Factors associated with risky sexual behavior among HIV negative partners in HIV discordant relationships in Nairobi, Kenya

Introduction: Whereas risky sexual behavior influences HIV acquisition, little information is available on risk taking practices among negative partners in HIV discordant relationships in our settings. This study sought to determine the associated factors among this population in Nairobi.Methods: This study was a cross-sectional descriptive study and 133 HIV negative partners participated in the study.Results: Out of the 133 participants, 66.9% were male and 33.1% were female. Overall, 44.4% of the study participants reported inconsistent condom use, 14.3% reported having another sexual partner and 30% reported ever engaging in sexual activities under the influence of alcohol. Monthly earnings (p- 0.02), alcohol use (p- 0.03) and the index partner being on anti-retroviral medication (p-0.02) were significantly associated with having another sexual partner. Focus group discussion findings showed that male gender, alcohol use and the duration of the relationship influenced the decision to use condoms while male gender influenced having another sexual partner.Conclusion: Risky sexual behavior practices still occur among the HIV negative partners in discordant relationships. More education and sensitization should be made on the risks associated with this behavior so as to reduce the risk of HIV infection from their infected partners.Afr J Health Sci. 2013; 26:324-33

The impact of scaling up cervical cancer screening and treatment services among women living with HIV in Kenya: a modelling study

Introduction: We aimed to quantify health outcomes and programmatic implications of scaling up cervical cancer (CC) screening and treatment options for women living with HIV in care aged 18–65 in Kenya. Methods: Mathematical model comparing from 2020 to 2040: (1) visual inspection with acetic acid (VIA) and cryotherapy (Cryo); (2) VIA and Cryo or loop excision electrical procedure (LEEP), as indicated; (3) human papillomavirus (HPV)-DNA testing and Cryo or LEEP; and (4) enhanced screening technologies (either same-day HPV-DNA testing or digitally enhanced VIA) and Cryo or LEEP. Outcomes measured were annual number of CC cases, deaths, screening and treatment interventions, and engaged in care (numbers screened, treated and cured) and five yearly age-standardised incidence. Results: All options will reduce CC cases and deaths compared with no scale-up. Options 1–3 will perform similarly, averting approximately 28 000 (33%) CC cases and 7700 (27%) deaths. That is, VIA screening would yield minimal losses to follow-up (LTFU). Conversely, LTFU associated with HPV-DNA testing will yield a lower care engagement, despite better diagnostic performance. In contrast, option 4 would maximise health outcomes, averting 43 200 (50%) CC cases and 11 800 (40%) deaths, given greater care engagement. Yearly rescreening with either option will impose a substantial burden on the health system, which could be reduced by spacing out frequency to three yearly without undermining health gains. Conclusions: Beyond the specific choice of technologies to scale up, efficiently using available options will drive programmatic success. Addressing practical constraints around diagnostics’ performance and LTFU will be key to effectively avert CC cases and deaths

Identifying user needs for weather and climate services to enhance resilience to climate shocks in sub-Saharan Africa

The vulnerability of social-ecological systems in sub-Saharan Africa (SSA) to climate variability and change means that there is an urgent need to better integrate weather and climate information into societal decision-making processes. Long-term climate adaptation in these regions has received increasing attention, with recent initiatives aiming to increase resilience to climate change at timescales of years to decades. Less focus has been given to weather and short-term climate information. However, users are principally interested in shorter timescales (hours to seasons) where actions can immediately reduce the impacts of severe weather events. Focusing on the priority sectors of agriculture and food security, water and disaster management, this paper uses a systematic literature review approach to analyse 61 empirical case studies drawn from academic literature and projects across SSA. We identify the main users of climate services and outline current practices and reported benefits. Barriers that impede the delivery and uptake of climate services are identified and potential strategies for overcoming them outlined based on the reporting of successful practices. Our findings show that greater capacity building of personnel working for National Meteorological and Hydrological Services and Agricultural Extension staff and reinforcing and sustaining collaboration between different stakeholders (climate scientists, hydrologists, extension workers, farmers and other user groups), are essential factors for improving the uptake and utility of weather and climate services to enhance resilience to climate shocks in SSA

Antimicrobial activity and cytotoxicity of selected medicinal plants found in Nandi County, Kenya

Background: Medicinal plants are widely used by the local people to treat various human diseases cause by drug resistant microorganisms. For instance, Kigelia Africana fruits and barks are boiled in water and taken orally as a laxative in treating stomach ailments, Ekebergia capensis bark is boiled in water and use for the control of gonorrhea and tuberculosis while Fagaropsis angolensis stem bark is used to treat pneumonia, back ache and joins. The efficacy and safety of most of these plants has not been determined. Objective: The present study seeks to determine antimicrobial activities and cytotoxicity of the selected medicinal plants indicated above, that are commonly used to treat infectious diseases. Materials and Methods: Fresh plants were collected from the field; air dried ground and extracted using acetone and water. The extracts were screened for antibacterial and antifungal activities using Staphylococcus aureus, Methicillin resistant Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Shigella dysentriae, Candida albicans, Cryptococcus neoformans, Microsporum gypseum and Trychophyton mentagrophytes. The methods were disc diffusion and broth dilution methods while in vitro cytotoxicity test was carried out following a modified rapid calorimetric assay, using actively dividing sub-confluent Vero E6 cells. Results: In disc diffusion assay, water extracts of E. capensis were the most active (14.7 mm) while those of Fagaropsis angolensis were the least (6.0 mm) against S. aureus. Acetone extracts of E. capensis and K. Africana had a Minimum Inhibitory Concentration of 3.125 mg/ml and 6.25 mg/ml respectively and were bactericidal. Cytotoxicity showed that K. africana was not cytotoxic against Vero cell lines while acetone extracts of E. capensis was moderately toxic with a CC 50(µg/ml) of 12.5. Conclusion: These results support the use of the plants in the traditional medicine as antimicrobials and they can be exploited for novel drugs. Key words: Antimicrobial activity, cytotoxicity, Kigelia africana, Ekebergia capensis, Fagaropsis angolensi

Indian Ocean Dipole drives malaria resurgence in East African highlands

Malaria resurgence in African highlands in the 1990s has raised questions about the underlying drivers of the increase in disease incidence including the role of El-Niño-Southern Oscillation (ENSO). However, climatic anomalies other than the ENSO are clearly associated with malaria outbreaks in the highlands. Here we show that the Indian Ocean Dipole (IOD), a coupled ocean-atmosphere interaction in the Indian Ocean, affected highland malaria re-emergence. Using cross-wavelet coherence analysis, we found four-year long coherent cycles between the malaria time series and the dipole mode index (DMI) in the 1990s in three highland localities. Conversely, we found a less pronounced coherence between malaria and DMI in lowland localities. The highland/lowland contrast can be explained by the effects of mesoscale systems generated by Lake Victoria on its climate basin. Our results support the need to consider IOD as a driving force in the resurgence of malaria in the East African highlands

Western Indian Ocean marine and terrestrial records of climate variability: a review and new concepts on land-ocean interactions since AD 1660

We examine the relationship between three tropical and two subtropical western Indian Ocean coral oxygen isotope time series to surface air temperatures (SAT) and rainfall over India, tropical East Africa and southeast Africa. We review established relationships, provide new concepts with regard to distinct rainfall seasons, and mean annual temperatures. Tropical corals are coherent with SAT over western India and East Africa at interannual and multidecadal periodicities. The subtropical corals correlate with Southeast African SAT at periodicities of 16–30 years. The relationship between the coral records and land rainfall is more complex. Running correlations suggest varying strength of interannual teleconnections between the tropical coral oxygen isotope records and rainfall over equatorial East Africa. The relationship with rainfall over India changed in the 1970s. The subtropical oxygen isotope records are coherent with South African rainfall at interdecadal periodicities. Paleoclimatological reconstructions of land rainfall and SAT reveal that the inferred relationships generally hold during the last 350 years. Thus, the Indian Ocean corals prove invaluable for investigating land–ocean interactions during past centuries

Larvicidal effect of Mundulea sericea (Leguminosaea) plant extract against Aedes aegypti (L.) (Diptera: Culicidae)

IntroductionThe medical importance of mosquitoes as vectors forthe transmission of serious diseases that causemorbidity, mortality, economic loss, and socialdisruption such as malaria, lymphatic filariasis, andviral diseases is well recorded (Becker et al, 2003).Aedes aegypti, the main carrier for viruses that causedengue and dengue hemorrhagic and yellow fevers, isfound majorly in the tropics and subtropics. There is noeffective vaccine against dengue, and thus the only wayof significantly lowering the incidence of this disease isthrough mosquito control (Malavige et al, 2004).Chemical measures were first tried, but they failed sincetheir overuse led to disruption of natural biologicalcontrol systems and outbreak of new insect species. Inaddition, use of insecticides led to the development ofmosquito resistance, environmental pollution, andundesirable effect on non-target organisms (Brown,1986). In a bid to resolve these problems, interest ininsecticides of natural origin, specifically plant-derivedproducts has recently received close attention.Several studies have emphasized the importance ofresearch and development of herbal substances forcontrolling mosquitoes (Shaala et al, 2005). Theirresults may vary, but natural plant products may be apossible alternative to synthetic substances, as they areeffective and compatible with human and animal lifeand the environment (Chaithong et al, 2006).The genus Mundulea consists of about 15 species,widespread throughout Africa, Madagascar, Mauritius,India, Sri Lanka and Papua New Guinea. Only a singlespecies, Mundulea sericea, is found in Southern Africa.This species occurs in South Africa, Botswana, Namibiaand Angola, north to tropical Africa, and east toMadagascar, India, Sri Lanka and Papua New Guinea(Watt and Breyer-Brandwick, 1962).Mundulea sericea is one of the commonest fish poisonswhere both bark and seeds are used (Neuwinger, 2004).In addition, the Chinese used M. sericea to controltobacco budworm Heliothis virescens (Lepidopteriae:Noctuidae) (Yoshida and Toscano, 1994).The toxic principal of the plant is rotenone, anisoflavonoid (Vedcourt and Trump, 1969). Therotenoids deguelin and tephrosin are the potent activeprinciples which have been isolated from extracts of M.sericea (Luyengi et al, 1994). Deguelin is a natural plantderivedrotenoid, most commonly used as an insecticidein Africa and South America (Udeani et al, 1997).Rotenoids from the bark of M. sericea have beencommercially used as insecticide. These chemicalcompounds in the bark, leaves and seed are the activecompounds responsible for the fish poison. It isreported that the strength varies geographically (Wattand Breyer-Brandwick, 1962).The current study involved extraction and evaluation ofroot bark and seedpod of M. sericea for larvicidalactivities on Aedes aegypt

Cpd-1 Null Mice Display a Subtle Neurological Phenotype

CPD1 (also known as ANP32-E) belongs to a family of evolutionarily conserved acidic proteins with leucine rich repeats implicated in a variety of cellular processes regulating gene expression, vesicular trafficking, intracellular signaling and apoptosis. Because of its spatiotemporal expression pattern, CPD1 has been proposed to play an important role in brain morphogenesis and synaptic development.We have generated CPD1 knock-out mice that we have subsequently characterized. These mice are viable and fertile. However, they display a subtle neurological clasping phenotype and mild motor deficits.CPD1 is not essential for normal development; however, it appears to play a role in the regulation of fine motor functions. The minimal phenotype suggests compensatory biological mechanisms