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Estimating the cost of HIV services for key populations provided by the LINKAGES program in Kenya and Malawi.

BACKGROUND: Data remain scarce on the costs of HIV services for key populations (KPs). The objective of this study was to bridge this gap in the literature by estimating the unit costs of HIV services delivered to KPs in the LINKAGES program in Kenya and Malawi. We estimated the mean total unit costs of seven clinical services: post-exposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP), HIV testing services (HTS), antiretroviral therapy (ART), sexually transmitted infection (STI) services, sexual and reproductive health (SRH) services, and management of sexual violence (MSV). These costs…

Спатиовременная эпидемиология заболеваний скота в различных полузасушливых пастбищах северной Кении.

Болезни, затрагивающие скот, могут оказывать значительное воздействие на животных, людей и экономику. В графстве Самбуру, Северная Кения, был проведен совместный эпидемиологический и пространственный анализ для оценки проблем, связанных с заболеваниями скота. При содействии местных лидеров были отобраны ключевые информаторы. Среди скота было установлено, что козлы имеют наибольшее экономическое значение. С другой стороны, было установлено, что болезни Pestes des Petits Ruminants (PPR), Foot and Muth Bealth (FMD) и Camel Tripanosomis оказывают наибольшее воздействие на средства к существованию

Совпадение в аннотации оригинала
Diseases affecting livestock can have significant impacts on the animal, humans and the economy. Participatory epidemiology and spatial analysis were conducted to assess livestock disease problems in Samburu County, northern Kenya. Key informants were selected purposively with the help of local leaders. Among the livestock, goats were identified to have the …

Experience and confidence in health technologies: evidence from malaria testing and treatment in Western Kenya.

BACKGROUND: Low adoption of effective health technologies increases illness morbidity and mortality worldwide. In the case of malaria, effective tools such as malaria rapid diagnostic tests (RDTs) and artemisinin-combination therapies (ACTs) are both under-used and used inappropriately. Individuals' confidence in RDTs and ACTs likely affects the uptake of these tools. METHODS: In a cohort of 36 households (280 individuals) in Western Kenya observed for 30 months starting in June 2017, we examined if experience with RDTs and ACTs changes people's beliefs about these technologies and how those …

Molecular Epidemiology of Mycobacterium tuberculosis Complex Strains in Urban and Slum Settings of Nairobi, Kenya.

Kenya is a country with a high tuberculosis (TB) burden. However, knowledge on the genetic diversity of Mycobacterium tuberculosis complex (MTBC) strains and their transmission dynamics is sparsely available. Hence, we used whole-genome sequencing (WGS) to depict the genetic diversity, molecular markers of drug resistance, and possible transmission clusters among MTBC strains in urban and slum settings of Nairobi. We analyzed 385 clinical MTBC isolates collected between 2010 and 2015 in combination with patients' demographics. We showed that the MTBC population mainly comprises strains of four…

A community-based approach to cervical cancer prevention in western Kenya: An AMPATH feasibility project.

OBJECTIVES: Centralized programs have been ineffective in reducing the burden of cervical cancer among Kenyan women. A community-based pilot study was initiated to screen Kenyan women for cervical cancer and to vaccinate their children against human papillomavirus (HPV). METHODS: Women were educated about cervical cancer prevention at community meetings. Women then provided self-collected vaginal swabs for oncogenic HPV testing using the Roche Cobas Assay. All women were then referred to the local clinic for Visual Inspection with Acetic Acid (VIA). Women were offered the quadrivalent HPV vac…

Shared component modelling of early childhood anaemia and malaria in Kenya, Malawi, Tanzania and Uganda.

BACKGROUND: Malaria and anaemia contribute substantially to child morbidity and mortality. In this study, we sought to jointly model the residual spatial variation in the likelihood of these two correlated diseases, while controlling for individual-level, household-level and environmental characteristics. METHODS: A child-level shared component model was utilised to partition shared and disease-specific district-level spatial effects. RESULTS: The results indicated that the spatial variation in the likelihood of malaria was more prominent compared to that of anaemia, for both the shared and

Trypanosoma Congolense Resistant to Trypanocidal Drugs Homidium and Diminazene and their Molecular Characterization in Lambwe, Kenya.

PURPOSE: African animal trypanosomiasis (AAT) is a disease affecting livestock in sub-Saharan Africa. The use of trypanocidal agents is common practice to control AAT. This study aimed to identify drug-resistant Trypanosoma congolense in Lambwe, Kenya, and assess if molecular test backed with mice tests is reliable in detecting drug sensitivity. METHODS: Blood samples were collected from cattle, in Lambwe, subjected to buffy coat extraction and Trypanosoma spp. detected under a microscope. Field and archived isolates were subjected to molecular characterization. Species-specific T. congolense…

Comparable Pregnancy Outcomes for HIV-Uninfected and HIV-Infected Women on Antiretroviral Treatment in Kenya.

BACKGROUND: The impact of human immunodeficiency virus (HIV) on pregnancy outcomes for women on antiretroviral therapy (ART) in sub-Saharan Africa remains unclear. METHODS: Pregnant women in Kenya were enrolled in the second trimester and followed up to delivery. We estimated effects of treated HIV with 3 pregnancy outcomes: loss, premature birth, and low birth weight and factors associated with HIV-positive status. RESULTS: Of 2113 participants, 311 (15%) were HIV infected and on ART. Ninety-one of 1762 (5%) experienced a pregnancy loss, 169/1725 (10%) a premature birth (<37 weeks), and 74/…

Connected diagnostics to improve accurate diagnosis, treatment, and conditional payment of malaria services in Kenya.

BACKGROUND: In sub-Saharan Africa, the material and human capacity to diagnose patients reporting with fever to healthcare providers is larg … a digital approach to improve efficiencies in diagnosis and treatment of malaria in endemic Kisumu, Kenya: Connected Diagnostics. The objective of this study is to evaluate the feasibility, user experience and clinical performance of this approach in Kisumu. METHODS: Our intervention was performed Oct 2017-Dec 2018 across five private providers in Kisu …

Magnitude of post-urethroplasty urinary tract infections in children with hypospadias at a tertiary hospital in Kenya.

INTRODUCTION: Children who have undergone urethroplasty procedure for hypospadias are at a higher risk of getting urinary tract infections ( … ermine the magnitude of urinary tract infections after urethroplasty for hypospadias in children at Kenyatta National Hospital (KNH), a tertiary hospital in Kenya. DESIGN: This was a prospective descriptive cross-sectional study of male children with hypospadias who had undergone urethroplasty between January 2014 to December 2018 (5years) at KNH with …

Efficiencies of stationary sampling tools for the tsetse fly Glossina fuscipes fuscipes in western Kenya.

Monitoring the effectiveness of tsetse fly control interventions that aim to reduce transmission of African trypanosomiasis requires highly … block design experiments were undertaken in Mbita area and Manga Island on Lake Victoria of western Kenya. Fly catches of each sampling tool were compared to those of the sampling tool flanked by electric (E) nets and analyzed using a negative binomial regression. The total catch for each sampling tool alone was divided by the total catch of the samplin …

Outcomes of Children and Adolescents Admitted with Diabetic Ketoacidosis at Kenyatta National Hospital (KNH), Kenya.

BACKGROUND: Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication that mainly occurs in patients with type 1 diabetes mellitus and is the foremost cause of death in these children. Overall mortality in children with DKA varies from 3.4% to 13.4% in developing countries. There is a need to understand outcomes among children with DKA in sub-Saharan African countries. OBJECTIVE: To determine the death rate and clinical outcomes of children and adolescents aged 0-18 years managed for DKA at Kenyatta National Hospital (KNH). Study Methods. This was a retrospective study car…

Molecular evidence confirms occurrence of Rhipicephalus microplus Clade A in Kenya and sub-Saharan Africa.

BACKGROUND: The tick vector Rhipicephalus microplus which transmits Babesia spp. and rickettsial pathogens has not been reported in Kenya since 1998. More recently, the pathogenic Babesia bovis has been detected in cattle blood DNA. The status of R. microplus in Kenya remains unknown. This study employed morphological and molecular tools to characterize R. microplus originating from Kenya and assess the genetic relationships between Kenyan and other African R. microplus genotypes. METHODS: Ticks were collected in south-eastern Kenya (Kwale County) from cattle and characterized to investigate …

A multiple baseline study of a brief alcohol reduction and family engagement intervention for fathers in Kenya.

OBJECTIVE: To evaluate a lay provider-delivered, brief intervention to reduce problem drinking and related family consequences among men in Kenya. The 5-session intervention combines behavioral activation (BA) and motivational interviewing (MI). It integrates family-related material explicitly and addresses central cultural factors through gender transformative strategies. METHOD: A nonconcurrent multiple-baseline design was used. We initiated treatment with 9 men ages 30 to 48 who were fathers and screened positive for problem drinking; the median Alcohol Use Identification Test score was 17…

Seroprevalence of canine neosporosis and bovine viral diarrhoea in dairy cattle in selected regions of Kenya.

Neospora caninum is the causative agent for canine neosporosis (CN), a disease of potential zoonotic importance causing reproductive losses in cattle while causing neuromuscular disease in dogs. Bovine viral diarrhoea on the other hand is caused by the bovine viral diarrhoea virus (BVDV) and is one of the most important reproductive diseases of cattle worldwide. In Kenya, these infections are of economic importance due to the losses they cause in farms in which they are diagnosed or are subclinical. Such losses include reduced milk production, reduced conception, early embryonic deaths and abo…

Changes in D-dimer after initiation of antiretroviral therapy in adults living with HIV in Kenya.

BACKGROUND: Increased coagulation biomarkers are associated with poor outcomes among people living with HIV (PLHIV). There are few data available from African cohorts demonstrating the effect of antiretroviral therapy (ART) on coagulation biomarkers. METHODS: From March 2014 to October 2014, ART-naïve PLHIV initiating non-nucleoside reverse transcriptase inhibitor-based ART were recruited from seven clinics in western Kenya and followed for up to 12 months. Demographics, clinical history and blood specimens were collected. Logistic regression models adjusted for intrasite clustering examined …

No Evidence of Acute Dengue Virus Infections at a Rural Site in Western Kenya, 2011 and 2013.

The incidence and spread of dengue virus (DENV) have increased rapidly in recent decades. Dengue is underreported in Africa, but recent outbreaks and seroprevalence data suggest that DENV is widespread there. A lack of ongoing surveillance limits knowledge about its spatial reach and hinders disease control planning. We sought to add data on dengue distribution in Kenya through diagnostic testing of serum specimens from persons with an acute febrile illness (AFI) attending an outpatient clinic in rural western Kenya (Asembo) during rainy seasons. Patients with symptoms not likely to be misclas…

Street-connected children with communication disabilities and their caregivers in Western Kenya: experiences, beliefs and needs.

PURPOSE: Although street-connected children with communication disability have been identified in Western Kenya, little is currently known about the impact of communication disability on this group. In order to inform future service development, this qualitative study sought to understand the experiences, views and needs of street-connected children with communication disability, and of their caregivers at home and at school. MATERIALS AND METHODS: 13 children, 12 caregivers and 12 school-based Learning Support Assistants participated in interactive sessions, semi-structured interviews and fo…

The Epidemiology and Burden of Influenza B/Victoria and B/Yamagata Lineages in Kenya, 2012-2016.

BACKGROUND: The impact of influenza B virus circulation in Sub-Saharan Africa is not well described. METHODS: We analyzed data from acute respiratory illness (ARI) in Kenya. We assessed clinical features and age-specific hospitalization and outpatient visit rates by person-years for influenza B/Victoria and B/Yamagata and the extent to which circulating influenza B lineages in Kenya matched the vaccine strain component of the corresponding season (based on Northern Hemisphere [October-March] and Southern Hemisphere [April-September] vaccine availability). RESULTS: From 2012 to 2016, influenz…

Prevalence and correlates of depressive symptoms among adults living with HIV in rural Kilifi, Kenya.

BACKGROUND: Published research on depression among people living with HIV/AIDS (PLWHA) from Africa is increasing, but data from Kenya remains scarce. This cross-sectional study measured the prevalence and correlates of depressive symptoms among PLWHA in rural Kilifi, on the Kenyan coast. METHODS: Between February and April 2018, we consecutively recruited and interviewed 450 adults living with HIV and on combination antiretroviral therapy (cART). Depressive symptoms were assessed with the 9-item Patient Health Questionnaire (PHQ-9), with a positive depression screen defined as PHQ-9 score ≥ 1…