Circumcision of male infants and children as a public health measure in developed countries: A critical assessment of recent evidence

Frisch, Mørten; Earp, Brian D.

doi:10.1080/17441692.2016.1184292

Cited by 55 publications

(34 citation statements)

References 63 publications

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“…Despite this, opponents of MC do not accept the CDC's position. Two prominent opponents, Frisch and Earp, published arguments that led them to conclude that “from a scientific and medical perspective, current evidence suggests that circumcision is not an appropriate public health measure for developed countries such as the United States.” 6 …”

Section: Introductionmentioning

confidence: 99%

“…In a recently published article, Frisch and Earp 6 oppose the 2014 draft MC recommendations from the U.S. Centers for Disease Control and Prevention (CDC), 3 referring to what they believe are “numerous scientific and conceptual shortcomings.” Here, we quote these 7 criticisms by Frisch and Earp and provide our response to each criticism.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

CDC's Male Circumcision Recommendations Represent a Key Public Health Measure

Morris

Krieger

Klausner³

2017

Glob Health Sci Pract

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CDC's Male Circumcision Recommendations Represent a Key Public Health Measure

Morris

Krieger

Klausner³

2017

Glob Health Sci Pract

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“…The overall complication rate for circumcision ranges from 0.2 to 10% with many USA physicians performing the procedure without formal training, being unaware of contraindications, and incapable of handling post-op complications (56, 91, 92). Lower complication rates for early and late adverse events have been attributed to underreporting with late adverse events mistakenly not attributed to circumcision (92, 93). Consequently, the low number ascribed to circumcision as the cause of death (63) may be underreported and erroneously attributed to other causes, such as sepsis (94) or SIDS.…”

Section: Introductionmentioning

confidence: 99%

A “Wear and Tear” Hypothesis to Explain Sudden Infant Death Syndrome

Elhaik

2016

Front. Neurol.

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Sudden infant death syndrome (SIDS) is the leading cause of death among USA infants under 1 year of age accounting for ~2,700 deaths per year. Although formally SIDS dates back at least 2,000 years and was even mentioned in the Hebrew Bible (Kings 3:19), its etiology remains unexplained prompting the CDC to initiate a sudden unexpected infant death case registry in 2010. Due to their total dependence, the ability of the infant to allostatically regulate stressors and stress responses shaped by genetic and environmental factors is severely constrained. We propose that SIDS is the result of cumulative painful, stressful, or traumatic exposures that begin in utero and tax neonatal regulatory systems incompatible with allostasis. We also identify several putative biochemical mechanisms involved in SIDS. We argue that the important characteristics of SIDS, namely male predominance (60:40), the significantly different SIDS rate among USA Hispanics (80% lower) compared to whites, 50% of cases occurring between 7.6 and 17.6 weeks after birth with only 10% after 24.7 weeks, and seasonal variation with most cases occurring during winter, are all associated with common environmental stressors, such as neonatal circumcision and seasonal illnesses. We predict that neonatal circumcision is associated with hypersensitivity to pain and decreased heart rate variability, which increase the risk for SIDS. We also predict that neonatal male circumcision will account for the SIDS gender bias and that groups that practice high male circumcision rates, such as USA whites, will have higher SIDS rates compared to groups with lower circumcision rates. SIDS rates will also be higher in USA states where Medicaid covers circumcision and lower among people that do not practice neonatal circumcision and/or cannot afford to pay for circumcision. We last predict that winter-born premature infants who are circumcised will be at higher risk of SIDS compared to infants who experienced fewer nociceptive exposures. All these predictions are testable experimentally using animal models or cohort studies in humans. Our hypothesis provides new insights into novel risk factors for SIDS that can reduce its risk by modifying current infant care practices to reduce nociceptive exposures.

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“…For example, a vaginal ring containing dapivirine was recently shown to be partially efficacious in preventing HIV acquisition among women [46, 47]. Similarly, male circumcision [48, 49] and oral anti-retroviral (ARV) use as pre-exposure prophylaxis (PrEP) have been found to be partially efficacious at preventing HIV acquisition in populations such as MSM, discordant couples, IDUs, heterosexual men, and some populations of women [50–54]. Topical and systemic PrEP have shown more variable efficacy in women in sub-Saharan Africa than in MSM [50–54].…”

Section: Accounting For the Evolving Hiv Prevention Landscapementioning

confidence: 99%

Modeling HIV vaccine trials of the future

Gilbert

Huang

Janes

2016

Current Opinion in HIV and AIDS

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Purpose of review Models of implementation of known-effective interventions for HIV prevention indicate that an efficacious vaccine to prevent HIV infection would be critical for controlling the HIV pandemic. Key issues in the design of future HIV vaccine trials are (1) How to develop reliable immunological correlates of vaccine efficacy, (2) How to down-select candidate vaccine regimens into efficacy trials, and (3) How to learn about vaccine efficacy in the context of the evolving HIV prevention landscape. Recent findings Whereas in the past phase-I/II HIV vaccine trials have addressed (1) and (2) using a small set of immunological assays and readouts, recently they have used a battery of assays with highly multivariate readouts. In addition, systems vaccinology studies of other pathogens measuring PBMC transcriptomics and other immunological features pre- and post-first vaccination are demonstrating value, for example providing discoveries that pre-immunization and early post-immunization cell population markers can predict influenza-specific antibody titer that is a correlate of vaccine protection. The HIV prevention landscape continues to evolve, and the design and analysis of vaccine trials is evolving alongside, to accommodate increasingly dynamic and regional standards of HIV prevention. Summary Development of interpretable and robust functional assays, in addition to the associated bioinformatics and statistical analytic tools, are needed to improve the assessment of correlates of protection in efficacy trials and the down-selection of candidate vaccine regimens into efficacy trials. Moreover, high-priority trials should integrate systems vaccinology, including analysis of pre-vaccination and early post-vaccination markers.

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Circumcision of male infants and children as a public health measure in developed countries: A critical assessment of recent evidence

Cited by 55 publications

References 63 publications

CDC's Male Circumcision Recommendations Represent a Key Public Health Measure

CDC's Male Circumcision Recommendations Represent a Key Public Health Measure

A “Wear and Tear” Hypothesis to Explain Sudden Infant Death Syndrome

Modeling HIV vaccine trials of the future

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