Original research article| Volume 88, ISSUE 1, P103-108, July 2013

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



      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.


      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).


      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.


      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.


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        • Steiner M.J.
        • Lopez L.M.
        • Grimes D.A.
        • et al.
        Sino-implant (II) ��� a levonorgestrel-releasing two-rod implant: systematic review of the randomized controlled trials.
        Contraception. 2010; 81: 197-201
        • Steiner M.J.
        • Boler T.
        • Obhai G.
        • Hubacher D.
        Assessment of a disposable trocar for insertion of contraceptive implants.
        Contraception. 2010; 81: 140-142
        • Hatcher R.A.
        • Trussell J.
        • Nelson A.L.
        • Cates Jr., W.
        • Kowal D.
        • Policar M.S.
        Contraceptive technology.
        20th ed. Ardent Media, New York2011
        • Grimes D.A.
        Forgettable contraception.
        Contraception. 2009; 80: 497-499
        • United Nations
        World Contraceptive Use 2010.
        Department of Economic and Social Affairs, Population Division, Geneva2011
        • Hubacher D.
        • Dorflinger L.
        Avoiding controversy in international provision of subdermal contraceptive implants (editorial).
        Contraception. 2012; 85: 432-433