The Ministry of Health has announced plans to roll out the new circumcision device, prepex, to more hospitals following its successful trials at Nyamata and Kanombe Military hospitals.The programme will start in three district referral hospitals and will eventually be scaled up to other health facilities, according to Dr Vincent Mutabazi, the Director of Research Grants Unit and Lead Investigator in the Prepex trials at the Rwanda Biomedical Centre. He said the system was approved by the World Health Organisation (WHO) Male Circumcision Technical Advisory Group.“In February 2012, after scientifically validating the safety and efficacy of the device, its comparison to surgical circumcision, and simplicity in the hands of low cadre health care, the use of prepex device for circumcision gained WHO’s approval,” Mutabazi said.The official noted that there was high demand for male circumcision, especially among young adults.“To date, 1,160 circumcision procedures using the PrePex device have been conducted safely in Rwanda, where 888 procedures were performed in the framework of clinical studies,” Mutabazi said.The objective is to reach 2 million adult men in a period of 24 months, to achieve the national goal of reducing HIV incidence rate by 50 percent.Since 2009, the Rwanda Ministry of Health has been carrying out clinical trials on the new and innovative device developed for adult male circumcision.The government has been keen to explore innovations in male circumcision that would be more suitable for non-physicians, in non-sterile rural settings, which would minimise the burden on the existing healthcare system.The Prepex device is the first known to facilitate male circumcision without injectable anaesthesia, stitches or sterile settings.The procedure is bloodless, faster than surgical circumcision and only requires a clean environment to be performed.It works through a special elastic mechanism that fits closely around an inner ring, trapping the penis foreskin, which dries up and is removed after a week.A few years ago, the World Health Organisation recommended that male circumcision be promoted as part of a comprehensive HIV prevention package after randomised and controlled studies in Africa showed male circumcision can reduce the lifetime risk of HIV infection by 53–60 percent.A Prepex Centre of Excellence to train trainers in Rwanda and the region has also been established.
