Prevalence and risk factors of previous or active Hepatitis B infection among HIV-1 discordant heterosexual couples

Background: Hepatitis B Virus (HBV) and HIV spread in the same manner, but HBV is more infectious  than HIV-1. Active HBV requires modification of HIV-1 therapy and is associated with increased risk for sexual transmission of HBV.Objective: To determine the prevalence and knowledge of HBV among HIV-1 discordant couples.Design: A cross-sectional study.Setting: Couple Counselling Centres in Nairobi and Thika clinics in Kenya.Subjects: HIV discordant couples attending Couples Counselling Centres in Nairobi and Thika clinics in Kenya.Results: One hundred and sixty one couples with a mean age of 33 years (Standard Deviation 8.4) were enrolled into the study. HBV prevalence was higher among HIV positive women than among HIV negative women (10.2% vs. 5.9%, OR=0.5, 95% CI 0.2-1.0; p=0.05). However, among men, prevalence of HBV was higher among the HIV negative than the HIV positive participants (8.4 vs. 6.2%, OR=3.0, CI  1.3-6.5; p=0.04). There was no association between HBV and HIV (p=0.4) or gender (p=0.5). HIV  positive participants were more likely to have adequate knowledge compared to HIV negative participants (13% vs. 3.7%, OR=2.7, 95% CI 1.95-7.9; p=0.05)Conclusions: Female index participants had the highest HBV prevalence. Knowledge on HBV was lacking, particularly among the HIV negative; a target group for health education regarding risk factors and prevention of HBV infection

Efficacy of combination therapy using extracts of Aloe secundiflora Eng L and Callistemon citrinus William C. in Leishmania major infected BALB/c mice

Background: Leishmania major causes cutaneous leishmaniasis which leads to painful skin sores in humans. In the current study, efficacy of combination therapy of A. secundiflora and C. citrinus against L. major infected mice treated intra-peritoneally and orally was studied. Pentostam administered intra-peritoneally and phosphate buffered saline intra-peritoneally and orally were used as a controls.Objective: To determine the efficacy of combined therapy of C. citrinus and A. secundiflora extracts in Leishmania major infected BALB/c mice.Design: Experimental-Laboratory based studySetting: Kenya Medical Research Institute (Leishmania Department)Subjects: Eight weeks Male BALB/c MiceResults: The minimum inhibitory concentration (MICs) of aqueous extracts of A. secundiflora (A), and C. citrinus (B) were 2 mg/ml and 5 mg/ml respectively while the IC50 for the same extracts were 467.09μg/ml and 457.88μg/ml respectively. The combination of these extracts at ratio (1:1) supported minimal growth of L. major promastigotes and had IC50 of 58.45μg/ml as compared to MICs of 12.50μg/ml for Pentostam. The combination therapy had Infection rate (IR) of 19% and MI of 52.81% compared to Pentostam (IR=21% and MI=11.64%). The combination therapy reduced the footpad lesion size significantly (P < 0.05) just like the Pentostam control drug and no significant nitric oxide was stimulated. The oral and intra-peritoneal combination treatment reduced spleen amastigotes in mice by 73.46% and 78.12% corresponding to total LDUs of 10.87±0.64 and 8.96±0.82 respectively compared to Pentostam at 94.58% and LDU of 2.22±0.13. The difference between efficacy of Pentostam and that of combined extracts was almost significant (t= 2.653, P= 0.057).Conclusion: The combination therapy was active against L. major parasite, reduced lesion size significantly and did not prevent visceralisation but reduced spleen parasite load significantly

Alcohol and illicit drug use among young people living with HIV compared to their uninfected peers from the Kenyan coast: prevalence and risk indicators

Background: In sub-Saharan Africa, there is paucity of research on substance use patterns among young people living with HIV (YLWH). To address the gap, we sought to: i) determine the prevalence of substance use, specifically alcohol and illicit drug use, among YLWH compared to their HIV-uninfected peers; ii) investigate the independent association between young people’s HIV infection status and substance use; iii) investigate the risk indicators for substance use among these young people. Methods: Between November 2018 and September 2019, a cross-sectional study was conducted at the Kenyan coast recruiting 819 young people aged 18–24 years (407 HIV-positive). Alcohol and drug use disorders identification tests (AUDIT and DUDIT) were administered via audio computer-assisted self-interview alongside other measures. Logistic regression was used to determine substance use risk indicators. Results: The point prevalence of current substance use was significantly lower among YLWH than HIV-uninfected youths: current alcohol use, 13% vs. 24%, p \u3c 0.01; current illicit drug use, 7% vs. 15%, p \u3c 0.01; current alcohol and illicit drug use comorbidity, 4 vs. 11%, p \u3c 0.01. Past-year prevalence estimates for hazardous substance use were generally low among young people in this setting (\u3c 10%) with no significant group differences observed. Being HIV-positive independently predicted lower odds of current substance use, but not hazardous substance use. There was overlap of some risk indicators for current substance use between young people with and without HIV including male sex, khat use and an experience of multiple negative life events, but risk indicators unique to either group were also identified. Among YLWH, none of the HIV-related factors was significantly associated with current substance use. Conclusions: At the Kenyan coast, substance use is a reality among young people. The frequency of use generally appears to be low among YLWH compared to the HIV-uninfected peers. Substance use prevention initiatives targeting young people, regardless of HIV infection status, are warranted in this setting to avert their potential risk for developing substance use disorders, including dependence. The multifaceted intrapersonal and interpersonal factors that place young people at risk of substance use need to be addressed as part of the substance use awareness and prevention initiatives

The Gender Context of HIV Risk and Pregnancy Goals in Western Kenya

Background: Intentional childbearing may place heterosexual couples at risk of HIV infection in resource-limited settings with high HIV prevalence areas where society places great value on having children.Objective: To explore cognitive, cultural, and spatial mapping of sexual and reproductive health domains and services in western Kenya among men and women.Design: Community-based formative qualitative study design.Setting: Five administrative/geographical divisions of Nyando District, western Kenya.Subjects: Adult male 18 years and older and female who were of reproductive-potential ages (15 to 49 years for females)(n=90).Results:Men and women have disparate goals for number of children and engage in gendered patterns of protective method use (contraceptives used by women often in secret, condoms by men but rarely).Conclusion: HIV infection was still seen as stigmatising. These study results are relevant to design of effective integrated delivery for reproductive and HIV services in high-burden sub-Saharan African countries

Opportunities and Challenges to Emergency Department-Based HIV Testing Services and Self-Testing Programs: A Qualitative Study of Healthcare Providers and Patients in Kenya

BACKGROUND: Young people in Sub-Saharan Africa, especially males, have been insufficiently engaged through HIV Testing Services (HTS). In Kenya, younger persons are often treated in emergency departments (EDs) for injuries, an interaction where HTS and HIV self-testing (HIVST) can be leveraged. Data from stakeholders on ED-HTS and HIVST is lacking and needed to understand opportunities and barriers for HIV testing and care, and inform program implementation. METHODS: Between December 2021 and March 2022, 32 in-depth interviews (IDIs) were conducted with 16 male and 16 female patients who had been treated in the Kenyatta National Hospital (KNH) ED, half of whom had been HIV-tested. Six focus-group discussions (FGDs) were also conducted with 50 nurses, doctors, HIV testing counselors, and administrators working in the ED. All transcripts were double-coded and thematically analyzed using Dedoose software and a parallel inductive and deductive coding approach which allowed for capture of both a priori and emergent themes. RESULTS: Patients and providers agreed that ED-HTS are facilitated by friendly staff, patient education, high perceived HIV risk, and confidentiality. However, ED-HTS is limited by burdens on staff, resources, time, and space, as well as severity of patient injuries limiting ability to consent to or prioritize HIV testing. These limitations provide opportunities for ED-HIVST: particularly the ability to test at a comfortable time and place, especially when provided alongside sufficient HIV and testing education, contact with healthcare providers, and psychosocial support. Barriers for ED-HIVST where identified and as patients’ concerns about HIVST accuracy and mental health impacts of a positive test, as well providers’ identified barriers on their concerns for loss to follow up and inability to complete confirmatory testing. COM-B Model [Figure: see text] Application of the COM-B Model of Behavior Change to ED-HIVST Acceptability in Kenya CONCLUSION: ED stakeholders are receptive to HTS and HIVST, and patients desire the opportunity to use HIVST. Potential challenges—such as psychological effects of testing positive, worries about access to follow-up care, and confusion about how to self-administer testing, may be addressed through programming designed to promote education, access and ensure follow-up mechanisms. DISCLOSURES: All Authors: No reported disclosures

Aspects determining the risk of pesticides to wild bees: risk profiles for focal crops on three continents.

In order to conduct a proper risk assessment of pesticides to bees, information is needed in three areas: (i) the toxicity of the pesticide; (ii) the probability of bee exposure to that pesticide; and (iii) the population dynamics of the bee species in question. Information was collected on such factors affecting pesticide risk to (primarily wild) bees in several crops in Brazil, Kenya and The Netherlands. These data were used to construct ?risk profiles? of pesticide use for bees in the studied cropping systems. Data gaps were identified and potential risks of pesticides to bees were compared between the crops. Initially, risk profiling aims to better identify gaps in our present knowledge. In the longer term, the established risk profiles may provide structured inputs into risk assessment models for wild and managed bees, and lead to recommendations for specific risk mitigation measures.Edição dos Proceedings of the 11 International Symposium Hazards of Pesticides to Bees, Wageningen, nov. 2011

Effect of SARS-CoV-2 Infection in Pregnancy on Maternal and Neonatal Outcomes in Africa: An AFREhealth Call for Evidence through Multicountry Research Collaboration

In the African context, there is a paucity of data on SARS-CoV-2 infection and associated COVID-19 in pregnancy. Given the endemicity of infections such as malaria, HIV, and tuberculosis (TB) in sub-Saharan Africa (SSA), it is important to evaluate coinfections with SARS-CoV-2 and their impact on maternal/infant outcomes. Robust research is critically needed to evaluate the effects of the added burden of COVID-19 in pregnancy, to help develop evidence-based policies toward improving maternal and infant outcomes. In this perspective, we briefly review current knowledge on the clinical features of COVID-19 in pregnancy; the risks of preterm birth and cesarean delivery secondary to comorbid severity; the effects of maternal SARS-CoV-2 infection on the fetus/neonate; and in utero mother-to-child SARS-CoV-2 transmission. We further highlight the need to conduct multicountry surveillance as well as retrospective and prospective cohort studies across SSA. This will enable assessments of SARS-CoV-2 burden among pregnant African women and improve the understanding of the spectrum of COVID-19 manifestations in this population, which may be living with or without HIV, TB, and/or other coinfections/comorbidities. In addition, multicountry studies will allow a better understanding of risk factors and outcomes to be compared across countries and subregions. Such an approach will encourage and strengthen much-needed intra-African, south-to-south multidisciplinary and interprofessional research collaborations. The African Forum for Research and Education in Health's COVID-19 Research Working Group has embarked upon such a collaboration across Western, Central, Eastern and Southern Africa