Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-15 (of 15 Records) |
Query Trace: Gichangi A[original query] |
---|
Tropical data: Approach and methodology as applied to trachoma prevalence surveys
Harding-Esch EM , Burgert-Brucker CR , Jimenez C , Bakhtiari A , Willis R , Bejiga MD , Mpyet C , Ngondi J , Boyd S , Abdala M , Abdou A , Adamu Y , Alemayehu A , Alemayehu W , Al-Khatib T , Apadinuwe SC , Awaca N , Awoussi MS , Baayendag G , Badiane MD , Bailey RL , Batcho W , Bay Z , Bella A , Beido N , Bol YY , Bougouma C , Brady CJ , Bucumi V , Butcher R , Cakacaka R , Cama A , Camara M , Cassama E , Chaora SG , Chebbi AC , Chisambi AB , Chu B , Conteh A , Coulibaly SM , Courtright P , Dalmar A , Dat TM , Davids T , Djaker MEA , de Fátima Costa Lopes M , Dézoumbé D , Dodson S , Downs P , Eckman S , Elshafie BE , Elmezoghi M , Elvis AA , Emerson P , Epée EE , Faktaufon D , Fall M , Fassinou A , Fleming F , Flueckiger R , Gamael KK , Garae M , Garap J , Gass K , Gebru G , Gichangi MM , Giorgi E , Goépogui A , Gómez DVF , Gómez Forero DP , Gower EW , Harte A , Henry R , Honorio-Morales HA , Ilako DR , Issifou AAB , Jones E , Kabona G , Kabore M , Kadri B , Kalua K , Kanyi SK , Kebede S , Kebede F , Keenan JD , Kello AB , Khan AA , Khelifi H , Kilangalanga J , Kim SH , Ko R , Lewallen S , Lietman T , Logora MSY , Lopez YA , MacArthur C , Macleod C , Makangila F , Mariko B , Martin DL , Masika M , Massae P , Massangaie M , Matendechero HS , Mathewos T , McCullagh S , Meite A , Mendes EP , Abdi HM , Miller H , Minnih A , Mishra SK , Molefi T , Mosher A , M'Po N , Mugume F , Mukwiza R , Mwale C , Mwatha S , Mwingira U , Nash SD , Nassa C , Negussu N , Nieba C , Noah Noah JC , Nwosu CO , Olobio N , Opon R , Pavluck A , Phiri I , Rainima-Qaniuci M , Renneker KK , Saboyá-Díaz MI , Sakho F , Sanha S , Sarah V , Sarr B , Szwarcwald CL , Shah Salam A , Sharma S , Seife F , Serrano Chavez GM , Sissoko M , Sitoe HM , Sokana O , Tadesse F , Taleo F , Talero SL , Tarfani Y , Tefera A , Tekeraoi R , Tesfazion A , Traina A , Traoré L , Trujillo-Trujillo J , Tukahebwa EM , Vashist P , Wanyama EB , Warusavithana SDP , Watitu TK , West S , Win Y , Woods G , Yajima A , Yaya G , Zecarias A , Zewengiel S , Zoumanigui A , Hooper PJ , Millar T , Rotondo L , Solomon AW . Ophthalmic Epidemiol 2023 30 (6) 544-560 PURPOSE: Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys. METHODS: Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported. RESULTS: Between 29(th) February 2016 and 24(th) April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma. CONCLUSION: This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets. |
Formative assessment to identify perceived benefits and barriers of HIV oral self-testing among female sex workers, service providers, outreach workers, and peer educators to inform scale-up in Kenya
Agot K , Cain M , Medley A , Kimani J , Gichangi P , Kiio C , Mukiri E , Odonde P , Toroitich-Ruto C , Bingham T , Downer M , Chesang K . AIDS Care 2021 34 (6) 1-8 In Kenya, HIV prevalence estimates among female sex workers (FSWs) are almost five times higher than among women in the general population. However, only 68% of infected FSWs are aware of their HIV-positive status. We aimed to identify perceived benefits, opportunities, and barriers of HIV self-testing (HIVST) in improving testing coverage among FSWs. Twenty focus group discussions were conducted with 77 service providers, 42 peer educators (PEs) and outreach workers, and 37 FSWs attending drop-in centers (DiCEs) in four regions of Kenya. An additional 8 FSWs with HIV-negative or unknown status-completed in-depth interviews. Data were analyzed thematically. Acceptability of HIVST was high, with cited benefits including confidentiality, convenience, and ease of use. Barriers included absence of counseling, potential for inaccurate results, fear of partner reaction, possible misuse, and fear that HIVST could lead to further stigmatization. PEs and DiCEs were the preferred models for distributing HIVST kits. FSWs wanted kits made available free or at a nominal cost (100 Kenya Shillings or ∼USD 1). Linkage to confirmatory testing, the efficiency of distributing HIVST kits using peers and DiCEs, and the types and content of effective HIVST messaging require further research. |
Disclosure and clinical outcomes among young adolescents living with HIV in Kenya
Ngeno B , Waruru A , Inwani I , Nganga L , Wangari EN , Katana A , Gichangi A , Mwangi A , Mukui I , Rutherford GW . J Adolesc Health 2018 64 (2) 242-249 Purpose: Informing adolescents of their own HIV infection is critical as the number of adolescents living with HIV increases. We assessed the association between HIV disclosure and retention in care and mortality among adolescents aged 10-14 years in Kenya's national program. Methods: We abstracted routinely collected patient-level data for adolescents enrolled into HIV care in 50 health facilities from November 1, 2004, through March 31, 2010. We defined disclosure as any documentation that the adolescent had been fully or partially made aware of his or her HIV status. We compared weighted proportions for categorical variables using chi2 and weighted logistic regression to identify predictors of HIV disclosure; we estimated the probability of LTFU using Kaplan-Meier methods and dying using Cox regression-based test for equality of survival curves. Results: Of the 710 adolescents aged 10-14 years analyzed; 51.3% had severe immunosuppression, 60.3% were in WHO stage 3 or 4, and 36.6% were aware of their HIV status. Adolescents with HIV-infected parents, histories of opportunistic infections (OIs), and enrolled in support groups were more likely to be disclosed to. At 36 months, disclosure was associated with lower mortality [1.5% (95% CI.6%-4.1%) versus 5.4% (95% CI 3.6.6%-8.0%, p <.001)] and lower LTFU [6.2% (95% CI 3.0%-12.6%) versus 33.9% (95% CI 27.3%-41.1%) p <.001]. Conclusions: Only one third of HIV-infected Kenyan adolescents in treatment programs had been told they were infected, and knowing their HIV status was associated with reduced LTFU and mortality. The disclosure process should be systematically encouraged and organized for HIV-infected adolescents. |
Vulnerabilities at first sex and their association with lifetime gender-based violence and HIV prevalence among adolescent girls and young women engaged in sex work, transactional sex, and casual sex in Kenya
Becker ML , Bhattacharjee P , Blanchard JF , Cheuk E , Isac S , Musyoki HK , Gichangi P , Aral S , Pickles M , Sandstrom P , Ma H , Mishra S . J Acquir Immune Defic Syndr 2018 79 (3) 296-304 BACKGROUND: Adolescent girls and young women (AGYW) experience high rates of HIV early in their sexual life-course. We estimated the prevalence of HIV-associated vulnerabilities at first sex, and their association with lifetime gender-based violence (GBV) and HIV. METHODS: We conducted a cross-sectional bio-behavioural survey among AGYW (14-24 years) in Mombasa, Kenya in 2015. We compared the prevalence of first sex vulnerabilities across AGYW who self-identified as engaging in sex work (N=408), transactional sex (N=177) or casual sex (N=714); and used logistic regression to identify age-adjusted associations between first sex vulnerabilities and outcomes (GBV after first sex; HIV). RESULTS: The median age at first sex was 16 years (IQR 14 - 18). 43.6% received gifts or money at first sex; 41.2% and 11.2% experienced a coerced and forced first sex respectively. First sex vulnerabilities were generally more common among AGYW in sex work. GBV (prevalence 23.8%) and HIV (prevalence 5.6%) were associated with first sex before age 15 (GBV AOR 1.4, 95% CI 1.0-1.9; HIV AOR 1.9, 95% CI 1.1-1.3); before or within 1 year of menarche (GBV AOR 1.3, 95% CI 1.0-1.7; HIV AOR 2.1, 95% CI 1.3-3.6); and receipt of money (GBV AOR 1.9, 95% CI 1.4-2.5; HIV AOR 2.0, 95% CI 1.2-3.4). CONCLUSION: HIV-associated vulnerabilities begin at first sex and potentially mediate an AGYW's trajectory of risk. HIV prevention programmes should include structural interventions that reach AGYW early, and screening for a history of first sex vulnerabilities could help identify AGYW at risk of ongoing GBV and HIV.This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Application of psychosocial models to Home-Based Testing and Counseling (HBTC) for increased uptake and household coverage in a large informal urban settlement in Kenya
Oluoch P , Orwa J , Lugalia F , Mutinda D , Gichangi A , Oundo J , Karama M , Nganga Z , Galbraith J . Pan Afr Med J 2017 27 285 Introduction: Home Based Testing and Counselling (HBTC) aims at reaching individuals who have low HIV risk perception and experience barriers which prevent them from seeking HIV testing and counseling (HTC) services. Saturating the community with HTC is needed to achieve the ambitious 90-90-90 targets of knowledge of HIV status, ARV treatment and viral suppression. This paper describes the use of health belief model and community participation principles in HBTC to achieve increased household coverage and HTC uptake. Methods: This cross sectional survey was done between August 2009 and April 2011 in Kibera slums, Nairobi city. Using three community participation principles; defining and mobilizing the community, involving the community, overcoming barriers and respect to cultural differences and four constructs of the health belief model; risk perception, perceived severity, perceived benefits of changed behavior and perceived barriers; we offered HTC services to the participants. Descriptive statistics were used to describe socio-demographic characteristics, calculate uptake and HIV prevalence. Results: There were 72,577 individuals enumerated at the start of the program; 75,141 residents were found during service delivery. Of those, 71,925 (95.7%) consented to participate, out of which 71,720 (99.7%) took the HIV test. First time testers were (39%). The HIV prevalence was higher (6.4%) among repeat testers than first time testers (4.0%) with more women (7.4%) testing positive than men (3.6%) and an overall 5.5% slum prevalence. Conclusion: This methodology demonstrates that the use of community participation principles combined with a psychosocial model achieved high HTC uptake, coverage and diagnosed HIV in individuals who believed they are HIV free. This novel approach provides baseline for measuring HTC coverage in a community. |
Enhancing maternal and child health using a combined mother & child health booklet in Kenya
Mudany MA , Sirengo M , Rutherford GW , Mwangi M , Nganga LW , Gichangi A . J Trop Pediatr 2015 61 (6) 442-7 Under Kenyan guidelines, HIV-exposed infants should be tested for HIV DNA at 6 weeks or at first clinical contact thereafter, as infants come for immunization. Following the introduction of early infant diagnoses programmes, however, many infants were not being tested and linked to care and treatment. We developed the Mother & Child Health Booklet to help relate mothers' obstetrical history to infants' healthcare providers to facilitate follow-up and timely management. The booklet contains information on the mother's pregnancy, delivery and postpartum course and her child's growth and development, immunization, nutrition and other data need to monitor the child to 5 years of age. It replaced three separate record clinical cards. In a 1 year pilot evaluation of the booklet in Nyanza province in 2007-08, the number of HIV DNA tests on infants increased by 34% from 9966 to 13 379. The booklet was subsequently distributed nationwide in 2009. Overall, the numbers of infants tested for HIV DNA rose from 27 000 in 2007 to 60 000 in 2012, which represents approximately 60% of the estimated HIV-exposed infants in Kenya. We believe that the booklet is an important strategy for identifying and treating infected infants and, thus, in progress toward Millennium Development Goal 4. |
Tuberculosis and HIV at the national level in Kenya: results from the second Kenya AIDS Indicator Survey
Mbithi A , Gichangi A , Kim AA , Katana A , Weyenga H , Williamson J , Robinson K , Oluoch T , Maina WK , Kellogg TA , De Cock KM . J Acquir Immune Defic Syndr 2014 66 Suppl 1 S106-15 BACKGROUND: Co-morbidity with tuberculosis and HIV is a common cause of mortality in sub-Saharan Africa. In the second Kenya AIDS Indicator Survey, we collected data on knowledge and experience of HIV and tuberculosis, as well as on access to and coverage of relevant treatment services and antiretroviral therapy (ART) in Kenya. METHODS: A national, population-based household survey was conducted from October 2012 to February 2013. Information was collected through household questionnaires, and blood samples were taken for HIV, CD4 cell counts, and HIV viral load testing at a central laboratory. RESULTS: Overall, 13,720 persons aged 15-64 years participated; 96.7% [95% confidence interval (CI): 96.3 to 97.1] had heard of tuberculosis, of whom 2.0% (95% CI: 1.7 to 2.2) reported having prior tuberculosis. Among those with laboratory-confirmed HIV infection, 11.6% (95% CI: 8.9 to 14.3) reported prior tuberculosis. The prevalence of laboratory-confirmed HIV infection in persons reporting prior tuberculosis was 33.2% (95% CI: 26.2 to 40.2) compared to 5.1% (95% CI: 4.5 to 5.8) in persons without prior tuberculosis. Among those in care, coverage of ART for treatment-eligible persons was 100% for those with prior tuberculosis and 88.6% (95% CI: 81.6 to 95.7) for those without. Among all HIV-infected persons, ART coverage among treatment-eligible persons was 86.9% (95% CI: 74.2 to 99.5) for persons with prior tuberculosis and 58.3% (95% CI: 47.6 to 69.0) for those without. CONCLUSIONS: Morbidity from tuberculosis and HIV remain major health challenges in Kenya. Tuberculosis is an important entry point for HIV diagnosis and treatment. Lack of knowledge of HIV serostatus is an obstacle to access to HIV services and timely ART for prevention of HIV transmission and HIV-associated disease, including tuberculosis. |
Engagement in HIV care among Kenyan adults and adolescents: results from a national population-based survey
Wafula R , Masyuko S , Ng'ang'a L , Kim AA , Gichangi A , Mukui I , Batuka J , Ngugi EW , Maina WK , Schwarcz S . J Acquir Immune Defic Syndr 2014 66 Suppl 1 S98-s105 BACKGROUND: Increasing access to care and treatment for HIV-infected persons is a goal in Kenya's response to the HIV epidemic. Using data from the second Kenya AIDS Indicator Survey (KAIS 2012), we describe coverage of services received among adults and adolescents who were enrolled in HIV care. METHODS: KAIS 2012 was a population-based survey that collected information from persons aged 15-64 years that included self-reported HIV status, and for persons reporting HIV infection, use of HIV care and antiretroviral therapy (ART). Blood specimens were collected and tested for HIV. HIV-positive specimens were tested for CD4 counts and viral load. RESULTS: Among 363 persons who reported HIV infection, 93.4% [95% confidence interval (CI): 87.2 to 99.6] had ever received HIV care. Among those receiving HIV care, 96.3% (95% CI: 94.1 to 98.4) were using cotrimoxazole prophylaxis, and 74.6% (95% CI: 69.0 to 80.2) were receiving ART. A lower proportion of persons in care and not on ART reported using cotrimoxazole (89.5%, 95% CI: 82.5 to 96.5 compared with 98.6%, 95% CI: 97.1 to 100) and had a CD4 count measurement done (72.9%, 95% CI: 64.0 to 81.9 compared with 90.0%, 95% CI: 82.8 to 97.3) than persons in care and on ART, respectively. Among persons in care and not on ART, 23.2% (95% CI: 6.8 to 39.7) had CD4 counts ≤350 cells per microliter. Viral suppression was observed in 75.3% (95% CI: 68.7 to 81.9) of persons on ART. CONCLUSIONS: Linkage and retention in care are high among persons with known HIV infection. However, improvements in care for the pre-ART population are needed. Viral suppression rates were comparable to developed settings. |
Male circumcision programmes in Kenya: lessons from the Kenya AIDS Indicator Survey 2007
Mwandi Z , Bunnell R , Cherutich P , Mermin J , Kim AA , Gichangi A , Mureithi P , Kellogg TA , Oluoch T , Muttunga J , Ngare C , Kim E , Kaiser R . Bull World Health Organ 2012 90 (9) 642-51 OBJECTIVE: To provide guidance for male circumcision programmes in Kenya by estimating the population of uncircumcised men and investigating the association between circumcision and infection with the human immunodeficiency virus (HIV), with particular reference to uncircumcised, HIV-uninfected men. METHODS: Data on men aged 15 to 64 years were derived from the 2007 Kenya AIDS Indicator Survey, which involved interviews and blood collection to test for HIV and herpes simplex virus 2 (HSV-2). The prevalence of HIV infection and circumcision in Kenyan provinces was calculated and the demographic characteristics and sexual behaviour of circumcised and uncircumcised, HIV-infected and HIV-uninfected men were recorded. FINDINGS: The national prevalence of HIV infection in uncircumcised men was 13.2% (95% confidence interval, CI: 10.8-15.7) compared with 3.9% (95% CI: 3.3-4.5) among circumcised men. Nyanza province had the largest estimated number of uncircumcised, HIV-uninfected men (i.e. 601,709), followed by Rift Valley, Nairobi and Western Province, respectively, and most belonged to the Luo ethnic tribe. Of these men, 77.8% did not know their HIV status and 33.2% were HSV-2-positive. In addition, 65.3% had had unprotected sex with a partner of discordant or unknown HIV status in the past 12 months and only 14.7% consistently used condoms with their most recent partner. However, only 21.8% of the uncircumcised, HIV-uninfected men aged 15 to 19 years were sexually active. CONCLUSION: The Kenyan male circumcision strategy should focus on the provinces with the highest number of uncircumcised, HIV-uninfected men and target young men before or shortly after sexual debut. |
Epidemiology of respiratory viral infections in two long-term refugee camps in Kenya, 2007-2010
Ahmed JA , Katz MA , Auko E , Njenga MK , Weinberg M , Kapella BK , Burke H , Nyoka R , Gichangi A , Waiboci LW , Mahamud A , Qassim M , Swai B , Wagacha B , Mutonga D , Nguhi M , Breiman RF , Eidex RB . BMC Infect Dis 2012 12 (1) 7 BACKGROUND: Refugees are at risk for poor outcomes from acute respiratory infections (ARI) because of overcrowding, suboptimal living conditions, and malnutrition. We implemented surveillance for respiratory viruses in Dadaab and Kakuma refugee camps in Kenya to characterize their role in the epidemiology of ARI among refugees. METHODS: From 1 September 2007 through 31 August 2010, we obtained nasopharyngeal (NP) and oropharyngeal (OP) specimens from patients with influenza-like illness (ILI) or severe acute respiratory infections (SARI) and tested them by RT-PCR for adenovirus (AdV), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), parainfluenza viruses (PIV), and influenza A and B viruses. Definitions for ILI and SARI were adapted from those of the World Health Organization. Proportions of cases associated with viral etiology were calculated by camp and by clinical case definition. In addition, for children <5 years only, crude estimates of rates due to SARI per 1000 were obtained. RESULTS: We tested specimens from 1815 ILI and 4449 SARI patients (median age=1 year). Proportion positive for virus were AdV, 21.7%; RSV, 12.5%; hMPV, 5.7%; PIV, 9.4%; influenza A, 9.7%; and influenza B, 2.6%; 49.8% were positive for at least one virus. The annual rate of SARI hospitalization for 2007-2010 was 57 per 1000 children per year. Virus-positive hospitalization rates were 14 for AdV; 9 for RSV; 6 for PIV; 4 for hMPV; 5 for influenza A; and 1 for influenza B. The rate of SARI hospitalization was highest in children <1 year old (156 per 1000 child-years). The ratio of rates for children <1 year and 1 to <5 years old was 3.7:1 for AdV, 5.5:1 for RSV, 4.4:1 for PIV, 5.1:1 for hMPV, 3.2:1 for influenza A, and 2.2:1 for influenza B. While SARI hospitalization rates peaked from November to February in Dadaab, no distinct seasonality was observed in Kakuma. CONCLUSIONS: Respiratory viral infections, particularly RSV and AdV, were associated with high rates of illness and make up a substantial portion of respiratory infection in these two refugee settings. |
Correlates of HIV infection among sexually active adults in Kenya: a national population-based survey
Oluoch T , Mohammed I , Bunnell R , Kaiser R , Kim AA , Gichangi A , Mwangi M , Dadabhai S , Marum L , Orago A , Mermin J . Open AIDS J 2011 5 125-34 OBJECTIVE: To identify factors associated with prevalent HIV in a national HIV survey in Kenya. METHODS: The Kenya AIDS Indicator Survey was a nationally representative population-based sero-survey that examined demographic and behavioral factors and serologic testing for HIV, HSV-2 and syphilis in adults aged 15-64 years. We analyzed questionnaire and blood testing data to identify significant correlates of HIV infection among sexually active adults. RESULTS: Of 10,957 eligible women and 8,883 men, we interviewed 10,239 (93%) women and 7,731 (87%) men. We collected blood specimens from 9,049 women and 6,804 men of which 6,447 women and 5,112 men were sexually active during the 12 months prior to the survey. HIV prevalence among sexually active adults was 7.4%. Factors independently associated with HIV among women were region (Nyanza vs Nairobi: adjusted OR [AOR] 1.6, 95%CI 1.1-2.3), number of lifetime sex partners (6-9 vs 0-1 partners: AOR 3.0, 95%CI 1.6-5.9), HSV-2 (AOR 6.5, 95%CI 4.9-8.8), marital status (widowed vs never married: AOR 2.7, 95%CI 1.5-4.8) and consistent condom use with last sex partner (AOR 2.3, 95%CI 1.6-3.4). Among men, correlates of HIV infection were 30-to-39-year-old age group (AOR 5.2, 95%CI 2.6-10.5), number of lifetime sex partners (10+ vs 0-1 partners, AOR 3.5, 95%CI 1.4-9.0), HSV-2 (AOR 4.7, 95%CI 3.2-6.8), syphilis (AOR 2.4, 95%CI 1.4-4.0), consistent condom use with last sex partner (AOR 2.1, 95% CI 1.5-3.1) and lack of circumcision (AOR 4.0, 95%CI 2.8 - 5.5). CONCLUSION: Kenya's heterogeneous epidemic will require regional and gender-specific prevention approaches. |
Unsafe sex among HIV-infected adults in Kenya: results of a nationally representative survey
Mwangi M , Bunnell R , Nyoka R , Gichangi A , Makokha E , Kim A , Kichamu G , Marum L , Ichwara J , Mermin J . J Acquir Immune Defic Syndr 2011 58 (1) 80-8 OBJECTIVE: Assess factors associated with knowledge of HIV status, sexual activity, and unprotected sex with a partner of unknown or negative HIV status (unsafe sex) among HIV-infected adults in Kenya. DESIGN: Nationally representative Kenya AIDS Indicator Survey among adults aged 15-64 years in 2007. METHODS: A standardized questionnaire was administered and blood samples tested for HIV. We assessed factors associated with knowledge of HIV infection, sexual activity, and unsafe sex. Analyses took into account stratification and clustering in the survey design and estimates were weighted to account for sampling probability. RESULTS: Of 15,853 participants with blood samples, 1104 (6.9%) were HIV infected. Of these, 83.8% did not know their HIV status (56% had never tested; 27.8% reported their last HIV test was negative), and 80.4% were sexually active. Of 861 sexually active adults, 76.9% reported unsafe sex in the past year. Adults who did not know their HIV status were more likely to be sexually active [never tested adjusted odds ratio (AOR): 5.5, 95% confidence interval (CI): 2.8 to 10.7; ever tested, incorrect knowledge AOR: 6.5, CI: 2.1 to 19.6) and to report unsafe sex (never tested AOR: 51.7, CI: 27.3 to 97.6; ever tested, incorrect knowledge of status AOR: 18.6, CI: 8.6 to 40.5) than those who knew their status. CONCLUSIONS: The majority of adults did not know they were infected and engaged in unsafe sex. Adults who knew their HIV status were less likely to be sexually active and report unsafe sex compared with those unaware of their infection. HIV prevention interventions that target HIV-infected adults are urgently needed. |
Epidemiology of syphilis in Kenya: results from a nationally representative serological survey
Otieno-Nyunya B , Bennett E , Bunnell R , Dadabhai S , Gichangi AA , Mugo N , Wanyungu J , Baya I , Kaiser R . Sex Transm Infect 2011 87 (6) 521-525 OBJECTIVES: The authors used data from the Kenya AIDS Indicator Survey (KAIS) 2007 to determine the prevalence of syphilis and associated risk factors among adults aged 15-64 years. METHODS: KAIS was a nationally representative population-based sero-survey that examined demographic and behavioural indicators and serological testing for syphilis, HIV and herpes simplex virus type 2 (HSV-2) in adults aged 15-64 years. The authors analysed data from 8935 women and 6727 men with complete syphilis results. Logistic regression models stratified by sex were used to assess potential factors associated with syphilis sero-prevalence. RESULTS: Overall, 262 adults tested positive for syphilis (1.8%, 95% CI 1.5% to 2.1%); sero-prevalence was similar among women and men (1.7%, 95% CI 1.3% to 2.0% and 1.9%, 95% CI 1.5% to 2.3%, respectively). Syphilis prevalence was the highest among men with HIV (6.4%, 95% CI 3.1% to 9.7%) and HSV-2 (4.5%, 95% CI 3.4% to 5.7%) infection. Independent risk factors for syphilis included HIV (men only, adjusted OR (AOR) 3.4, 95% CI 1.6% to 7.1%), HSV-2 (women, AOR 3.5, 95% CI 2.1% to 5.8%; men AOR 2.2, 95% CI 1.3% to 3.7%), lack of male circumcision (AOR 2.2, 95% CI 1.3% to 3.7%), poorest or poorer versus richest wealth index (women, AOR 2.0, 95% CI 1.0% to 4.2%; men AOR 2.5, 95% CI 1.4% to 4.9%) and no primary versus secondary or more education in men (AOR 4.8, 95% CI 2.0% to 11.7%). CONCLUSIONS: Syphilis prevalence in the general population in Kenya is relatively low and eradication could be possible but would require intensified syphilis prevention and control efforts, including routine screening in HIV, sexually transmitted infection and antenatal care clinics as well as in family planning and male circumcision settings. |
Population-based biochemistry, immunologic and hematological reference values for adolescents and young adults in a rural population in Western Kenya
Zeh C , Amornkul PN , Inzaule S , Ondoa P , Oyaro B , Mwaengo DM , Vandenhoudt H , Gichangi A , Williamson J , Thomas T , Decock KM , Hart C , Nkengasong J , Laserson K . PLoS One 2011 6 (6) e21040 BACKGROUND: There is need for locally-derived age-specific clinical laboratory reference ranges of healthy Africans in sub-Saharan Africa. Reference values from North American and European populations are being used for African subjects despite previous studies showing significant differences. Our aim was to establish clinical laboratory reference values for African adolescents and young adults that can be used in clinical trials and for patient management. METHODS AND FINDINGS: A panel of 298, HIV-seronegative individuals aged 13-34 years was randomly selected from participants in two population-based cross-sectional surveys assessing HIV prevalence and other sexually transmitted infections in western Kenya. The adolescent (<18 years)-to-adults (≥18 years) ratio and the male-to-female ratio was 1:1. Median and 95% reference ranges were calculated for immunohematological and biochemistry values. Compared with U.S-derived reference ranges, we detected lower hemoglobin (HB), hematocrit (HCT), red blood cells (RBC), mean corpuscular volume (MCV), neutrophil, glucose, and blood urea nitrogen values but elevated eosinophil and total bilirubin values. Significant gender variation was observed in hematological parameters in addition to T-bilirubin and creatinine indices in all age groups, AST in the younger and neutrophil, platelet and CD4 indices among the older age group. Age variation was also observed, mainly in hematological parameters among males. Applying U.S. NIH Division of AIDS (DAIDS) toxicity grading to our results, 40% of otherwise healthy study participants were classified as having an abnormal laboratory parameter (grade 1-4) which would exclude them from participating in clinical trials. CONCLUSION: Hematological and biochemistry reference values from African population differ from those derived from a North American population, showing the need to develop region-specific reference values. Our data also show variations in hematological indices between adolescent and adult males which should be considered when developing reference ranges. This study provides the first locally-derived clinical laboratory reference ranges for adolescents and young adults in western Kenya. |
Blood donors in Kenya: a comparison of voluntary and family replacement donors based on a population-based survey
Kimani D , Mwangi J , Mwangi M , Bunnell R , Kellogg TA , Oluoch T , Gichangi A , Kaiser R , Mugo N , Odongo T , Oduor M , Marum L . Vox Sang 2010 100 (2) 212-8 BACKGROUND AND OBJECTIVES: Blood safety and sufficiency are major challenges in Kenya and other sub-Saharan African countries forcing many countries to rely on family replacement donors (FRD). We analysed data from a national AIDS indicator survey to describe blood donors in Kenya and potential risks of transfusion transmissible infections (TTI) comparing voluntary donors and FRD. MATERIALS AND METHODS: A population-based, cross-sectional survey was conducted in 2007 among 15- to 64- year-olds. Consenting participants were interviewed about blood donation history and were tested for HIV, HSV-2 and syphilis. RESULTS: Of the 17 940 people surveyed, 445 (2.3%) reported donating blood in the prior 12 months. Sixty-four per cent were voluntary donors, and the rest were FRD. Compared to FRD, the majority of voluntary donors were < 25 years old (59% versus 18%), from the highest wealth quintile (57% versus 42%) and single (64% versus 23%). In addition, voluntary donors were less likely to have been sexually active than replacement donors (43% versus 13%). HIV prevalence was lower among voluntary donors than among FRD (2.6% versus 7.4%, P-value = 0.07). CONCLUSIONS: The majority of blood donors in Kenya are voluntary with lower potential risk of TTI. |
- Page last reviewed:Feb 1, 2024
- Page last updated:May 06, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure