BackgroundApproximately one in three men are circumcised globally, but there are relatively few data on the safety of the procedure. The aim of this paper is to summarize the literature on frequency of adverse events following pediatric circumcision, with a focus on developing countries.MethodsPubMed and other databasess were searched with keywords and MeSH terms including infant/newborn/pediatric/child, circumcision, complications and adverse events. Searches included all available years and were conducted on November 6th 2007 and updated on February 14th 2009. Additional searches of the Arabic literature included searches of relevant databases and University libraries for research theses on male circumcision.Studies were included if they contained data to estimate frequency of adverse events following neonatal, infant and child circumcision. There was no language restriction. A total of 1349 published papers were identified, of which 52 studies from 21 countries met the inclusion criteria. The Arabic literature searches identified 46 potentially relevant papers, of which six were included.ResultsSixteen prospective studies evaluated complications following neonatal and infant circumcision. Most studies reported no severe adverse events (SAE), but two studies reported SAE frequency of 2%. The median frequency of any complication was 1.5% (range 0-16%). Child circumcision by medical providers tended to be associated with more complications (median frequency 6%; range 2-14%) than for neonates and infants. Traditional circumcision as a rite of passage is associated with substantially greater risks, more severe complications than medical circumcision or traditional circumcision among neonates.ConclusionsStudies report few severe complications following circumcision. However, mild or moderate complications are seen, especially when circumcision is undertaken at older ages, by inexperienced providers or in non-sterile conditions. Pediatric circumcision will continue to be practiced for cultural, medical and as a long-term HIV/STI prevention strategy. Risk-reduction strategies including improved training of providers, and provision of appropriate sterile equipment, are urgently needed.

The COVID-19 pandemic underscored the importance of vaccination to support individual health across the life-course, with vaccination playing a central strategy role in mitigating transmission and disease. This required unprecedented mobilization and coordination across all sectors to meet people where they are, enable equitable access, and build vaccination confidence. A literature search was conducted with combinations of the keywords and variations of vaccination and faith-based organizations (FBOs). Search inclusion criteria were: (1) FBO programs that supported public health emergency efforts, including vaccination efforts as the primary outcome; and (2) articles written in English language. A total of 37 articles met inclusion criteria (n = 26 focused on general public health campaigns, n = 11 focused on vaccination efforts). The findings related to public health campaigns fell into four themes: FBO’s ability to (1) tailor public health campaigns; (2) mitigate barriers; (3) establish trust; and (4) disseminate and sustain efforts. The findings related to vaccine uptake efforts fell into three themes: (1) pre-pandemic influenza and HPV vaccination efforts, (2) addressing vaccine disparities in minority communities, and (3) enabling COVID-19 vaccination. This review demonstrated that FBOs have a vital role in both public health campaigns and vaccination initiatives to support high vaccine uptake and confidence.

BackgroundMale circumcision can provide life-long reduction in the risk of acquiring HIV infection. In South Africa, the KwaZulu-Natal Provincial Department of Health committed to rolling out circumcision programs to address the HIV epidemic. The Department of Health enlisted the help of St. Mary’s Hospital in Mariannhill and the Operation Abraham Collaborative.MethodsSt. Mary’s Hospital and the Operation Abraham Collaborative partnered to establish a voluntary medical male circumcision facility, called Asiphile, and to train surgeons, nurses and health clinic staff to serve KwaZulu-Natal.ResultsOver the course of the implementation period, 9,980 circumcisions were conducted at the Asiphile facility. The uptake numbers increased throughout 2010 and 2011 and began to level off as the demand of early adopters may have been met. Uptake spiked during school vacations and staff training sessions. Additionally, 92 % of clients returned for post-operation follow-up and only 2 % of clients experienced any adverse event.ConclusionSt. Mary’s Hospital and the Operation Abraham Collaborative were able to cooperate and successfully implement a voluntary medical male circumcision facility in KwaZulu-Natal. Although uptake was lower than projected, lessons learned from efforts to overcome challenges in recruitment, transportation, and coordination can help inform and improve new and existing population-based male circumcision programs.

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