Performance of Sino-implant (II) in routine service delivery in Madagascar

Contraception. 2013 Jul;88(1):103-8. doi: 10.1016/j.contraception.2013.03.006. Epub 2013 Mar 19.

Abstract

Background: Sino-implant (II) is a low-cost subdermal contraceptive implant containing levonorgestrel that is currently labeled for 4 years of use. Widely used in China and Indonesia, it has been little studied elsewhere. We conducted a prospective study of Sino-implant (II) use by women in Madagascar.

Methods: We enrolled a total of 621 women 18 or older who had Sino-implant (II) inserted on day of enrollment, some in fixed clinical sites, and some at outreach sites. Half of the women were scheduled for follow-up visits at 3 months and at 12 months postinsertion (active follow-up cohort); the other half were advised to return if they desired care for any problem, thought they were pregnant or wanted the implants removed (passive surveillance cohort).

Results: No insertion complications were reported. A total of 384 women returned for an earlier visit, and 351 returned for a later visit, for a total of 419 woman-years of observation. No postinsertion pregnancies or serious adverse events were observed. Twenty-eight implant removals were reported by 12 months, a cumulative removal probability of 7.3 per 100 women. Acceptability of the implants was very high, as was satisfaction with clinic services.

Conclusions: This is the first report on the performance of Sino-implant (II) from outside China and Indonesia and among the first in the English-language literature. These initial data from Madagascar indicate a favorable level of safety, effectiveness and acceptability during the first year of use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Contraception Behavior / ethnology
  • Contraceptive Agents, Female* / administration & dosage
  • Contraceptive Agents, Female* / adverse effects
  • Device Removal
  • Drug Implants
  • Female
  • Humans
  • Levonorgestrel* / administration & dosage
  • Levonorgestrel* / adverse effects
  • Longitudinal Studies
  • Madagascar
  • Patient Acceptance of Health Care / ethnology
  • Patient Satisfaction / ethnology
  • Product Surveillance, Postmarketing
  • Prospective Studies
  • Young Adult

Substances

  • Contraceptive Agents, Female
  • Drug Implants
  • Levonorgestrel