{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:35:33Z","timestamp":1774611333008,"version":"3.50.1"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T00:00:00Z","timestamp":1630627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Voluntary Medical Male Circumcision (VMMC) is a key intervention in HIV\/AIDS. Improving VMMC program uptake in Zambia requires careful monitoring of adverse events (AE) to inform program quality and safety. We investigate the prevalence of VMMC AE and their associated factors among adult males in Ndola, Copperbelt Province, Zambia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We performed a cross-sectional study using secondary clinical data collected in 2015 using two validated World Health Organisation\/Ministry of Health reporting forms. We reviewed demographics and VMMC surgical details from 391 randomly sampled adult males aged \u226518 years at Ndola Teaching Hospital, a specialised VMMC fixed site in Zambia. Non-parametric tests (Fisher\u2019s exact test or Chi-square depending on assumptions being met) and logistic regression were conducted to determine the relationships between associated factors and VMMC AE.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The overall VMMC AE prevalence was 3.1% (95% CI 1.60%\u2013 5.30%) and most AEs occurred postoperatively. In decreasing order, the commonly reported VMMC AE included; bleeding (47.1%), swelling (29.4%), haematoma (17.6%), and delayed wound healing (5.9%). There was an inversely proportional relationship between VMMC volume (as measured by the number of surgeries conducted per VMMC provider) and AEs. Compared to the highest VMMC volume of 63.2% (247\/391) as reference, as VMMC volume reduced to 35.0% (137\/391) and then 1.8% (7\/391), the likelihood of AEs increased by five times (aOR 5.08; 95% CI 1.33\u201319.49; p = 0.018) and then sixteen times (aOR 16.13; 95% CI 1.42\u2013183.30; p = 0.025) respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our study found a low prevalence of VMMC AEs in Ndola city, Copperbelt Province of Zambia guaranteeing the safety of the VMMC program. We recommend more surgically proficient staff to continue rendering this service. There is a need to explore other high priority national\/regional areas of VMMC program safety\/quality, such as adherence to follow-up visits.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0256955","type":"journal-article","created":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T17:39:13Z","timestamp":1630690753000},"page":"e0256955","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study"],"prefix":"10.1371","volume":"16","author":[{"given":"Imukusi","family":"Mutanekelwa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seter","family":"Siziya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9490-5609","authenticated-orcid":true,"given":"Victor","family":"Daka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elijah","family":"Kabelenga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth L.","family":"Mfune","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misheck","family":"Chileshe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Mulenga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert Tato","family":"Nyirenda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Nyirenda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steward","family":"Mudenda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bright","family":"Mukanga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kasonde","family":"Bowa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,9,3]]},"reference":[{"key":"pone.0256955.ref001","unstructured":"WHO. 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Available from: http:\/\/journals.plos.org\/plosmedicine\/article?id=10.1371\/journal.pmed.0020298.","DOI":"10.1371\/journal.pmed.0020298"},{"issue":"9562","key":"pone.0256955.ref004","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/S0140-6736(07)60312-2","article-title":"Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial","volume":"369","author":"RC Bailey","year":"2007","journal-title":"Lancet"},{"issue":"9562","key":"pone.0256955.ref005","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S0140-6736(07)60313-4","article-title":"Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial","volume":"369","author":"RH Gray","year":"2007","journal-title":"Lancet"},{"issue":"5","key":"pone.0256955.ref006","first-page":"609","article-title":"The effectiveness of male circumcision for HIV prevention and effects on risk behaviors in a post-trial follow up study in Rakai","volume":"26","author":"RH Gray","year":"2012","journal-title":"Uganda. 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Available from: http:\/\/makir.mak.ac.ug\/handle\/10570\/4367.","DOI":"10.21203\/rs.3.rs-31743\/v1"},{"issue":"1","key":"pone.0256955.ref013","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1097\/QAI.0000000000000535","article-title":"Evaluation of Loss-to-Follow-up and Postoperative Adverse Events in a Voluntary Medical Male Circumcision Program in Nyanza Province, Kenya","volume":"69","author":"J Reed","year":"2015","journal-title":"Acquir Immune Defic Syndr"},{"issue":"19275","key":"pone.0256955.ref014","first-page":"1","article-title":"Low adverse event rates following voluntary medical male circumcision in a high HIV disease burden public sector prevention programme in South Africa.","volume":"17","author":"R Phili","year":"2014","journal-title":"Journal of the International AIDS Society"},{"key":"pone.0256955.ref015","unstructured":"WHO. Manual for male circumcision under local anaesthesia and HIV prevention services for adolescent boys and men. [Internet]. 2018 [cited 2020 August 08]. Available from: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/272387\/9789241513593-eng.pdf?ua=1."},{"key":"pone.0256955.ref016","unstructured":"GRZ. Zambia National VMMC Operational Plan (2016\u20132020). [Internet]. Lusaka: Government printers; 2016 [cited 2020 August 09]. Available from: http:\/\/dspace.unza.zm\/bitstream\/handle\/123456789\/5108\/ZambiaVMMCoperationalPlan2016-2020(1).pdf;jsessionid=FDD56C481EBADD5111AA97235A551930?sequence=1."},{"key":"pone.0256955.ref017","unstructured":"GRZ. The 2012 List of Health Facilities in Zambia. [Internet]. 2012 [cited 2016 February 11]. 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Shang Ring Device for Voluntary Medical Male Circumcision. [Internet]. 2020 [cited 2021 April 20]. 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