Influence of Health Literacy on Antiretroviral Treatment Adherence Among HIV/AIDS Infected Adolescents in Thika Level 5 Hospital, Kiambu County

Young people including adolescents constitute a significant number of the people living with Human Immune Deficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) in the world today. The study sought to establish the antiretroviral treatment adherence determinants among HIV/AIDS infected adolescents in Thika level 5 Hospital. The specific objective of the study was to find out how health literacy influence adherence to antiretroviral treatment among HIV/AIDS infected adolescents, The study was cross sectional and   adopted a systematic sampling study design targeting 350 active HIV/AIDS infected adolescent aged between 10-19 years. The study also targeted 25 health care providers (HCPs) delivering care and treatment services to HIV/AIDS infected adolescents in Thika Level 5 hospital.  A systematic sampling design was used to get the study respondents, purposive sampling was used to select 25 HCPs . The respondents were selected based on systematic sampling and a sampling interval was calculated. A structured questionnaire and an interview schedule were used as the main tools for data collection.  Quantitative data collected was coded and keyed into SPSSv20. The summaries of quantitative findings were presented using tables, figures and discussions. Qualitative data was analyzed using content analysis. Data was grouped into themes and presented in prose form. Frequency counts percentages; Chi-square test and Pearson Product Moment Correlation were used as Descriptive and inferential statistics respectively. The results of the analysis were then presented using tables, column charts and pie charts. 50% of the respondents had difficulty in taking HIV medications, (85.3%) respondents had an abnormal viral load, majority of the respondents viral load was greater than 1000 copies (89.3%).Respondents had normal CD4 counts .The study concludes that health literacy affects adherence to HIV medications  among HIV/AIDS infected adolescents in Thika level 5 Hospital. The study recommends that decision-makers come up with relevant social policy to support compliance with HIV medications supplied to adolescent respondents. Majority of the adolescents are most of the time in schools and thus focus to be shifted to school by establishing school health clubs where messages on drugs adherence should be given, the stakeholders in education which includes parents, teachers and pupils and non teaching staff to be empowered on ART adherence so that they can be able to support the adolescents in schools

Measurements in swirling spray flames at blow-off

Various characteristics of swirling spray flames of ethanol, n-heptane, n-decane, and n-dodecane have been measured at conditions far from and close to blow-off using phase Doppler anemometry and OH* chemiluminescence, OH-planar laser-induced fluorescence, and Mie scattering at 5 kHz. The blow-off transient has also been examined. The OH* showed that the two main heat release regions lie around the spray jet at the inner recirculation zone and along the outer shear layer between the inner recirculation zone and the annular air jet. The heat release region is shortened and more attached as the flame approached blow-off. Mie images and phase Doppler anemometry data showed a wider dispersion of the ethanol spray compared to the other fuels. Similar spatial distributions of the Sauter mean diameter were observed for the four fuels for identical flow conditions, with the Sauter mean diameter value increasing with decreasing fuel volatility, but with the exception of significant presence of droplets in the nominally hollow cone for the ethanol spray. The OH-planar laser-induced fluorescence measurements showed an intermittent lift-off from the corner of the bluff body and the average lift-off height decreased with increasing air velocity, with less extinction along the inner flame branch especially for the heavier fuels. At the blow-off conditions, local extinctions appeared at both flame branches. The blow-off process followed a gradual reduction of the size of the flame, with the less volatile fuels showing a more severe flame area reduction compared to the condition far from blow-off. The average blow-off duration, [Formula: see text], calculated from the evolution of the area-integrated OH* signal, was a few tens of milliseconds and for all conditions investigated the ratio [Formula: see text] /( D/ UB) was around 11, but with large scatter. The measurements provide useful information for validation of combustion models focusing on local and global extinction. </jats:p

Heat Release Imaging in Turbulent Premixed Ethylene-Air Flames Near Blow-off

The focus of this work is to visualise the regions of CH2O and heat release (HR) of an unconfined turbulent premixed bluff body stabilised ethylene-air flame at conditions approaching lean blow-off using simultaneous imaging of OH- and CH2O-PLIF. The HR regions are estimated from the product of the OH and CH2O profiles. At conditions near blow-off, wide regions of CH2O are observed inside the recirculation zone (RZ). The presence of CH2O and HR inside the RZ is observed to follow fragmentation of the downstream flame parts near the top of the RZ. The presence of wide regions void of both OH and CH2O inside the RZ at conditions very close to blow-off indicates the possible entrainment of un-reacted gases into the RZ. The behaviour of the lean ethylene-air flame with Lewis number (Le) greater than 1 is compared to that of a lean methane-air flame with Le of approximately 1. For both fuels, qualitatively similar observations of flame fragmentation downstream followed by build-up of CH2O and HR inside the RZ are observed at conditions near lean blow-off. Also, a similar trend of flame front curvature conditioned on HR was observed for both the ethylene-air and methane-air flames, where the magnitude of HR was observed to increase with the absolute value of curvature.Funding of this study was obtained from the Engineering and Physical Sciences Research Council (EPSRC), research grant EP/G063788/1, and the UCL/EPSRC Doctoral Training Account.This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s10494-016-9720-

The Dantu blood group prevents parasite growth in vivo: Evidence from a controlled human malaria infection study

Background: The long co-evolution of Homo sapiens and Plasmodium falciparum has resulted in the selection of numerous human genetic variants that confer an advantage against severe malaria and death. One such variant is the Dantu blood group antigen, which is associated with 74% protection against severe and complicated P. falciparum malaria infections in homozygous individuals, similar to that provided by the sickle haemoglobin allele (HbS). Recent in vitro studies suggest that Dantu exerts this protection by increasing the surface tension of red blood cells, thereby impeding the ability of P. falciparum merozoites to invade them and reducing parasite multiplication. However, no studies have yet explored this hypothesis in vivo. Methods: We investigated the effect of Dantu on early phase P. falciparum (Pf) infections in a controlled human malaria infection (CHMI) study. 141 sickle-negative Kenyan adults were inoculated with 3.2 × 103 aseptic, purified, cryopreserved Pf sporozoites (PfSPZ Challenge) then monitored for blood-stage parasitaemia for 21 days by quantitative polymerase chain reaction (qPCR)analysis of the 18S ribosomal RNA P. falciparum gene. The primary endpoint was blood-stage P. falciparum parasitaemia of ≥500/μl while the secondary endpoint was the receipt of antimalarial treatment in the presence of parasitaemia of any density. On study completion, all participants were genotyped both for Dantu and for four other polymorphisms that are associated with protection against severe falciparum malaria: α+-thalassaemia, blood group O, G6PD deficiency, and the rs4951074 allele in the red cell calcium transporter ATP2B4. Results: The primary endpoint was reached in 25/111 (22.5%) non-Dantu subjects in comparison to 0/27 (0%) Dantu heterozygotes and 0/3 (0.0%) Dantu homozygotes (p=0.01). Similarly, 49/111 (44.1%) non-Dantu subjects reached the secondary endpoint in comparison to only 7/27 (25.9%) and 0/3 (0.0%) Dantu heterozygotes and homozygotes, respectively (p=0.021). No significant impacts on either outcome were seen for any of the other genetic variants under study. Conclusions: This study reveals, for the first time, that the Dantu blood group is associated with high-level protection against early, non-clinical, P. falciparum malaria infections in vivo. Learning more about the mechanisms involved could potentially lead to new approaches to the prevention or treatment of the disease. Our study illustrates the power of CHMI with PfSPZ Challenge for directly testing the protective impact of genotypes previously identified using other methods

Regulation of informed consent: a focus on fertility treatments in Kenya

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