University of Nairobi

About: University of Nairobi is a education organization based out in Nairobi, Nairobi, Kenya. It is known for research contribution in the topics: Population & Health care. The organization has 6702 authors who have published 10777 publications receiving 231294 citations. The organization is also known as: UoN & IAU-020319.

Human and natural impacts on forests along lower Tana river, Kenya: implications towards conservation and management of endemic primate species and their habitat

Abstract: Seventy-three forest patches were assessed to determine the effects of human and natural impact on native forests along the Lower Tana River flood plains in Kenya between January and March 2001. Seventeen of these forests were within the Tana River Primate National Reserve (TRPNR) while 56 were outside the protected area. Cultivation and dyke construction had the most devastating human impact, which involved partial or complete forest clearing resulting in further fragmentation of forest patches [Suleman MA, Wahungu GM, Mouria PK, Karere GM, Oguge N, Moinde NN (2001) Tana River primate census and forest evaluation. A report to Kenya Wildlife Services]. Natural impacts were either die back or flooding, which appeared to cause progressive degradation of forest structure and biodiversity. Overall, forest area in the Lower Tana significantly reduced by 34.5% (P < 0.001) over a 21-year period. Forest loss was greater outside the reserve (38%) than inside (29.2%) reiterating the significant role played by this protected area in habitat and species conservation. Continued forest loss increases extinction risks for the endemic primate species the Tana River Red Colobus (Procolobus rufomitratus) and the Crested Mangabey sub-species (Cercocebus galeritus galeritus). Initiation of community conservation programmes outside the reserve and introduction of sustainable micro-economic projects were recommended to enhance sustainable livelihoods and the environment.

Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

Abstract: Background Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.

Partner notification by HIV-1 seropositive pregnant women: association with infant feeding decisions

Abstract: Many countries in sub-Saharan Africa are in the process of integrating antenatal voluntary HIV-1 counseling and testing (VCT), antiretroviral prophylaxis, and counseling regarding infant feeding into routine maternal and child health services.1 Even with greater availability of interventions to protect infants from HIV-1 acquisition, many women choose not to receive their HIV-1 test results, and many who learn that they are HIV infected do not implement interventions to prevent vertical or sexual transmission. In both research and non-research settings, <75% of HIV-infected pregnant women who are tested learn their HIV-1 status2,3 and <50% of these women obtain antiretrovirals to prevent mother-to-child HIV-1 transmission2,4–6 or use condoms postpartum.7,8 Not disclosing HIV-1 test results to a sexual partner may impede a woman’s access to interventions to prevent vertical and sexual HIV-1 transmission. There is evidence that lack of partner support is associated with poor uptake of antiretroviral medication and the inability to modify infant feeding practices.9,10 Sexual abstinence and condom use have also been shown to be more common among postpartum women who reveal HIV-positive results to partners.7 These associations between partner involvement and uptake of interventions underscore the importance of involving the male partner in HIV-1 prevention efforts initiated in the antenatal setting. Antenatal VCT involves counseling and testing the woman alone, with the expectation that she will disclose results to her partner. Using this model, the majority of pregnant women in stable relationships who are tested as part of routine care do not inform their partner of positive HIV-1 results, fearing domestic violence, abandonment, or stigmatization.7,11,12 We hypothesized that conducting VCT for pregnant women together with partners could facilitate notification and increase partner participation in the decision-making process. This could in turn improve maternal access to mother-to-child HIV-1 prevention interventions. Studies among discordant couples in nonantenatal settings support this hypothesis and demonstrate that couple counseling is associated with significant behavior change, including sustainable increases in condom use.13–15 In addition, when comparing couple counseling and individual counseling, provision of counseling to couples appears to be more cost-effective in averting HIV-1 infections.16 To examine whether couple counseling in the antenatal setting could be used as a strategy to increase use of interventions to prevent perinatal and sexual HIV-1 transmission, we introduced couple VCT into a Nairobi antenatal clinic and determined the prevalence and correlates of partner participation and couple counseling. The study’s primary aim was to assess the impact of partner involvement, specifically being counseled as a couple, on perinatal intervention uptake and condom use.

Female sex workers in Africa: Epidemiology overview, data gaps, ways forward

Abstract: More than three decades after the first reported case of AIDS (1983), Africa continues to experience unacceptable levels of new HIV infections. East Africa and Southern Africa remain most affected by the epidemic with 34% of the global burden of infections concentrated in 10 Southern African countries (D'Costa, Plummer, Bowmer, Fransen, Piot, Ronald, et al. 1985; Joint United Nations Programme, 2005; Moses, Plummer, Ngugi, Nagelkerke, Anzala & Ndinya Achola 1991; Ngugi, Simonsen, Bosire, Ronald, Plummer, Camero, et al. 1988; WHO Library Cataloguing in Publication Data 2011). Some of these countries reported the first case of HIV infection early in the epidemic (Ethiopia 1984; Kenya 1985). Female sex workers (FSWs) comprise an important sub population in the epidemiology of HIV infection in many countries as evidenced by HIV prevalence amongst FSWs and their clients often being 10 20 fold higher than that in the rest of the general population (Laga, Monoka, Kivuvu, Malele, Tuliza, Nzila, et al. 1993). For example, in Ethiopia, after the first HIV infection was reported in 1984, only 4 years later, the HIV prevalence amongst FSWs had already risen to 17% (Cote, Sobela, Dzokolo, Nzambi, Asamoall Adu, Labbe, et al.). Today, even within Africa's generalized epidemic, research shows that FSWs remain an important epidemiological sub population in relation to HIV related risk throughout the continent (Cowan, Langhaug, Hargrove, Jaffers, Mhurengwe, Searthout, et al. 2005; Ghose, Swendeman, George & Chowdhury 2008; McClelland, Graham, Richardson, Peshu, Masese, Wanje, et al. 2010). These findings point to the need to further under stand the social, behavioural, biological and structural factors that place African FSWs at high risk of HIV infection and establish strategies to reduce HIV transmission in this population (Stefan, Beyrer, Muessig, Poteat, Wirtz, Decker, et al. 2012).