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https://www.readbyqxmd.com/read/28431108/investments-in-children-s-health-and-the-kenyan-cash-transfer-for-orphans-and-vulnerable-children-evidence-from-an-unconditional-cash-transfer-scheme
#1
Carolyn Huang, Kavita Singh, Sudhanshu Handa, Carolyn Halpern, Audrey Pettifor, Harsha Thirumurthy
Child mortality is one of the most pressing global health and policy issues in the developing world. The leading drivers of death-pneumonia, diarrhea and malaria-are preventable and treatable. However, these illnesses are exacerbated by a lack of accessible nutrition, water, basic and preventive health services, and sanitary living conditions-all factors which are more likely to disproportionately impact the poor. We examine whether Kenya's largest social protection impacts children's incidence of upper respiratory illness...
April 18, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28424253/identification-of-acute-hiv-1-infection-by-hologic-aptima-hiv-1-rna-qualitative-assay
#2
Mark M Manak, Leigh Anne Eller, Jennifer Malia, Linda L Jagodzinski, Rapee Trichavaroj, Joseph Oundo, Cornelia Lueer, Fatim Cham, Mark de Souza, Nelson L Michael, Merlin L Robb, Sheila A Peel
The Hologic Aptima HIV-1 Qualitative RNA assay was used in a rigorous screening approach designed to identify individuals at the earliest stage of HIV-1 infection for enrollment into subsequent studies of cellular and viral events in early infection (RV217/Early Capture HIV Cohort - ECHO Study). Volunteers at high risk of HIV-1 infection were recruited from study sites in Thailand, Tanzania, Uganda and Kenya with high HIV-1 prevalence rates among the populations examined. Small volume blood samples were collected by finger-stick at twice-weekly intervals and tested by Aptima...
April 19, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28424189/diagnostic-criteria-for-severe-acute-malnutrition-among-infants-aged-under-6-mo
#3
Martha Mwangome, Moses Ngari, Greg Fegan, Neema Mturi, Mohammed Shebe, Evasius Bauni, James A Berkley
Background: There is an increasing recognition of malnutrition among infants under 6 mo of age (U6M). Current diagnosis criteria use weight-for-length z scores (WLZs), but the 2006 WHO standards exclude infants shorter than 45 cm. In older children, midupper arm circumference (MUAC) predicts mortality better than does WLZ. Outcomes may also be influenced by exposure to HIV and size or gestational age at birth. Diagnostic thresholds for WLZ, MUAC, and other indexes have not been fully evaluated against mortality risk among U6M infants...
April 19, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28409013/lay-beliefs-about-hypertension-among-hiv-infected-adults-in-kenya
#4
Tecla M Temu, Ehete Bahiru, Fredrick Bukachi, Gerald S Bloomfield, Peter Muiruri, Carey Farquhar
OBJECTIVE: Hypertension affects 23% of Kenyans and is the most prevalent modifiable risk factor for cardiovascular disease. Despite this, hypertension awareness and treatment adherence is very low. We conducted a qualitative study to explore lay beliefs about hypertension among HIV-infected adults to inform the development of culture sensitive hypertension prevention and control program. METHODS: Eight focus group discussions were held for 53 HIV-infected adults at the HIV clinic in Kenya...
2017: Open Heart
https://www.readbyqxmd.com/read/28403211/the-potential-impact-and-cost-of-focusing-hiv-prevention-on-young-women-and-men-a-modeling-analysis-in-western-kenya
#5
Ramzi A Alsallaq, Jasmine Buttolph, Charles M Cleland, Timothy Hallett, Irene Inwani, Kawango Agot, Ann E Kurth
OBJECTIVE: We compared the impact and costs of HIV prevention strategies focusing on youth (15-24 year-old persons) versus on adults (15+ year-old persons), in a high-HIV burden context of a large generalized epidemic. DESIGN: Compartmental age-structured mathematical model of HIV transmission in Nyanza, Kenya. INTERVENTIONS: The interventions focused on youth were high coverage HIV testing (80% of youth), treatment at diagnosis (TasP, i.e...
2017: PloS One
https://www.readbyqxmd.com/read/28399133/establishment-of-reference-intervals-during-normal-pregnancy-through-six-months-postpartum-in-western-kenya
#6
Collins Odhiambo, Paul Omolo, Boaz Oyaro, John Williamson, John Kinuthia, Daniel Matemo, Alison Drake, Grace John-Stewart, Clement Zeh
BACKGROUND: Pregnancy is associated with changes in hematological and biochemistry values, yet there are no African reference intervals for clinical management of pregnant women. We sought to 1) develop laboratory reference intervals during pregnancy and up to 24 weeks postpartum and 2) determine the proportion of women in a previous clinical trial who would be misclassified as having out-of-range values using reference intervals from a United States (U.S.) population. METHODS AND FINDINGS: This was a longitudinal sub-study of 120 clinically healthy, HIV-uninfected, self-selected pregnant women seeking antenatal care services at either of two public hospitals in western Kenya...
2017: PloS One
https://www.readbyqxmd.com/read/28398959/emergence-of-untreatable-multidrug-resistant-hiv-1-in-patients-failing-second-line-therapy-in-kenya
#7
Seth C Inzaule, Raph L Hamers, Irene Mukui, Kennedy Were, Prestone Owiti, Daniel Kwaro, Tobias F Rinke de Wit, Clement Zeh
: We performed a countrywide assessment of HIV drug resistance among 123 patients with virological failure on second-line antiretroviral therapy (ART) in Kenya. The percentage of patients harboring intermediate-to-high-level resistance was 27% for lopinavir-ritonavir, 24% for atazanavir-ritonavir and 7% for darunavir-ritonavir, and 25% had complete loss of activity to all available first- and second-line drugs. Overall, one in four patients failing second-line ART have completely exhausted available antiretrovirals in Kenya, highlighting the need for increased access to third-line drugs...
April 10, 2017: AIDS
https://www.readbyqxmd.com/read/28394821/predictors-of-retention-in-hiv-care-among-youth-15-24-in-a-universal-test-and-treat-setting-in-rural-kenya
#8
Lillian B Brown, James Ayieko, Florence Mwangwa, Asiphas Owaraganise, Dalsone Kwarisiima, Vivek Jain, Theodore Ruel, Tamara Clark, Douglas Black, Gabriel Chamie, Elizabeth A Bukusi, Craig R Cohen, Moses R Kamya, Maya L Petersen, Edwin D Charlebois, Diane V Havlir
No abstract text is available yet for this article.
April 6, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28391964/associations-between-fathers-and-sons-sexual-risk-in-rural-kenya-the-potential-for-intergenerational-transmission
#9
Ali M Giusto, Eric P Green, Eve S Puffer
PURPOSE: Despite high rates of HIV in areas of Sub-Saharan Africa and men's role in driving the epidemic, little is known about whether or how sexual risk-both behaviors and beliefs-may be passed down through generations of males. This study examined associations between sexual risk behaviors and sex-related beliefs of adolescent males and those of their male caregivers in Kenya, as well as the potential moderating effects of parenting characteristics and father-son relationship quality...
April 5, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28364982/medical-male-circumcision-is-associated-with-improvements-in-pain-during-intercourse-and-sexual-satisfaction-in-kenya
#10
Monica P C Nordstrom, Nelli Westercamp, Walter Jaoko, Timothy Okeyo, Robert C Bailey
BACKGROUND: Two cohort studies using data from randomized controlled trials in Africa offer the best evidence to date on the effects of voluntary medical male circumcision (VMMC) on male sexual function and satisfaction, suggesting no significant impairments in sexual function or satisfaction and some improvements in sexual function after male circumcision. AIM: To assess the effects of VMMC on sexual function and satisfaction in a large population-based cohort of men circumcised as adults and uncircumcised controls in Kenya...
April 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28364566/identifying-gaps-in-hiv-service-delivery-across-the-diagnosis-to-treatment-cascade-findings-from-health-facility-surveys-in-six-sub-saharan-countries
#11
Kathryn Church, Kazuyo Machiyama, Jim Todd, Brian Njamwea, Mary Mwangome, Vicky Hosegood, Janet Michel, Samuel Oti, Constance Nyamukapa, Amelia Crampin, Nyaguara Amek, Gertrude Nakigozi, Denna Michael, F Xavier Gómez-Olivé, Jessica Nakiyingi-Miiro, Basia Zaba, Alison Wringe
INTRODUCTION: Despite the rollout of antiretroviral therapy (ART), challenges remain in ensuring timely access to care and treatment for people living with HIV. As part of a multi-country study to investigate HIV mortality, we conducted health facility surveys within 10 health and demographic surveillance system sites across six countries in Eastern and Southern Africa to investigate clinic-level factors influencing (i) use of HIV testing services, (ii) use of HIV care and treatment and (iii) patient retention on ART...
January 12, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28362869/high-prevalence-of-curable-sexually-transmitted-infections-among-pregnant-women-in-a-rural-county-hospital-in-kilifi-kenya
#12
Simon Chengo Masha, Elizabeth Wahome, Mario Vaneechoutte, Piet Cools, Tania Crucitti, Eduard J Sanders
BACKGROUND: Women attending antenatal care (ANC) in resource-limited countries are frequently screened for syphilis and HIV, but rarely for other sexually transmitted infections (STIs). We assessed the prevalence of curable STIs, defined as infection with either Chlamydia trachomatis or Neisseria gonorrhoeae or Trichomonas vaginalis, from July to September 2015. METHODS: In a cross-sectional study, women attending ANC at the Kilifi County Hospital, Kenya, had a urine sample tested for C...
2017: PloS One
https://www.readbyqxmd.com/read/28362073/feasibility-and-acceptability-of-hiv-self-testing-among-pre-exposure-prophylaxis-users-in-kenya
#13
Kenneth Ngure, Renee Heffron, Nelly Mugo, Kerry A Thomson, Elizabeth Irungu, Njambi Njuguna, Lawrence Mwaniki, Connie Celum, Jared M Baeten
INTRODUCTION: HIV testing is key to the delivery of pre-exposure prophylaxis (PrEP): testing HIV-uninfected at-risk persons is the first step for PrEP initiation and ongoing HIV testing is an essential part of PrEP delivery. Thus, novel and cost-effective HIV-testing approaches to streamline delivery of PrEP are urgently needed. Within a demonstration project of PrEP for HIV prevention among high-risk HIV serodiscordant couples in Kenya (the Partners Demonstration Project), we conducted a pilot evaluation of HIV self-testing...
February 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361508/delivering-safer-conception-services-to-hiv-serodiscordant-couples-in-kenya-perspectives-from-healthcare-providers-and-hiv-serodiscordant-couples
#14
Kenneth Ngure, Grace Kimemia, Kristin Dew, Njambi Njuguna, Nelly Mugo, Connie Celum, Jared M Baeten, Renee Heffron
INTRODUCTION: For HIV serodiscordant couples in resource-limited settings, pregnancy is common despite the risk of sexual and/or perinatal HIV transmission. Some safer conception strategies to reduce HIV transmission during pregnancy attempts are available but often not used for reasons including knowledge, accessibility, preference and others. We sought to understand Kenyan health providers' and HIV serodiscordant couples' perspectives and experiences with safer conception. METHODS: Between August 2015 and March 2016, we conducted key informant interviews (KIIs) with health providers from public and private HIV care and fertility clinics and in-depth interviews (IDIs) and focus group discussions (FGDs) with HIV serodiscordant couples participating in an open-label study of integrated pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) for HIV prevention (the Partners Demonstration Project)...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28360249/understanding-the-acceptability-and-adherence-to-paediatric-antiretroviral-treatment-in-the-new-formulation-of-pellets-lpv-r-the-protocol-of-a-realist-evaluation
#15
Ariadna Nebot Giralt, Christiana Nöstlinger, Janice Lee, Olawale Salami, Marc Lallemant, Onyango Ouma, Isaac Nyamongo, Bruno Marchal
BACKGROUND: Improving access to paediatric HIV treatment requires both large-scale treatment programmes and medication that is adapted to infants and children's needs. The WHO recommends lopinavir/ritonavir as first-line antiretroviral therapy for all HIV-infected children younger than 3 years. There is currently little evidence on the acceptability of, and adherence to, a formulation of this combination treatment if given in the form of pellets. This protocol presents how we will carry a realist evaluation to assess the factors that contribute to the acceptability and adherence to the new pellets formulation in 3 hospitals in Kenya...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28351364/task-shifting-alcohol-interventions-for-hiv-persons-in-kenya-a-cost-benefit-analysis
#16
Omar Galárraga, Burke Gao, Benson N Gakinya, Debra A Klein, Richard G Wamai, John E Sidle, Rebecca K Papas
BACKGROUND: Among HIV+ patients, alcohol use is a highly prevalent risk factor for both HIV transmission and poor adherence to HIV treatment. The large-scale implementation of effective interventions for treating alcohol problems remains a challenge in low-income countries with generalized HIV epidemics. It is essential to consider an intervention's cost-effectiveness in dollars-per-health-outcome, and the long-term economic impact -or "return on investment" in monetary terms. METHODS: We conducted a cost-benefit analysis, measuring economic return on investment, of a task-shifted cognitive-behavioral therapy (CBT) intervention delivered by paraprofessionals to reduce alcohol use in a modeled cohort of 13,440 outpatients in Kenya...
March 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28346527/a-qualitative-study-of-secondary-distribution-of-hiv-self-test-kits-by-female-sex-workers-in-kenya
#17
Suzanne Maman, Katherine R Murray, Sue Napierala Mavedzenge, Lennah Oluoch, Florence Sijenje, Kawango Agot, Harsha Thirumurthy
Promoting awareness of serostatus and frequent HIV testing is especially important among high risk populations such as female sex workers (FSW) and their sexual partners. HIV self-testing is an approach that is gaining ground in sub-Saharan Africa as a strategy to increase knowledge of HIV status and promote safer sexual decisions. However, little is known about self-test distribution strategies that are optimal for increasing testing access among hard-to-reach and high risk individuals. We conducted a qualitative study with 18 FSW who participated in a larger study that provided them with five oral fluid-based self-tests, training on how to use the tests, and encouragement to offer the self-tests to their sexual partners using their discretion...
2017: PloS One
https://www.readbyqxmd.com/read/28329184/the-causal-effect-of-tracing-by-peer-health-workers-on-return-to-clinic-among-patients-who-were-lost-to-follow-up-from-antiretroviral-therapy-in-eastern-africa-a-randomized-natural-experiment-arising-from-surveillance-of-lost-patients
#18
Anna Bershetyn, Thomas A Odeny, Rita Lyamuya, Alice Nakiwogga-Muwanga, Lameck Diero, Mwebesa Bwana, Paula Braitstein, Geoffrey Somi, Andrew Kambugu, Elizabeth Bukusi, Wendy Hartogensis, David V Glidden, Kara Wools-Kaloustian, Constantin Yiannoutsos, Jeffrey Martin, Elvin H Geng
Background: The effect of tracing HIV patients who are lost to follow-up (LTFU) on re-engagement has not been rigorously assessed. We carried out an ex-post analysis of a surveillance study in which LTFU patients were randomly selected for tracing to identify the effect of tracing on re-engagement. Methods: We evaluated HIV-infected adults on antiretroviral therapy who were LTFU (> 90 days late for last visit) at 14 clinics in Uganda, Kenya, and Tanzania. A random sample of LTFU patients was selected for tracing by peer health workers...
March 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28328966/integration-of-family-planning-services-into-hiv-care-clinics-results-one-year-after-a-cluster-randomized-controlled-trial-in-kenya
#19
Craig R Cohen, Daniel Grossman, Maricianah Onono, Cinthia Blat, Sara J Newmann, Rachel L Burger, Starley B Shade, Norah Bett, Elizabeth A Bukusi
OBJECTIVES: To determine if integration of family planning (FP) and HIV services led to increased use of more effective contraception (i.e. hormonal and permanent methods, and intrauterine devices) and decreased pregnancy rates. DESIGN: Cohort analysis following cluster randomized trial, when the Kenya Ministry of Health led integration of the remaining control (delayed integration) sites and oversaw integrated services at the original intervention (early integration) sites...
2017: PloS One
https://www.readbyqxmd.com/read/28325068/the-relationship-between-health-worker-stigma-and-uptake-of-hiv-counseling-and-testing-and-utilization-of-non-hiv-health-services-the-experience-of-male-and-female-sex-workers-in-kenya
#20
Laura Nyblade, Aditi Reddy, David Mbote, John Kraemer, Melissa Stockton, Caroline Kemunto, Karol Krotki, Javier Morla, Stella Njuguna, Arin Dutta, Catherine Barker
The barrier HIV-stigma presents to the HIV treatment cascade is increasingly documented; however less is known about female and male sex worker engagement in and the influence of sex-work stigma on the HIV care continuum. While stigma occurs in all spheres of life, stigma within health services may be particularly detrimental to health seeking behaviors. Therefore, we present levels of sex-work stigma from healthcare workers (HCW) among male and female sex workers in Kenya, and explore the relationship between sex-work stigma and HIV counseling and testing...
March 22, 2017: AIDS Care
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