Patterns of Upper Gastrointestinal Diseases Based on Endoscopy in the Period 1998-2001

Upper gastrointestinal complaints are common in Kenya. Though these have remained unchanged over the last 20 years, the pattern of upper gastrointestinal disease on endoscopic examination seems to be changing. There appears to be progressive increase in oesophagitis and cancer of the stomach. Peptic ulcer disease has remained stable while Cancer of the oesophagus is still common. The paper intends to report on endoscopic findings at the Centre for Clinical Research, Kenya Medical Research Institute (KEMRI) over the period October 1998 and May 2001. The sources of information are records made at the time of endoscopy and histology reports on biopsies taken. Seven hundred and sixty eight patients were endoscoped. The male to female ratio was 1.7:1 with mean age \ub1SD of 40.8 \ub120.1 years and age range was 3 to 96 years. Majority of the patients had abnormal findings with gastritis being the most common ( 25.8%). It is concluded that gastritis is an important cause of morbidity in Kenya. Oesophagitis, mainly due to gastroesopahageal reflux disease, seems to be on the increase. Gastric cancer is not as rare as previously thought and peptic ulcer disease is still common

Yellow Fever Outbreak, Imatong, Southern Sudan

In May 2003, the World Health Organization received reports about a possible outbreak of a hemorrhagic disease of unknown cause in the Imatong Mountains of southern Sudan. Laboratory investigations were conducted on 28 serum samples collected from patients in the Imatong region. Serum samples from 13 patients were positive for immunoglobulin M antibody to flavivirus, and serum samples from 5 patients were positive by reverse transcription–polymerase chain reaction with both the genus Flavivirus–reactive primers and yellow fever virus–specific primers. Nucleotide sequencing of the amplicons obtained with the genus Flavivirus oligonucleotide primers confirmed yellow fever virus as the etiologic agent. Isolation attempts in newborn mice and Vero cells from the samples yielded virus isolates from five patients. Rapid and accurate laboratory diagnosis enabled an interagency emergency task force to initiate a targeted vaccination campaign to control the outbreak

Survey on prevalence and risk factors on HIV-1 among pregnant women in North-Rift, Kenya: a hospital based cross-sectional study conducted between 2005 and 2006

<p>Abstract</p> <p>Background</p> <p>The HIV/AIDS epidemic in Kenya is a major public-health problem. Estimating the prevalence of HIV in pregnant women provides essential information for an effective implementation of HIV/AIDS control measures and monitoring of HIV spread within a country. The objective of this study was to determine the prevalence of HIV infection, risk factors for HIV/AIDS and immunologic (lymphocyte profile) characteristics among pregnant women attending antenatal clinics in three district hospitals in North-Rift, Kenya.</p> <p>Methods</p> <p>Blood samples were collected from pregnant women attending antenatal clinics in three district hospitals (Kitale, Kapsabet and Nandi Hills) after informed consent and pre-test counseling. The samples were tested for HIV antibodies as per the guidelines laid down by Ministry of Health, Kenya. A structured pretested questionnaire was used to obtain demographic data. Lymphocyte subset counts were quantified by standard flow cytometry.</p> <p>Results</p> <p>Of the 4638 pregnant women tested, 309 (6.7%) were HIV seropositive. The majority (85.1%) of the antenatal attendees did not know their HIV status prior to visiting the clinic for antenatal care. The highest proportion of HIV infected women was in the age group 21–25 years (35.5%). The 31–35 age group had the highest (8.5%) HIV prevalence, while women aged more than 35 years had the lowest (2.5%).</p> <p>Women in a polygamous relationship were significantly more likely to be HIV infected as compared to those in a monogamous relationship (p = 0.000). The highest HIV prevalence (6.3%) was recorded among antenatal attendees who had attended secondary schools followed by those with primary and tertiary level of education (6% and 5% respectively). However, there was no significant relationship between HIV seropositivity and the level of education (p = 0.653 and p = 0.469 for secondary and tertiary respectively). The mean CD4 count was 466 cells/mm³(9–2000 cells/mm³). Those that had less than 200 cells/mm³accounted for 14% and only nine were on antiretroviral therapy.</p> <p>Conclusion</p> <p>Seroprevalence of HIV was found to be consistent with the reports from the national HIV sentinel surveys. Enumeration of T-lymphocyte (CD4/8) should be carried out routinely in the antenatal clinics for proper timing of initiation of antiretroviral therapy among HIV infected pregnant women.</p

HIV-1 subtype and viral tropism determination for evaluating antiretroviral therapy options: an analysis of archived Kenyan blood samples

<p>Abstract</p> <p>Background</p> <p>Infection with HIV-1 is characterized by genetic diversity such that specific viral subtypes are predominant in specific geographical areas. The genetic variation in HIV-1 <it>pol </it>and <it>env </it>genes is responsible for rapid development of resistance to current drugs. This variation has influenced disease progression among the infected and necessitated the search for alternative drugs with novel targets. Though successfully used in developed countries, these novel drugs are still limited in resource-poor countries. The aim of this study was to determine HIV-1 subtypes, recombination, dual infections and viral tropism of HIV-1 among Kenyan patients prior to widespread use of antiretroviral drugs.</p> <p>Methods</p> <p>Remnant blood samples from consenting sexually transmitted infection (STI) patients in Nairobi were collected between February and May 2001 and stored. Polymerase chain reaction and cloning of portions of HIV-1 <it>gag</it>, <it>pol </it>and <it>env </it>genes was carried out followed by automated DNA sequencing.</p> <p>Results</p> <p>Twenty HIV-1 positive samples (from 11 females and 9 males) were analyzed. The average age of males (32.5 years) and females (26.5 years) was significantly different (p value < 0.0001). Phylogenetic analysis revealed that 90% (18/20) were concordant HIV-1 subtypes: 12 were subtype A1; 2, A2; 3, D and 1, C. Two samples (10%) were discordant showing different subtypes in the three regions. Of 19 samples checked for co-receptor usage, 14 (73.7%) were chemokine co-receptor 5 (CCR5) variants while three (15.8%) were CXCR4 variants. Two had dual/mixed co-receptor use with X4 variants being minor population.</p> <p>Conclusion</p> <p>HIV-1 subtype A accounted for majority of the infections. Though perceived to be a high risk population, the prevalence of recombination in this sample was low with no dual infections detected. Genotypic co-receptor analysis showed that most patients harbored viruses that are predicted to use CCR5.</p

Patterns of upper gastrointestinal diseases based on endoscopy in the period 1998-2001

Upper gastrointestinal complaints are common in Kenya. Though these have remained unchanged over the last 20 years, the pattern of upper gastrointestinal disease on endoscopic examination seems to be changing. There appears to be progressive increase in oesophagitis and cancer of the stomach. Peptic ulcer disease has remained stable while Cancer of the oesophagus is still common. The paper intends to report on endoscopic findings at the Centre for Clinical Research, Kenya Medical Research Institute (KEMRI) over the period October 1998 and May 2001. The sources of information are records made at the time of endoscopy and histology reports on biopsies taken. Seven hundred and sixty eight patients were endoscoped. The male to female ratio was 1.7:1 with mean age ±SD of 40.8 ±20.1 years and age range was 3 to 96 years. Majority of the patients had abnormal findings with gastritis being the most common (25.8%). It is concluded that gastritis is an important cause of morbidity in Kenya. Oesophagitis, mainly due to gastroesopahageal reflux disease, seems to be on the increase. Gastric cancer is not as rare as previously thought and peptic ulcer disease is still common.African Journal of Health Sciences Vol. 12(1-2) 2005: 49-5