Predictors of linkage to care following community-based HIV counseling and testing in rural Kenya

Despite innovations in HIV counseling and testing (HCT), important gaps remain in understanding linkage to care. We followed a cohort diagnosed with HIV through a community-based HCT campaign that trained persons living with HIV/AIDS (PLHA) as navigators. Individual, interpersonal, and institutional predictors of linkage were assessed using survival analysis of self-reported time to enrollment. Of 483 persons consenting to follow-up, 305 (63.2%) enrolled in HIV care within 3 months. Proportions linking to care were similar across sexes, barring a sub-sample of men aged 18–25 years who were highly unlikely to enroll. Men were more likely to enroll if they had disclosed to their spouse, and women if they had disclosed to family. Women who anticipated violence or relationship breakup were less likely to link to care. Enrolment rates were significantly higher among participants receiving a PLHA visit, suggesting that a navigator approach may improve linkage from community-based HCT campaigns.Vestergaard Frandse

Risks to Birds Traded for African Traditional Medicine: A Quantitative Assessment

Few regional or continent-wide assessments of bird use for traditional medicine have been attempted anywhere in the world. Africa has the highest known diversity of bird species used for this purpose. This study assesses the vulnerability of 354 bird species used for traditional medicine in 25 African countries, from 205 genera, 70 families, and 25 orders. The orders most represented were Passeriformes (107 species), Falconiformes (45 species), and Coraciiformes (24 species), and the families Accipitridae (37 species), Ardeidae (15 species), and Bucerotidae (12 species). The Barn owl (Tyto alba) was the most widely sold species (seven countries). The similarity of avifaunal orders traded is high (analogous to ‘‘morphospecies’’, and using Sørensen’s index), which suggests opportunities for a common understanding of cultural factors driving demand. The highest similarity was between bird orders sold in markets of Benin vs. Burkina Faso (90%), but even bird orders sold in two geographically separated countries (Benin vs. South Africa and Nigeria vs. South Africa) were 87% and 81% similar, respectively. Rabinowitz’s ‘‘7 forms of rarity’’ model, used to group species according to commonness or rarity, indicated that 24% of traded bird species are very common, locally abundant in several habitats, and occur over a large geographical area, but 10% are rare, occur in low numbers in specific habitats, and over a small geographical area. The order with the highest proportion of rare species was the Musophagiformes. An analysis of species mass (as a proxy for size) indicated that large and/or conspicuous species tend to be targeted by harvesters for the traditional medicine trade. Furthermore, based on cluster analyses for species groups of similar risk, vultures, hornbills, and other large avifauna, such as bustards, are most threatened by selective harvesting and should be prioritised for conservation action.University of the Witwatersrand SPARC Prestigious and URC Postdoctoral Fellowships; National Research Foundatio

Risk factor profile and the occurrence of microvascular complications in short term type 2 diabetes mellitus at Kenyatta National Hospital, Nairobi

Background: Type 2 diabetes has a long pre-clinical period before diagnosis, during which there may be development of complications, both of microvascular and macrovascular types. Objective: To determine the risk factor profile of hyperglycaemia, hypertension and dyslipidaemia in patients with short-term (=/< 2 years) type 2 diabetes. Design: Cross-sectional descriptive study over six months. Setting: Outpatient diabetic clinic of Kenyatta National Hospital. Subjects: Ambulatory patients with type 2 diabetes.Results: One hundred patients were included. The mean (SD) duration of diabetes was 10.3 (7.5) months. There were 66% of the study subjects with obesity, 50% with hypertension, 29% had ideal glucose control and less than 40% had high LDLcholesterol. Twenty eight (28%) who had polyneuropathy had significant differences in their older age, higher total and LDL-cholesterol compared with those who did not have polyneuropathy. Twenty five (25%) of the study patients had micro-albuminuria and only 1% had macro-albuminuria. There were no significant differences in the selected characteristics between study patients with and those without albuminuria. Only 7% of the study patients had retinopathy on direct ophthalmoscopy. Conclusion: Microvascular complications occurred in patients with type 2 diabetes of short duration of not more than two years. The risk factors of hypertension, poor glycaemic control, dyslipidaemia and cigarette smoking were present in a fair proportion of the study patients. Patients with type 2 diabetes should be actively screened for complications and the risk factors thereof, even if the diabetes was of recent onset. East African Medical Journal Vol. 82(12) 2005: S163-S17

Promising post-consumer PET-derived activated carbon electrode material for non-enzymatic electrochemical determination of carbofuran hydrolysate

Abstract In this work, activated carbon (AC) materials, prepared from polyethylene terephthalate (PET) waste bottles were used as the sensing platform for the indirect detection of carbofuran. The morphology and surface properties of the PET-derived AC (PET-AC) were characterized by N2 adsorption/desorption isotherm, X-ray diffraction (XRD), field-emission scanning/transmission electron microscopy (FE-SEM/TEM) and Raman spectroscopy. The electrochemical activity of the PET-AC modified glassy carbon electrode (GCE) (PET-AC/GCE) was measured by cyclic voltammetry and amperometry. The enhanced surface area and desirable porosities of PET-AC are attributed for the superior electrocatalytic activity on the detection of carbofuran phenol, where, the proposed sensor shows low detection limit (0.03 µM) and remarkable sensitivity (0.11 µA µM−1 cm−2). The PET-AC/GCE holds high selectivity towards potentially interfering species. It also provides desirable stability, repeatability and reproducibility on detection of carbofuran phenol. Furthermore, the proposed sensor is utilized for the detection of carbofuran phenol in real sample applications. The above mentioned unique properties and desirable electrochemical performances suggest that the PET-derived AC is the most suitable carbonaceous materials for cost-effective and non-enzymatic electrochemical sensor