Hiv testing and counselling for women attending child health clinics: An opportunity for entry to prevent mother-to-child transmission and hiv treatment. Author
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Document Number: 293551 Prevalence of HCV and HIV / HCV co-infection among volunteer blood donors and VCT clients. Author: Karuru JW; Lule GN; Joshi M; Anzala O Source: East African Medical Journal. 2005 Apr;82(4):166-169. Abstract: The objective was to determine the prevalence of HCV infection and HCV/HIV co-infection among voluntary blood donors at the National Blood Transfusion Centre and clients at the Kenyatta National Hospital HIV-Voluntary Counselling and Testing (VCT) Centre. Design: A prospective cross-sectional descriptive study. Setting: Kenyatta National Hospital, a tertiary referral and teaching hospital and the National Blood Transfusion Services Centre, Nairobi. Subjects: Volunteer blood donors and VCT attendants. The prevalence of HCV/HIV co-infection among 6154 blood donors in the NBTSC was very low, at 0.02. The HIV prevalence among the 353 KNH HIV-VCT clients was 9.3%, none of the clients tested positive for HCV. The incidence of risk factors in the persons with HCV and/or HIV infection(s) was low. The prevalence of HCV infection among pre-screened volunteer blood donors was low. However the current practice of screening all donated blood for HCV remains indispensable to prevent its Language: English Keywords: KENYA | RESEARCH REPORT | PROSPECTIVE STUDIES | PREVALENCE | INCIDENCE | HIV POSITIVE PERSONS | CLIENTS | BLOOD DONORS | VOLUNTARY COUNSELING AND TESTING | HIV INFECTIONS | AFRICA, EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA | DEVELOPING COUNTRIES | STUDIES | RESEARCH METHODOLOGY | MEASUREMENT | PERSONS LIVING WITH HIV/AIDS | VIRAL DISEASES | DISEASES | PROGRAM ACTIVITIES | PROGRAMS | ORGANIZATION AND ADMINISTRATION | BLOOD SUPPLY | EQUIPMENT AND SUPPLIES | MEDICAL PROCEDURES | MEDICINE | HEALTH SERVICES | DELIVERY OF HEALTH CARE | HEALTH | HIV TESTING | LABORATORY EXAMINATIONS AND DIAGNOSES | EXAMINATIONS AND DIAGNOSES Document Number: 293571 High probability of female-to-male HIV-1 transmission for uncircumcised men with multiple partners. Author: Crabb C Source: AIDS. 2005;19(10):N1. Notes and Quotes Abstract: Compared to circumcised men, uncircumcised men are more than twice as likely to acquire HIV-1 each time they have unprotected sex with an infected woman, according to a team of researchers in the US and Kenya. The study----the first to measure infectivity, or the probability of HIV-1 transmission per sex act, in a context of multiple partnerships----also found that infectivity among men, whether circumcised or not, who have several female partners is many fold higher than estimates based on monogamous HIV-1 discordant couples. Jared Baeten of the University of Washington in Seattle and his colleagues calculated infectivity from data collected during a 4-year prospective study of 745 male employees of six trucking companies in Mombasa, Kenya. Ninety-five of the men were uncircumcised. In quarterly check-ups at a mobile research clinic that visited the companies on a weekly basis, each participant reported his sexual behavior with wives, casual partners and prostitutes during the previous 3 months. (excerpt) Language: English Keywords: UNITED STATES | KENYA | RESEARCH REPORT | PROSPECTIVE STUDIES | MEN | WOMEN | HIV TRANSMISSION | MALE CIRCUMCISION | MULTIPLE PARTNERS | RISK FACTORS | CONDOM USE | NORTH AMERICA | AMERICAS | DEVELOPED COUNTRIES | AFRICA, EASTERN | AFRICA, SUB SAHARAN | AFRICA | DEVELOPING COUNTRIES | STUDIES | RESEARCH METHODOLOGY | DEMOGRAPHIC FACTORS | POPULATION | HIV INFECTIONS | VIRAL DISEASES | DISEASES | MEDICAL PROCEDURES | MEDICINE | HEALTH SERVICES | DELIVERY OF HEALTH CARE | HEALTH | SEXUAL PARTNERS | SEX BEHAVIOR | BEHAVIOR | BIOLOGY | RISK REDUCTION BEHAVIOR Document Number: 306908 Mortality among married men in rural Kenya and Malawi. Author: Doctor HV; Weinreb AA Source: African Population Studies/Etude de la Population Africaine. 2005;20(2):165-177. Abstract: Using prospective longitudinal data, this article describes recent changes in the levels of adult mortality among married men aged 20-59 in selected rural areas of Malawi and Kenya, and in the age pattern of their mortality. Sampled areas have, respectively, moderate and high HIV prevalence. The observed annual probability of dying for males interviewed in an initial wave of each study and then reported as deceased in follow-up interviews is 0.031 in Nyanza and 0.016 in Malawi. Compared to life table estimates for equivalent age groups generated from Kenya's 1989 census and Malawi's 1987 census, these results represent a 3-fold increase over 1980s census levels. These changes have reduced life expectancy at age 20 by about 14 years in Nyanza and 7 years in Malawi. Observed mortality is consistent with a younger age of HIV infection in Nyanza. Sample characteristics suggest that these levels underestimate the total effect of AIDS on mortality. (author's) Language: English Keywords: MALAWI | KENYA | RESEARCH REPORT | LONGITUDINAL STUDIES | PROSPECTIVE STUDIES | MEN | RURAL POPULATION | CURRENTLY MARRIED | MORTALITY | AGE SPECIFIC DEATH RATE | DEATH RATE | LIFE EXPECTANCY | AIDS | AGE FACTORS | AFRICA, SOUTHERN | AFRICA, SUB SAHARAN | AFRICA | DEVELOPING COUNTRIES | AFRICA, EASTERN | STUDIES | RESEARCH METHODOLOGY | DEMOGRAPHIC FACTORS | POPULATION | POPULATION CHARACTERISTICS | MARITAL STATUS | NUPTIALITY | POPULATION DYNAMICS | LENGTH OF LIFE | HIV INFECTIONS | VIRAL DISEASES | DISEASES Document Number: 311125 Vitamin A, mastitis, and mother-to-child transmission of HIV-1 through breast-feeding: current information and gaps in knowledge. Author: Dorosko SM Source: Nutrition Reviews. 2005 Oct;63(10):332-346. Abstract: Mastitis has been implicated as a risk factor for mother-to-child transmission (MTCT) of HIV-1 through breast-feeding. Maternal vitamin A deficiency is also associated with increased MTCT, as well as with episodes of mastitis in lactating animals. This review describes the complex interrelationship between vitamin A, mastitis, and MTCT of HIV-1 via mothers' milk. Current gaps in knowledge, as well as recommendations for future research efforts, are also discussed. (author's) Language: English Keywords: DEVELOPING COUNTRIES | KENYA | RESEARCH REPORT | MOTHERS | MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | BREASTFEEDING | VITAMIN A | BREAST EXAM | MAMMARY GLAND EFFECTS | AFRICA, EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA | PARENTS | FAMILY RELATIONSHIPS | FAMILY CHARACTERISTICS | FAMILY AND HOUSEHOLD | SOCIOCULTURAL FACTORS | TRANSMISSION | INFECTIONS | DISEASES | VIRAL DISEASES | INFANT NUTRITION | NUTRITION | HEALTH | VITAMINS AND MINERALS | PHYSIOLOGY | BIOLOGY | PHYSICAL EXAMINATIONS AND DIAGNOSES | EXAMINATIONS AND DIAGNOSES | MEDICAL PROCEDURES | MEDICINE | HEALTH SERVICES | DELIVERY OF HEALTH CARE Document Number: 305136 Lessons learned in the conduct, validation, and interpretation of national population based HIV surveys. Author: Garcia Calleja JM; Marum LH; Carcamo CP; Kaetano L; Muttunga J Source: AIDS. 2005 May;19 Suppl 2:S9-S17. Abstract: In the past few years several countries have conducted national population-based HIV surveys. Survey methods, levels of participation bias from absence or refusal and lessons learned conducting such surveys are compared in four national population surveys: Mali, Kenya, Peru and Zambia. In Mali, Zambia, and Kenya, HIV testing of adult women and men was included in the national-level demographic and health surveys carried out regularly in these countries, whereas in Peru the national HIV survey targeted young people in 24 cities with populations over 50 000. The household response rate was above 90% in all countries, but some individuals were absent for interviews. HIV testing rates were between 70 and 79% of those eligible, with higher test rates for women. Three critical questions in this type of survey need to be answered: who did the surveys miss; how much it matters that they were missed; and what can be done to increase the participation of respondents so the coverage rates are adequate. The level of representativeness of the populations tested was adequate in each survey to provide a reliable national estimate of HIV prevalence that complements other methods of HIV surveillance. Different lessons were learned from each survey. These population-based HIV seroprevalence surveys demonstrate that reliable and useful results can be obtained, although they require careful planning and increased financial and human resource investment to maximize responses at the household and individual level, which are key elements to validate survey results. This review was initiated through an international meeting on 'New strategies for HIV/ AIDS Surveillance in Resource-constrained Countries' held in Addis Ababa on 26--30 January 2004 to share and develop recommendations to guide future surveys. (author's) Language: English Keywords: MALI | KENYA | PERU | ZAMBIA | METHODOLOGICAL STUDIES | DEMOGRAPHIC AND HEALTH SURVEYS | EPIDEMIOLOGIC METHODS | HOUSEHOLDS | HIV INFECTIONS | PREVALENCE | DATA QUALITY | AFRICA, WESTERN | AFRICA SOUTH OF THE SAHARA | AFRICA | DEVELOPING COUNTRIES | AFRICA, EASTERN | SOUTH AMERICA, WESTERN | SOUTH AMERICA | LATIN AMERICA | AMERICAS | AFRICA, SOUTHERN | DEMOGRAPHIC SURVEYS | POPULATION DYNAMICS | DEMOGRAPHIC FACTORS | POPULATION | RESEARCH METHODOLOGY | FAMILY AND HOUSEHOLD | SOCIOCULTURAL FACTORS | VIRAL DISEASES | DISEASES | MEASUREMENT | DATA ANALYSIS Document Number: 306899 The HIV / AIDS epidemic in Kenya. HIV / AIDS policy fact sheet. Author: Kates J; Leggoe AW Source: Menlo Park, California, Henry J. Kaiser Family Foundation, 2005 Oct. [2] p. (HIV / AIDS Policy Fact Sheet) Abstract: Kenya has more than one million people estimated to be living with HIV/AIDS (1.2 million as of the end of 2003). Kenya's HIV/AIDS prevalence rate (the percent of people living with the disease) is just below that of the sub-Saharan African region overall (6.7% compared to 7.5%). Recent data indicate that the country's HIV prevalence rate may be on the decline in some areas. However, the HIV/AIDS epidemic poses significant challenges to this low-income country. The Government of Kenya first established a National AIDS Control Council (NACC) in 1999, and has a National Strategic Framework for HIV/AIDS for 2005-2010. (excerpt) Language: English Keywords: KENYA | SUMMARY REPORT | PREVALENCE | PERSONS LIVING WITH HIV/AIDS | YOUTH | HIV | AIDS | KNOWLEDGE | INTERNATIONAL AGENCIES | INFORMATION SOURCES | FINANCIAL ACTIVITIES | FOREIGN AID | ANTIRETROVIRAL THERAPY | GOVERNMENT PROGRAMS | AFRICA, EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA | DEVELOPING COUNTRIES | MEASUREMENT | RESEARCH METHODOLOGY | HIV INFECTIONS | VIRAL DISEASES | DISEASES | AGE FACTORS | POPULATION CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION | SOCIOCULTURAL FACTORS | ORGANIZATIONS | POLITICAL FACTORS | INFORMATION | ECONOMIC FACTORS | PROGRAMS | ORGANIZATION AND ADMINISTRATION Document Number: 309697 Prospects for financial sustainability of scaling up antiretroviral therapy programs. Author: Kyomuhangi L Source: Health Policy and Development. 2005 Aug;3(2):154-164. Abstract: The program costs of antiretroviral therapy (ART) were analyzed using the Cape Town Antiretroviral Costing Model (Boulle, et al, (2004). The total ART costs by end of 2008 for starting 18,500 patients in Senegal, 82,000 patients in Uganda and 165,000 in Kenya were estimated at US$ 20.5 million, US$ 68 million and US$ and US$ 126 million respectively. The lifetime costs per patient on treatment were estimated at US$ 5,015 for Uganda, US$ 5,782 for Senegal, and US$ 6,186 for Kenya. The available funds for ART are about US$ 79 million for Senegal, US$ 74 million for Uganda and US$ 94 million for Kenya. Senegal has committed about US$ 13.3 million from its domestic budget and acquired a loan of US$ 40 million from the World Bank for ART services. Kenya has so far allocated only US$ 1.4 million from the national budget for its ART services. There are no funds from the government budget directed for the ART program in Uganda. The three countries are mainly depending on donor funding. The study concludedthat ART services in Uganda and Kenya might not be financially sustainable whereas Senegal may be able to financially its ART program if the current low prevalence levels and political and financial commitment prevail. (author's) Language: English Keywords: SENEGAL | UGANDA | KENYA | CROSS SECTIONAL ANALYSIS | HIV POSITIVE PERSONS | GOVERNMENT | ANTIRETROVIRAL THERAPY | ECONOMIC FACTORS | CAPACITY BUILDING | PROGRAM SUSTAINABILITY | DEVELOPING COUNTRIES | AFRICA, WESTERN | AFRICA, SUB SAHARAN | AFRICA | AFRICA, EASTERN | RESEARCH METHODOLOGY | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | VIRAL DISEASES | DISEASES | POLITICAL FACTORS | SOCIOCULTURAL FACTORS | HIV | PROGRAMS | ORGANIZATION AND ADMINISTRATION Document Number: 319828 HIV / AIDS and sexually transmitted infection in Kenya. Behavioural surveillance survey 2002. Author: Kenya. Ministry of Health. National AIDS / STI Control Program Source: Nairobi, Kenya, Ministry of Health, National AIDS / STI Control Program, 2005. [65] p. (USAID Development Experience Clearinghouse DocID / Order No. PC-AAB-540) Abstract: The government of Kenya through the National AIDS/STI Control Program (NASCOP) of the Ministry of Health in collaboration with Family Health International (FHI), the Centers for Disease Control and Prevention (CDC), and the Central Bureau of Statistics (CBS) conducted a national behavioural surveillance survey of HIV/AIDS and sexually transmitted infection in Kenya in late 2002 in order to understand the behaviour dynamics driving the HIV epidemic. The behavioural surveillance survey is a monitoring and evaluation tool to track trends in HIV/AIDS knowledge, attitudes and behaviour in populations at particular risk of HIV infection, such as youth, female sex workers and migrant men. It is envisaged that this survey will be repeated every two or three years to monitor trends and changes in HIV and sexually transmitted infection risky behaviour in the country. The populations selected to participate in the first round of the national behavioural surveillance survey were out-of-school youth, youth in school, female sex workers, women in low-income settings, matatu or mini-van drivers and their touts or helpers, bodaboda or bicycle taxi cyclists, policemen, and men in large worksites. Questionnaires were developed in both English and Kiswahili. They were administered to respondents in the selected groups by trained interviewers under close supervision of a team of supervisors. High standards of conducting the survey were adhered to in terms of a well-planned data collection strategy and a commitment to establish high-quality data systems. EpiData software was used for data entry and processing, and a statistical software package for social sciences was used for data analysis. (excerpt) Language: English Keywords: KENYA | SUMMARY REPORT | INTERVIEWS | MULTIPLE PARTNERS | SEXUAL PARTNERS | SEX WORKERS | POLICE | YOUTH | HIV INFECTIONS | AIDS | SEXUALLY TRANSMITTED DISEASES | KNOWLEDGE | RISK BEHAVIOR | SEX BEHAVIOR | CONDOM | BEHAVIOR CHANGE | AFRICA, EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA | DEVELOPING COUNTRIES | DATA COLLECTION | RESEARCH METHODOLOGY | BEHAVIOR | CORRECTIONS OFFICERS | GOVERNMENT | POLITICAL FACTORS | SOCIOCULTURAL FACTORS | AGE FACTORS | POPULATION CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION | VIRAL DISEASES | DISEASES | REPRODUCTIVE TRACT INFECTIONS | INFECTIONS | BARRIER METHODS | CONTRACEPTIVE METHODS | CONTRACEPTION | FAMILY PLANNING Document Number: 315319 Dual infection with HIV and malaria fuels the spread of both diseases in sub-Saharan Africa. Author: Abu-Raddad LJ Source: Science. 2006 Dec 8;314(5805):1603-1606. Abstract: Mounting evidence has revealed pathological interactions between HIV and malaria in dually infected patients, but the public health implications of the interplay have remained unclear. A transient almost one-log elevation in HIV viral load occurs during febrile malaria episodes; in addition, susceptibility to malaria is enhanced in HIV-infected patients. A mathematical model applied to a setting in Kenya with an adult population of roughly 200,000 estimated that, since 1980, the disease interaction may have been responsible for 8,500 excess HIV infections and 980,000 excess malaria episodes. Co-infection might also have facilitated the geographic expansion of malaria in areas where HIV prevalence is high. Hence, transient and repeated increases in HIV viral load resulting from recurrent co-infection with malaria may be an important factor in promoting the spread of HIV in sub-Saharan Africa. 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