Seroprevalence of HAV, HBV, HCV, and HEV among acute hepatitis patients at Kenyatta National Hospital in Nairobi, Kenya

Background: Acute viral hepatitis is most frequently caused by the hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV) and hepatitis E virus (HEV).Objectives: To determine seroprevalence of HAV, HBV, HCV and HEV among patients with acute hepatitis in Nairobi, Kenya, elucidate various risk factors for hepatitis viral infection and determine the co-infection rates with these viruses in the acute hepatitis patients.Design: Across sectional descriptive study.Setting: Kenyatta National Hospital, from November 2007 to April 2008.Subjects: One hundred patients were recruited by purposive sampling method and comprised of 57 males and 43 females.Results: Among the enrolled patients, twenty three tested positive for one or more markers of acute viral hepatitis, that is, HAV, HBV, HCV and HEV. No markers were detected in 77 patients, 2% tested positive for IgM anti-HAV; 11% for IgM anti-HBc; 3% for HBsAg; 5% for HCV RNA and 7% for IgM anti-HEV.Various risk factors associated with acute viral hepatitis were identified; poor sanitation, source of water, occupation, place of residence, level of education,household size, drug abuse and sexual behaviours. Co-infection rate with hepatitis Viruses was at 4%, IgM anti-HAV and IgM anti-HEV 1 % (n=1); IgM anti-HBc and IgM anti-HEV 1% (n=1); IgM anti-HBc and anti-HCV 2% (n=2).Three patients were positive for HBsAg; among this two were negative for IgM anti-HBc and this accounted for HBV carriage (2 %).Conclusion: Hepatitis viruses’ infections are common cause of hepatitis among patients with acute hepatitis at Kenyatta National Hospital. Co-infection with these viruses was also identified among these patients

Prevalence of Hepatitis C Virus and its genotypes among a cohort of drug users in Kenya

Background: Prevalence of hepatitis C virus and that of its main genotypes varies between the worlds geographic regions. The risk factors for infection with HCV include blood transfusion, tattoing and injecting drug use. Objectives: To examine the prevalence of HCV and determine its main genotypes among a cohort of drug users in Kenya. Design: A laboratory based study. Setting: Hepatitis research laboratory in the Centre for Virus Research at the Kenya Medical Research Institute, Nairobi. Subjects: Three hundred and fourteen male and 19 female intravenous and non-intravenous drug users aged between 15-55 years. Results: Seventy four (22.2%) out of 333 samples tested positive for anti-HCV. Sixty nine out of the 74 serum samples were assayed for HCV RNA and 38 (55.5%) were positive. The RNA positive samples were further subjected to sequencing and 19 (73%) of the samples were classified as genotype la, while seven (27%) samples were classified as genotype 4. Genotypes 2, 3, 5 and 6 were not identified in this study. Conclusions: These results demonstrate a high HCV infection prevalence among this cohort of drug users (22.2 %) as compared to that of the general population, which is estimated to be 0.2- 0.9%. The study also confirms the presence of at least two major genotypes among Kenyan drug users (genotypes 1 and 4). East African Medical Journal Vol. 85 (7) 2008: pp. 318-32

Editorial: Dynamics of blood-borne diseases

No Abstract East African Medical Journal Vol.82(4) 2005: 16

Tuberculosis and oral Candida species surveillance in HIV infected individuals in Northern Kenya, and the implications of tuberculin skin test screening for DOPT-P

No Abstract. East African Medical Journal Vol 82(12) 2005: 609-61

Hepatitis-B virus endemicity: heterogeneity, catastrophic dynamics and control.

Hepatitis-B virus infection is globally ubiquitous, but its distribution is very heterogeneous, with prevalence of serological markers in various nations ranging from less than 1% to more than 90%. We propose an explanation for this diversity using a mathematical model of hepatitis-B virus transmission dynamics that shows, for the first time, 'catastrophic' behavior using realistic epidemiological processes and parameters. Our major conclusion is that the prevalence of infection is largely determined by a feedback mechanism that relates the rate of transmission, average age at infection and age-related probability of developing carriage following infection. Using the model we identify possible, highly non-linear, consequences of chemotherapy and immunization interventions, for which the starting prevalence of carriers is the most influential, predictive quantity. Taken together, our results demand a re-evaluation of public health policy towards hepatitis-B

African Women\u27s Movements and Struggles over Land

Access to land and other property is crucial to the livelihoods of women across the African continent. Women need land for residence, to grow crops and raise livestock, and to operate businesses and to secure access to and control over property which can provide them with a degree of stability in otherwise precarious and uncertain times. This chapter reviews contemporary women’s struggles for land and property rights in Africa. Drawing from country-focused, regional, and continental analyses, it addresses collective efforts by women’s and land rights movements to increase women’s access to and control over property through policy advocacy, litigation, and education; discusses the barriers to gender-equitable land and property rights reforms; and suggests that women property claimants may be propelling a shift toward more gender equitable property norms and practices in many places. The chapter concludes that supportive public policies and social institutional changes are both necessary to ensure that women have access to and control over the property necessary to their livelihoods. It further highlights the need for more research on the property struggles of differently situated African women such as those without children, those living in informal settlements, and those who are queer or trans, as well as on the counter-mobilization against women’s property rights movements