Serologic testing algorithm for recent HIV seroconversion in estimating incidence of HIV-1 among adults visiting a VCT centre at a Kenyan tertiary health institution

Objective: To determine HIV high risk groups among adults visiting Kenyatta National Hospital Voluntary Counselling and Testing Centre by use of Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS).Design: A cross-sectional study of adults.Setting: Kenyatta National Hospital Voluntary and Counselling Centre.Results: Of the 6,415 adults screened for antibodies to HIV at Kenyatta National Hospital VCT Centre between July 2002 and February 2003, 728 tested positive in the two HIV screening tests used at the center, indicating a prevalence of 11%. Of these seropositive cases, 355 consented to participate in the study. Using STARHS, 34 (9.6%) of the plasma samples were classified as being from individuals with recent infection (within 170 days), giving an annual estimated HIV-1 incidence in this population of 1.3 infections per 100 person-years with a 95% CI of 0.872–1.728%. Young adults had a higher rate of new infection than older adults. Young females were infected much earlier in life, with a peak age of new infections of 26 years, versus. 31 years for young males.Conclusion: This study confirms our hypothesis that STARHS or Detuned assay can be used to determine HIV incidence in this population. The HIV high risk groups as identified by this study are young women between ages 16 to 26 years old and men between ages 45 to 55 years of age

Historestorative effects of Warbugia ugandensis on high fat diet induced atherosclerosis in New Zealand rabbits

Background: Historestorative feature is a vital component that any organ can acquire secondary to its damage. Most of the time damage arises from traumatic injury or toxification by toxic agents. In the current context the aortic intima lumen significantly histologically changed secondary to administration of Warbugia ugandensis thus increasing blood supply to vital organs. Methods: Posttest only true experimental study design was used with 33 male New Zeeland rabbits considered for this study. In grouping of animals, Systematic sampling method was used to assign them as control and experimental groups. W. ugandensis extract was obtained after which phytochemical analysis and acute oral toxicity were conducted to determine safe dose. The animals were fed on high fat diet to induce atherosclerosis. Results: The mean fraction of restorative group reduced significantly (p=0.0001) relative to vehicle control group. There was no significant difference in mean area fraction of W. ugandensis restorative group when compared with negative control group (p=1.000). On histological features, restorative group had a smaller lesion as compared to vehicle group. The lipid core was smaller in size with large fibrous cap around it. The endothelial cells surrounded the lesion as opposed to vehicle control group make it more stable. Conclusions: Therefore, it can be concluded that W. ugandensis has historestorative benefits portrayed by reduction of atherosclerotic lesion with a lipid core covered by a large fibrous cap

Comparative assessment of diet and condition factor of Cyprinus carpio and Oreochromis leucostictus in Lake Naivasha, Kenya

The study compared and assessed the diet and condition factors of two fish species, Oreochromis leucostictus and Cyprinus carpio, in Lake Naivasha. Fish samples were collected monthly using gill nets (35-70 mm mesh size) from July to December 2013. Stomach contents of all the specimens were analysed using the point method. Results indicated that detritus was the most abundant food item in the diet of both O. leucostictus and C. carpio accounting for 50% and 63%, respectively, while benthic macroinvertebrates contributed the least with each fish having 2%. Rooting and digging behaviour of the carp probably led to both C. carpio and O. leucostictus ingesting the suspended detritus as their main source of food with C. carpio outcompeting O. leucostictus due to its prolific nature and better adaptability to benthic conditions. Fulton’s condition factor of all the fish samples had values of >1. A comparison of the two fish species showed C. carpio had a condition factor of 1.51 while O. leucostictus had 1.32. The higher condition factor of C. carpio in Lake Naivasha is an indication that the fish have better tissue energy reserves, greater reproductive potential and higher survival rates compared to O. leucostictus with a lower condition factor

Association between thrombocytes count and Plasmodium falcipurum infection among children under five years attending Kombewa Sub-County Hospital

Malaria is a leading cause of morbidity and mortality especially among children, expectant women and continues to be a global health burden. Haematological changes mark some of the most common complications in malaria as they play a major role in malaria pathology. Thrombocytes in particular, have been shown to bind infected erythrocytes and kill intracellular malaria parasites thereby indicating a protective function of platelets in the early stages. However, the mechanism that leads to low thrombocytes count in malaria infected individuals is not clear. Understanding the mechanism of platelet reduction during pathogenesis of malaria infection will be fundamental in malaria severity classification, monitoring of platelet count during infection and prompt initiation of anti-malarial therapy. In trying to understand these facts, this study sort to establish the association between platelet count and P. falciparum infection amongst children less than five years. This was a retrospective case-control study, n=549. Children below the age of five years that attending Kombewa Sub -County Hospital were recruited. Study participants were identified using the inclusion criteria and followed horizontally to retrieve platelet count from complete blood count results. The respective malaria blood film reads were then recorded, stratified to give case and control from which random sampling was done. Chi-square test and Tukey’s multiple comparison tests from Graph pad prism 5 were used in the analysis. The odds of exposure to low platelet count were then established with a confidence level of 95%. We found significant difference between the cases and controls in regard to parasite density (Chi square=157.5, p value <0.05), mean parasite density in controls =2042.1/?l compared to cases= 142880/?l. The odds of cases being exposed to malaria was 12 times more than controls (OR=12.382, 95%). We also found no variation in thrombocytes counts in relation to gender, children with thrombocytopenia were having higher parasite density, parasite density as a result of P.falciparum infection is not dependent on gender and children that suffered malarial infection were twelve times likely to develop thrombocytopenia. Further studies are then recommended to establish the effects of incorporation of platelet aggregation inhibitors such as aspirin in malaria treatment.Key Words: Plasmodium falciparum, thrombocytopenia, infectio

Affective Correlates of Stimulant Use and Adherence to Anti-retroviral Therapy Among HIV-positive Methamphetamine Users

The use of stimulants has important implications for HIV prevention and care. However, few investigations have examined psychological correlates of substance use and adherence to anti-retroviral therapy (ART) among HIV-positive stimulant users. This cross-sectional investigation examined affective correlates of stimulant use and ART adherence among HIV-positive methamphetamine users. In total, 122 HIV-positive men who have sex with men or transgendered individuals on ART who reported using methamphetamine in the past 30 days were recruited from the community. HIV-specific traumatic stress was consistently and independently associated with more frequent cocaine/crack use (but not with methamphetamine use). Positive affect was independently associated with a decreased likelihood of reporting any injection drug use and an increased likelihood of reporting perfect ART adherence. HIV-specific traumatic stress may be an important determinant of increased cocaine/crack use in this population. Positive affect may increase the likelihood that individuals will refrain from injection drug use and achieve high levels of ART adherence

A facility-based study of women' satisfaction and perceived quality of reproductive and maternal health services in the Kenya output-based approach voucher program

Background: This is a facility-based study designed to assess perceived quality of care and satisfaction of reproductive health services under the output-based approach (OBA) services in Kenya from clients’ perspective. Method: An exit interview was conducted on 254 clients in public health facilities, non-governmental organizations, faith-based organizations and private facilities in Kitui, Kilifi, Kiambu, and Kisumu counties as well as in the Korogocho and Viwandani slums in Nairobi, Kenya using a 23-item scale questionnaire on quality of reproductive health services. Descriptive analysis, exploratory factor analysis, reliability test, and subgroup analysis using linear regression were performed. Results: Clients generally had a positive view on staff conduct and healthcare delivery but were neutral on hospital physical facilities, resources, and access to healthcare services. There was a high overall level of satisfaction among the clients with quick service, good handling of complications, and clean hospital stated as some of the reasons that enhanced satisfaction. The County of residence was shown to impact the perception of quality greatly with other social demographic characteristics showing low impact. Conclusion: Majority of the women perceived the quality of OBA services to be high and were happy with the way healthcare providers were handling birth related complications. The conduct and practice of healthcare workers is an important determinant of client’s perception of quality of reproductive and maternal health services. Findings can be used by health care managers as a guide to evaluate different areas of healthcare delivery and to improve resources and physical facilities that are crucial in elevating clients’ level of satisfaction