DOI: 10.5061/dryad.c30hk
title: Data from: Prospective comparison of two models of integrating early infant male circumcision with maternal child health services in Kenya: the Mtoto Msafi Mbili Study

description: As countries scale up adult voluntary medical male circumcision (VMMC) for
 HIV prevention, they are looking ahead to long term sustainable
 strategies, including introduction of early infant male circumcision
 (EIMC). To address the lack of evidence regarding introduction of EIMC
 services in sub-Saharan African settings, we conducted a simultaneous,
 prospective comparison of two models of EIMC service delivery in Homa Bay
 County, Kenya. In one division a standard delivery package (SDP) was
 introduced and included health facility-based provision of EIMC services
 with community engagement for client referral versus in a different
 division a standard package plus (SDPplus) that included
 community-delivered EIMC services. Babies 1–60 days old were eligible for
 EIMC. A representative sample of mothers and fathers of baby boys at 16
 health facilities was surveyed. We examined differences between mothers
 and fathers in the SDP and SDPplus divisions and identified factors
 associated with EIMC uptake. We report adjusted prevalence ratios (aPR).
 Of 1660 mothers interviewed, 1501 (89%) gave approval to contact the
 father, and 1259 fathers (84%) were interviewed. The proportion of babies
 circumcised was slightly greater in the SDPplus division than the SDP
 division (27.3% vs 23.7%), but the difference was not significant (p =
 0.08). In adjusted analyses, however, the prevalence of babies being
 circumcised was greater in the SDPplus division (aPR = 1.23, 95%
 CI:1.04–1.45) and the factors associated with a baby being circumcised
 were the mother having received information about EIMC (during pregnancy,
 aPR = 4.81, 95% CI: 2.21–3.42), having discussed circumcision with the
 father if married or cohabiting (aPR = 5.39, 95% CI: 3.31–8.80) or being
 single (aPR = 5.67, 95% CI: 3.31–9.69), perceiving herself to be living
 with HIV (aPR = 1.39, 95% CI: 1.15–1.67), or having a post-secondary
 education (aPR = 1.33, 95% CI: 1.04–1.69), and the father being Muslim
 (aPR = 1.85, 95% CI: 1.29–2.65) or circumcised (aPR = 1.34, 95% CI:
 1.13–1.59). The median age of 2117 babies circumcised was 8 days (IQR:
 1–36), and the median weight was 3.6 kg (IQR: 3.2–4.4). There were 6
 moderate adverse events (AEs) (0.28%); 5 severe AEs (0.24%), all involving
 an injury to the glans penis, requiring hospitalization and corrective
 surgery; and one death probably related to the procedure. There were no
 AEs among the 365 procedures performed outside health facilities.
 Information and education campaigns must reach members of the general
 population, especially men and fathers, who are influential to the EIMC
 decision. Serious AEs using the Mogen clamp are rare, but do occur and
 require efficient, reliable emergency back-up. Our results can assist
 countries considering scale-up of EIMC services for HIV prevention as
 their adult VMMC programs mature.
description: Mtoto Msafi Mbili
 Project Mothers SurveyQuestionnaire data from
 survey of mothers.MM2_MothersSurvey.csvMtoto Msafi Mbili Project Fathers SurveyQuestionnaire data from survey of fathersMM2_FathersSurvey.csvMtoto Msafi Mbili Project Infant DataData from Ministry of Health Infant Male Circumcision Client FormMM2_Infants.csvMtoto Msafi Mbilii Study FormsThis pdf file contains the Ministry of Health client form and mother and father questionnaires.MM2_Study_Forms.pdf