Seroprevalence of hepatitis B virus infection, anti-HCV antibodies and HIV and knowledge among people who use drugs attending methadone therapy clinic in Tanzania; a cross-sectional study

Background Methadone therapy clinics have been recently introduced in Tanzania, aiming at reducing risk behaviors and infection rates of viral hepatitis and HIV among people who use drugs. The objective of this study was to estimate the prevalence, associated factors and knowledge level of these conditions among people who use drugs attending a methadone clinic in Tanzania. Methods We enrolled 253 People who using drugs receiving Methadone therapy. Clinical data was retrospectively collected from the medical records and face-to face interviews were conducted to determine the behavioral risk factors and respondents’ knowledge on viral hepatitis and HIV. Results An overall seroprevalence of viral hepatitis (either hepatitis B surface antigen or anti-hepatitis C virus) was 6.3%, while that of hepatitis B virus mono infection was 3.5% and anti-hepatitis C antibodies was 3.5%. Seroprevalence of HIV was 12.6%. Viral hepatitis was strongly predicted by advanced age (\u3e 35 years) (p = 0.02) and staying at Kirumba area (p = 0.004), and HIV infection was predicted by increased age (\u3e 37 years) (p = 0.04) and female sex (p \u3c 0.001). Regarding the knowledge of viral hepatitis, majority of the respondents were unaware of the transmission methods and availability of hepatitis B virus vaccines and only 17% were classified as well informed (provided ≥4 correct answers out of 7 questions). Good knowledge was highly predicted by higher education level of the individual (p = 0.001). Conclusions Despite the efforts to curb viral hepatitis and HIV infections through Methadone clinics, infection rates among people who use drugs are still high and the general knowledge on preventive measures is inadequate

Joint management of shared resources as an alternative approach for addressing maritime boundary disputes : the Kenya-Somalia maritime boundary dispute

Socio-economic security has motivated African states to explore natural resources in areas of overlapping maritime claims. However, Africa’s maritime boundaries are characterized by unresolved disputes. Resolution of these disputes is time-consuming, expensive and can undermine the state’s ability to exploit natural resources. The Somalia and Kenya maritime dispute under litigation with the International Court of Justice demonstrates the continental commitment to peaceful resolution. Citing cases from across Africa, we discuss outright delimitation or Joint Management Zones (JMZs) as means to address disputes over shared resources, particularly transboundary fisheries, which have received little attention. Reframing the Kenya-Somalia maritime dispute resolution process as cooperation over fisheries management will have spill-over effects into greater diplomatic relations. Fish do not abide by maritime boundaries. As such, we posit that the peaceful resolution of maritime boundary disputes lies in Africa’s ability to consider settlements by way of JMZs to motivate sustainable use of natural resources.PostprintPeer reviewe

Pregnancy interval and delivery outcome among HIV-seropositive and HIV-seronegative women in Kisumu, Kenya.

OBJECTIVE: A short pregnancy interval (PI) has been associated with increased child mortality, but mechanisms are unclear. We studied factors associated with PI and the effect of PI on birthweight and haemoglobin. METHODS: Information was analysed from 2218 multigravidae who were recruited at the prenatal clinic (1758) or in the labour ward (460) of the Provincial Hospital in Kisumu between June 1996 and July 2000 for a study to assess the interaction between placental malaria and vertical HIV transmission. RESULTS: The HIV prevalence was 28.9%. HIV seropositivity, older age, being unmarried, and <8 years of education were associated with a prolonged PI; among all women, a stillbirth, abortion, or death of a liveborn child as outcome of the previous pregnancy, and death of a child other than the last born among HIV-seronegative women, were associated with a shortened PI. No significant effect of short PI (an interval <24 months) on low birth weight (LBW), prematurity, small-for-gestational-age infants or maternal anaemia was evident. An abortion, stillbirth, or death of a liveborn child as outcome of the previous pregnancy was associated at the present delivery with LBW among HIV-seronegative women [adjusted odds ratio (AOR) 3.33, 95% confidence interval (CI) 1.63-6.81], and a low haemoglobin (<11 g/dl) among HIV-seropositive women (AOR 2.01, 95% CI 1.05-4.03 in the third trimester). CONCLUSION: Public health efforts to ensure 'adequate' birth spacing may run contrary to family planning decisions to replace a deceased child and may be spent on prenatal issues like prevention of anaemia, and vertical HIV transmission