub 2005 Oct 25. Erratum In: PLoS Med. 2006 May;3(5):e298. — View Citation
Awori QD, Lee RK, Li PS, Moguche JN, Ouma D, Sambai B, Goldstein M, Barone MA. Use of the ShangRing circumcision device in boys below 18 years old in Kenya: results from a pilot study. J Int AIDS Soc. 2017 Jul 12;20(1):21588. doi: 10.7448/IAS.20.1.21588. — View Citation
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Barone MA LP, Zulu R, Awori QD, et al. A Field Study of Male Circumcision Using the Shang Ring, a Minimally Invasive Disposable Device, in Routine Clinical Settings in Kenya and Zambia. 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; Kuala Lumpur, Malaysia, 2013.
Barone MA, Awori QD, Li PS, Simba RO, Weaver MA, Okech JO, Aduda AO, Cherutich P, Muraguri N, Wekesa JM, Nyanchoka J, Perchal P, Masson P, Lee R, Goldstein M, Kioko J, Lusi O, Sokal DC. Randomized trial of the Shang Ring for adult male circumcision with removal at one to three weeks: delayed removal leads to detachment. J Acquir Immune Defic Syndr. 2012 Jul 1;60(3):e82-9. doi: 10.1097/QAI.0b013e31824ea1f2. — View Citation
Barone MA, Li PS, Awori QD, Lee R, Goldstein M. Clinical trials using the Shang Ring device for male circumcision in Africa: a review. Transl Androl Urol. 2014 Mar;3(1):113-24. doi: 10.3978/j.issn.2223-4683.2014.01.09. — View Citation
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* Note: There are 19 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of Adverse Events | Total numbers and types of known adverse events (AE)s occurring among clients, including all severities of AEs (mild, moderate, severe) and serious AEs, including detailed information about all instances of device displacement/detachment/self-removal/malfunction, need for medical attention or intervention, and final outcomes in those experiencing AEs | 49 days post device placement | |
Primary | Number of Clients with Adverse Events | Total number of clients with known adverse events (AEs) (may be different from above if clients experience multiple AEs), including all severities of AEs and serious AEs | 49 days post device placement | |
Primary | Descriptions of Adverse Events | A description of each adverse event by type and classification, severity, time of occurrence (during placement, in situ, or during removal) time of detection (days post-application and/or post-removal) captured as date AE is diagnosed, clinical management, and resolution | 49 days post device placement | |
Secondary | Provider Training | Determine the training needed for proficiency, including number of procedures required under supervision to become certified as fully proficient. This will involve analyzing AE rates stratified by during training and post-training in addition to overall. | 49 days post device placement | |
Secondary | Client Follow-up Visit Rate | Total number of clients who return for recommended follow-up at 49 days post-device placement, divided by the total number of ShangRing-circumcised clients | 49 days post device placement | |
Secondary | Client Preference for ShangRing Over Surgical Circumcision | Proportion of ShangRing clients who report they would still choose ShangRing method over surgical circumcision. This was captured using multiple choice:
"After having worn the ring for a week, would you still choose ShangRing for circumcision, or would you choose surgery?" I would definitely choose ShangRing again I would probably choose ShangRing again I would probably choose surgery I would definitely choose surgery I don't know |
At device removal (7 days post device placement) | |
Secondary | Client Recommendation Rate | Proportion of clients who report they would recommend VMMC using ShangRing. This was captured with a yes/no question:
"At this point would you recommend ShangRing to someone you know who is considering circumcision?" Yes No I don't know |
At device removal (7 days post device placement) | |
Secondary | Cosmetic Result Acceptability | Client reporting on the cosmetic result post-removal. This was captured with multiple choice:
"How satisfied are you with the appearance of your penis?" I am very satisfied I am satisfied I am dissatisfied I am very dissatisfied I don't know |
At device removal (7 days post device placement) | |
Secondary | Client Experience While Performing Routine Activities | Client reports on their experience while wearing ShangRing. This is captured with multiple choice:
"How much did the ring affect you while performing day-to-day activities?" It did not affect me at all It only affected me while performing certain activities It affected me during all activities, but I could still do them It prevented me from performing certain activities |
At device removal (7 days post device placement) | |
Secondary | Client Discomfort | Clients' opinions discomfort while wearing the ShangRing. This was captured with multiple choice:
"How much discomfort did you experience while wearing the ShangRing device over the past seven days?" I had no discomfort while wearing the ring I had minor discomfort while wearing the ring I had moderate discomfort while wearing the ring I had a lot of discomfort while wearing the ring |
At device removal (7 days post device placement) | |
Secondary | Provider Ease of Application | Provider perceived ease of application, captured with a Likert scale:
"I found ShangRing circumcisions to be easy to perform." Strongly disagree Disagree Neither Agree nor Disagree Agree Strongly Agree |
Immediately after the completion of the provider ShangRing training | |
Secondary | Provider Preference | Provider perceived preference of performing ShangRing procedures, captured with a Likert scale:
"I prefer performing ShangRing procedures over surgical circumcision." Strongly disagree Disagree Neither Agree nor Disagree Agree Strongly Agree |
Immediately after the completion of the provider ShangRing training | |
Secondary | Provider Recommendation | Provider recommendation of ShangRing to potential clients, captured with a Likert scale:
"I would advise that clients select ShangRing circumcision over surgical circumcision." Strongly disagree Disagree Neither Agree nor Disagree Agree Strongly Agree |
Immediately after the completion of the provider ShangRing training | |
Secondary | Description of Procedures | Measure both the ShangRing application and removal times, including the time it took for topical anesthesia to take effect | 49 days post device placement | |
Secondary | Healing rate | The percentage of clients determined by a clinician to be clinically healed 49-52 days post-placement of the ShangRing device (42 days post-removal), and the time at which point all clients are clinically healed | 52 days post device placement |
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