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Feasibility and validity of telephone triage for adverse events during a voluntary medical male circumcision campaign in Swaziland.

Journal Article
(Published September, 2014)
Adamu, T. (Author),
Grund, J. (Author),
Mhlanga, M. (Author),
Hlophe, T. (Author),
Mirira, M. (Author),
Bock, N. (Author),
Njeuhmeli, E. (Author),
Curran, K. (Author),
Mallas, E. (Author),
Fitzgerald, L. (Author),
Shoshore, R. (Author),
Khumbulani, M. (Author),
Bicego, G. (Author)
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The article describes a retrospective study that analyzed a dataset of telephone calls logged by the voluntary medical male circumcision (VMMC) hotline during a VMMC campaign. The objectives were to determine reasons clients called the VMMC hotline and to ascertain the accuracy of telephone-based triage for VMMC adverse events (AEs). A total of 17,059 calls were registered by the triage nurses from April to December 2011. Seventy-three percent of the calls requested VMMC education and counseling and were the most common type of call. Triage nurses diagnosed 384 clients with 420 (2.5%) AEs. According to the predefined clinical algorithms, all moderate and severe AEs (153) diagnosed through telephone triage were referred for clinical management at a health facility. Clinicians at the VMMC sites diagnosed 341 (4.1%) total clients as having a mild (46.0%), moderate (47.8%), or severe (6.2%) AE. Eighty-nine (26%) of the 341 clients who were diagnosed with AEs by clinicians at a VMMC site had initially called the VMMC hotline.

The authors concluded that the use of a telephone-based triage system may be an appropriate first step to identify life-threatening and urgent complications following VMMC surgery. This is especially essential as safety and community perception of safety in large-scale surgical services are critical components of acceptability. An important next step will be to determine the cost of the system in its initial and recurrent elements and thus its viability and sustainability in Swaziland and other countries where VMMC scale-up is part of the national HIV prevention strategy.

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Citation: 
Ashengo TA, Grund J, Mhlanga M, Hlophe T, Mirira M, Bock N, et al. Feasibility and validity of telephone triage for adverse events during a voluntary medical male circumcision campaign in Swaziland. BMC Public Health. 2014;14(1):858.