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https://www.readbyqxmd.com/read/29346385/combined-effectiveness-of-anthelmintic-chemotherapy-and-wash-among-hiv-infected-adults
#1
Arianna R Means, Lisette van Lieshout, Eric Brienen, Krista Yuhas, James P Hughes, Paul Ndungu, Benson Singa, Judd L Walson
INTRODUCTION: Current global helminth control guidelines focus on regular deworming of targeted populations for morbidity control. However, water, sanitation, and hygiene (WASH) interventions may also be important for reducing helminth transmission. We evaluated the impact of different potential helminth protective packages on infection prevalence, including repeated treatment with albendazole and praziquantel with and without WASH access. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a cohort study nested within a randomized trial of empiric deworming of HIV-infected adults in Kenya...
January 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29342180/increased-prevalence-of-pregnancy-and-comparative-risk-of-program-attrition-among-individuals-starting-hiv-treatment-in-east-africa
#2
Charles B Holmes, Constantin T Yiannoutsos, Batya Elul, Elizabeth Bukusi, John Ssali, Andrew Kambugu, Beverly S Musick, Craig Cohen, Carolyn Williams, Lameck Diero, Nancy Padian, Kara K Wools-Kaloustian
BACKGROUND: The World Health Organization now recommends initiating all pregnant women on life-long antiretroviral therapy (ART), yet there is limited information about the characteristics and program outcomes of pregnant women already on ART in Africa. Our hypothesis was that pregnant women comprised an increasing proportion of those starting ART, and that sub-groups of these women were at higher risk for program attrition. METHODS AND FINDINGS: We used the International Epidemiology Databases to Evaluate AIDS- East Africa (IeDEA-EA) to conduct a retrospective cohort study including HIV care and treatment programs in Kenya, Uganda, and Tanzania...
2018: PloS One
https://www.readbyqxmd.com/read/29329299/multi-drug-resistant-non-typhoidal-salmonella-associated-with-invasive-disease-in-western-kenya
#3
Adam Akullian, Joel M Montgomery, Grace John-Stewart, Samuel I Miller, Hillary S Hayden, Matthew C Radey, Kyle R Hager, Jennifer R Verani, John Benjamin Ochieng, Jane Juma, Jim Katieno, Barry Fields, Godfrey Bigogo, Allan Audi, Judd Walson
Non-typhoidal Salmonella (NTS) is a leading cause of bloodstream infections in Africa, but the various contributions of host susceptibility versus unique pathogen virulence factors are unclear. We used data from a population-based surveillance platform (population ~25,000) between 2007-2014 and NTS genome-sequencing to compare host and pathogen-specific factors between individuals presenting with NTS bacteremia and those presenting with NTS diarrhea. Salmonella Typhimurium ST313 and Salmonella Enteritidis ST11 were the most common isolates...
January 12, 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29324811/scale-up-of-kenya-s-national-hiv-viral-load-program-findings-and-lessons-learned
#4
Matilu Mwau, Catherine Akinyi Syeunda, Maureen Adhiambo, Priska Bwana, Lucy Kithinji, Joy Mwende, Laura Oyiengo, Martin Sirengo, Caroline E Boeke
OBJECTIVES: Kenya is one of the first African countries to scale up a national HIV viral load monitoring program. We sought to assess program scale up using the national database and identify areas for systems strengthening. METHODS: Data from January 2012 to March 2016 were extracted from Kenya's national viral load database. Characteristics of 1,108,356 tests were assessed over time, including reason for testing, turnaround times, test results, treatment regimens, and socio-demographic information...
2018: PloS One
https://www.readbyqxmd.com/read/29321026/lay-health-worker-experiences-administering-a-multi-level-combination-intervention-to-improve-pmtct-retention
#5
Abby DiCarlo, Ruby Fayorsey, Masila Syengo, Duncan Chege, Martin Sirengo, William Reidy, Juliana Otieno, Jackton Omoto, Mark P Hawken, Elaine J Abrams
BACKGROUND: The recent scale-up of prevention of mother-to-child transmission of HIV (PMTCT) services has rapidly accelerated antiretroviral therapy (ART) uptake among pregnant and postpartum women in sub-Saharan Africa. The Mother and Infant Retention for Health (MIR4Health) study evaluates the impact of a combination intervention administered by trained lay health workers to decrease attrition among HIV-positive women initiating PMTCT services and their infants through 6 months postpartum...
January 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29317437/infant-feeding-practices-among-hiv-exposed-infants-less-than-6-months-of-age-in-bomet-county-kenya-an-in-depth-qualitative-study-of-feeding-choices
#6
Purity Chepkorir Lang'at, Irene Ogada, Audrey Steenbeek, Noni E MacDonald, Sophie Ochola, Wesley Bor, Godfrey Odinga
BACKGROUND: In children, HIV can be acquired from the mother during pregnancy, delivery and through breast milk. The WHO recommends exclusive breast feeding or exclusive replacement feeding for the first 6 months after birth for HIV-exposed infants. Barriers such as HIV-related stigma, inadequate resources, lack of access to safe water and negative cultural beliefs have been shown to influence infant feeding among HIV-exposed infants in some settings. In Kenya, there is limited literature on the barriers...
January 9, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29316883/active-ingredients-of-a-person-centred-intervention-for-people-on-hiv-treatment-analysis-of-mixed-methods-trial-data
#7
Keira Lowther, Richard Harding, Victoria Simms, Aabid Ahmed, Zipporah Ali, Nancy Gikaara, Lorraine Sherr, Hellen Kariuki, Irene J Higginson, Lucy Ellen Selman
BACKGROUND: A new model of care is required to meet the changing needs of people living with HIV (PLWH), particularly in low and middle-income countries, where prevalence is highest. We evaluated a palliative care intervention for PLWH in Mombasa, Kenya. Although we found no effect on pain (primary outcome), there was a positive effect on mental health (secondary outcome) in the intervention group. To inform replication and implementation, we have determined the active ingredients of the intervention and their mechanisms of action...
January 10, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29316511/young-africans-social-representations-of-rape-in-their-hiv-related-creative-narratives-2005-2014-rape-myths-and-alternative-narratives
#8
Robyn Singleton, Kate Winskell, Siphiwe Nkambule-Vilakati, Gaëlle Sabben
Sexual violence is both a major human rights issue and an important driver of HIV infection in sub-Saharan Africa. While quantitative indicators of sexual violence have evolved to facilitate cross-national comparison and country-level decision making, qualitative findings typically remain constrained to single sites and populations. We analyzed social representations of sexual violence, specifically rape, in a sample of 1446 narratives about HIV written by young Africans between 2005 and 2014. The narratives were written at 5 discrete time points (2005, 2008, 2011, 2013 and 2014) by equal numbers of males and females aged 10-24 in urban and rural areas of Swaziland, Kenya, South-East Nigeria, Burkina Faso and Senegal...
December 26, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29314658/comparative-assessment-of-five-trials-of-universal-hiv-testing-and-treatment-in-sub-saharan-africa
#9
REVIEW
Delphine Perriat, Laura Balzer, Richard Hayes, Shahin Lockman, Fiona Walsh, Helen Ayles, Sian Floyd, Diane Havlir, Moses Kamya, Refeletswe Lebelonyane, Lisa A Mills, Velephi Okello, Maya Petersen, Deenan Pillay, Kalpana Sabapathy, Kathleen Wirth, Joanna Orne-Gliemann, François Dabis
DESIGN: Universal voluntary HIV counselling and testing followed by prompt initiation of antiretroviral therapy (ART) for all those diagnosed HIV-infected (universal test and treat, UTT) is now a global health standard. However, its population-level impact, feasibility and cost remain unknown. Five community-based trials have been implemented in sub-Saharan Africa to measure the effects of various UTT strategies at population level: BCPP/YaTsie in Botswana, MaxART in Swaziland, HPTN 071 (PopART) in South Africa and Zambia, SEARCH in Uganda and Kenya and ANRS 12249 TasP in South Africa...
January 2018: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29297375/the-role-of-male-partners-in-women-s-participation-in-research-during-pregnancy-a-case-study-from-the-partners-demonstration-project
#10
Kenneth Ngure, Susan Brown Trinidad, Kristin Beima-Sofie, Jared M Baeten, Nelly R Mugo, Elizabeth A Bukusi, Renee Heffron, Grace John-Stewart, Maureen C Kelley
The exclusion of pregnant women from health research remains a significant challenge globally. In settings where cultural traditions and gender norms support a more restricted decision-making role for women in general, little is known about the attitudes of male partners toward the inclusion of women in research during pregnancy. Understanding the expectations of both men and women in such cultural settings offers an opportunity to engage and address local ethical concerns to improve women's access to research during pregnancy and enhance intervention development...
December 14, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29296104/addressing-the-dual-health-epidemics-of-hiv-and-sexual-abuse-among-children-and-adolescents-in-kenya-uptake-of-hiv-counseling-and-post-exposure-prophylaxis
#11
Carolyne Ajema, Charity Mbugua, Peter Memiah, Camille Wood, Courtney Cook, Ronald Kotut, Lina Digolo
Purpose: Child sexual abuse and HIV are key health challenges in Kenya. In 2015, LVCT Health conducted a study aimed at assessing the quality of HIV-related services offered to child survivors of sexual violence in public health facilities. Materials and methods: A qualitative data collection approach was utilized. Qualitative data were collected through in-depth interviews with 31 providers. Quantitative methods included a retrospective review of 164 records of child survivors of rape who had accessed services 6 months prior to the commencement of the study...
2018: Adolescent Health, Medicine and Therapeutics
https://www.readbyqxmd.com/read/29291251/gaps-in-the-child-tuberculosis-care-cascade-in-32-rural-communities-in-uganda-and-kenya
#12
Florence Mwangwa, Gabriel Chamie, Dalsone Kwarisiima, James Ayieko, Asiphas Owaraganise, Theodore D Ruel, Albert Plenty, Khai Hoan Tram, Tamara D Clark, Craig R Cohen, Elizabeth A Bukusi, Maya Petersen, Moses R Kamya, Edwin D Charlebois, Diane V Havlir, Carina Marquez
Background: Reducing tuberculosis (TB) deaths among children requires a better understanding of the gaps in the care cascade from TB diagnosis to treatment completion. We sought to assess the child TB care cascade in 32 rural communities in Uganda and Kenya using programmatic data. Methods: This is a retrospective cohort study of 160,851 children (ages <15 years) living in 12 rural communities in Kenya and 22 in Uganda. We reviewed national TB registries from health centers in and adjacent to the 32 communities, and we included all child TB cases recorded from January 1, 2013 to June 30, 2016...
December 2017: Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
https://www.readbyqxmd.com/read/29287090/immune-activation-despite-preserved-cd4-t-cells-in-perinatally-hiv-infected-children-and-adolescents
#13
Patricia Alvarez, Mussa Mwamzuka, Fatma Marshed, Adam Kravietz, Tiina Ilmet, Aabid Ahmed, William Borkowsky, Alka Khaitan
BACKGROUND: HIV disease progresses more rapidly in children than adults with mortality rates exceeding 50% by 2 years of age without antiretroviral therapy (ART) in sub-Saharan Africa. Recent World Health Organization (WHO) guidelines recommend universal treatment for all living persons with HIV, yet there is limited supporting evidence in pediatric populations. The objective of this study was to determine whether CD4 cell counts reflect immunological markers associated with disease progression in ART naïve perinatally-infected HIV+ children and adolescents and their response to ART...
2017: PloS One
https://www.readbyqxmd.com/read/29282109/simulated-patient-encounters-to-improve-adolescent-retention-in-hiv-care-in-kenya-study-protocol-of-a-stepped-wedge-randomized-controlled-trial
#14
Kate S Wilson, Cyrus Mugo, David Bukusi, Irene Inwani, Anjuli D Wagner, Helen Moraa, Tamara Owens, Joseph B Babigumira, Barbra A Richardson, Grace C John-Stewart, Jennifer A Slyker, Dalton C Wamalwa, Pamela K Kohler
BACKGROUND: Adolescent-friendly policies aim to tailor HIV services for adolescents and young adults aged 10-24 years (AYA) to promote health outcomes and improve retention in HIV care and treatment. However, few interventions focus on improving healthcare worker (HCW) competencies and skills for provision of high-quality adolescent care. Standardized patients (SPs) are trained actors who work with HCWs in mock clinical encounters to improve clinical assessment, communication, and empathy skills...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29281636/healthcare-provider-perspectives-on-managing-sexually-transmitted-infections-in-hiv-care-settings-in-kenya-a-qualitative-thematic-analysis
#15
Kipruto Chesang, Sureyya Hornston, Odylia Muhenje, Teresa Saliku, Joy Mirjahangir, Amanda Viitanen, Helgar Musyoki, Christine Awuor, George Githuka, Naomi Bock
BACKGROUND: The burden of sexually transmitted infections (STIs) has been increasing in Kenya, as is the case elsewhere in sub-Saharan Africa, while measures for control and prevention are weak. The objectives of this study were to (1) describe healthcare provider (HCP) knowledge and practices, (2) explore HCP attitudes and beliefs, (3) identify structural and environmental factors affecting STI management, and (4) seek recommendations to improve the STI program in Kenya. METHODS AND FINDINGS: Using individual in-depth interviews (IDIs), data were obtained from 87 HCPs working in 21 high-volume comprehensive HIV care centers (CCCs) in 7 of Kenya's 8 regions...
December 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29280769/disclosure-consent-opportunity-costs-and-inaccurate-risk-assessment-deter-pediatric-hiv-testing-a-mixed-methods-study
#16
Anjuli D Wagner, Gabrielle O'malley, Olivia Firdawsi, Cyrus Mugo, Irene N Njuguna, Elizabeth Maleche-Obimbo, Irene W Inwani, Dalton C Wamalwa, Grace C John-Stewart, Jennifer A Slyker
(250/250 words) BACKGROUND:: Prompt child HIV testing and treatment is critical; however, children are often not diagnosed until symptomatic. Understanding factors that influence pediatric HIV testing can inform strategies to increase testing. METHODS: A mixed-methods study was conducted at a tertiary hospital in Nairobi, Kenya. Three focus group discussions with health care workers (HCW) and 18 in-depth interviews with HIV-infected adults with children of unknown status were analyzed using thematic analysis...
December 22, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29258342/gender-differences-in-health-related-quality-of-life-at-the-time-of-a-positive-hiv-test-a-cross-sectional-study-in-a-resource-poor-high-prevalence-setting-in%C3%A2-nairobi-kenya
#17
Mia L van der Kop, Samuel Muhula, Anik Patel, Lehana Thabane, Patricia Awiti, Lennie Kyomuhangi, Bonface Abunah, Patrick I Nagide, Kirsten Smillie, David I Ojakaa, Joshua Kimani, Anna Mia Ekström, Richard T Lester
Few studies have examined gender differences in sub-Saharan Africa, where HIV disproportionately affects women. Objectives of this cross-sectional study were to determine gender differences in HRQoL at the time of a positive HIV test, and whether factors associated with HRQoL differed between men and women. Adults testing HIV-positive were recruited from two clinics located in informal settlements. HRQoL was measured with the SF-12. Multiple linear regression was used to test whether there were gender differences in physical (PCS) and mental composite summary (MCS) scores...
December 19, 2017: AIDS Care
https://www.readbyqxmd.com/read/29242195/key-programme-science-lessons-from-an-hiv-prevention-learning-site-for-sex-workers-in-mombasa-kenya
#18
Leigh M McClarty, Parinita Bhattacharjee, Shajy Isac, Faran Emmanuel, Japheth Kioko, Margaret Njiraini, Peter Gichangi, Clifford Duncan Okoth, Janet Musimbi-Mbole, James F Blanchard, Stephen Moses, Helgar Muysyoki, Marissa L Becker
OBJECTIVES: In 2013, Kenya's National AIDS and STI Control Programme established a Learning Site (LS) in Mombasa County to support and strengthen capacity for HIV prevention programming within organisations working with sex workers. A defining feature of LS was the use of a Programme Science approach throughout its development and implementation. We provide an overview of the key components of LS, present findings from 23 months of programme monitoring data, and highlight key Programme Science lessons from its implementation and monitoring...
December 14, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/29237583/high-yield-hiv-testing-facilitated-linkage-to-care-and-prevention-for-female-youth-in-kenya-girls-study-implementation-science-protocol-for-a-priority-population
#19
Irene Inwani, Nok Chhun, Kawango Agot, Charles M Cleland, Jasmine Buttolph, Harsha Thirumurthy, Ann E Kurth
BACKGROUND: Sub-Saharan Africa is the region with the highest HIV burden. Adolescent girls and young women (AGYW) in the age range of 15 to 24 years are twice as likely as their male peers to be infected, making females in sub-Saharan Africa the most at-risk group for HIV infection. It is therefore critical to prioritize access to HIV testing, prevention, and treatment for this vulnerable population. OBJECTIVE: Using an implementation science framework, the purpose of this research protocol was to describe the approaches we propose to optimize engagement of AGYW in both the HIV prevention and care continuum and to determine the recruitment and testing strategies that identify the highest proportion of previously undiagnosed HIV infections...
December 13, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29236362/implementation-of-repeat-hiv-testing-during-pregnancy-in-southwestern-kenya-progress-and-missed-opportunities
#20
Anna J Rogers, Eliud Akama, Elly Weke, Justin Blackburn, George Owino, Elizabeth A Bukusi, Patrick Oyaro, Zachary A Kwena, Craig R Cohen, Janet M Turan
INTRODUCTION: Repeat HIV testing during the late antenatal period is crucial to identify and initiate treatment for pregnant women with incident HIV infection to prevent perinatal HIV transmission and keep mothers alive. In 2012, the Kenya Ministry of Health adopted international guidelines suggesting that pregnant women be offered retesting three months after an initial negative HIV test. Our objectives were to determine the current rate of antenatal repeat HIV testing; identify successes, missed opportunities and factors associated with retesting; and estimate the incidence of HIV during pregnancy...
December 2017: Journal of the International AIDS Society
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