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.

HIV prevention cost-effectiveness: a systematic review

Abstract: After more than 25 years, public health programs have not been able to sufficiently reduce the number of new HIV infections. Over 7,000 people become infected with HIV every day. Lack of convincing evidence of cost-effectiveness (CE) may be one of the reasons why implementation of effective programs is not occurring at sufficient scale. This paper identifies, summarizes and critiques the CE literature related to HIV-prevention interventions in low- and middle-income countries during 2005-2008. Systematic identification of publications was conducted through several methods: electronic databases, internet search of international organizations and major funding/implementing agencies, and journal browsing. Inclusion criteria included: HIV prevention intervention, year for publication (2005-2008), setting (low- and middle-income countries), and CE estimation (empirical or modeling) using outcomes in terms of cost per HIV infection averted and/or cost per disability-adjusted life year (DALY) or quality-adjusted life year (QALY). We found 21 distinct studies analyzing the CE of HIV-prevention interventions published in the past four years (2005-2008). Seventeen CE studies analyzed biomedical interventions; only a few dealt with behavioral and environmental/structural interventions. Sixteen studies focused on sub-Saharan Africa, and only a handful on Asia, Latin America and Eastern Europe. Many HIV-prevention interventions are very cost effective in absolute terms (using costs per DALY averted), and also in country-specific relative terms (in cost per DALY measured as percentage of GDP per capita). There are several types of interventions for which CE studies are still not available or insufficient, including surveillance, abstinence, school-based education, universal precautions, prevention for positives and most structural interventions. The sparse CE evidence available is not easily comparable; thus, not very useful for decision making. More than 25 years into the AIDS epidemic and billions of dollars of spending later, there is still much work to be done both on costs and effectiveness to adequately inform HIV prevention planning.

Negative mucosal synergy between Herpes simplex type 2 and HIV in the female genital tract.

Abstract: Objective: There is substantial epidemiological evidence that infection by Herpes simplex virus type 2 (HSV2) enhances both HIV susceptibility and subsequent sexual transmission. Both infections are extremely common in female sex workers (FSWs) in sub-Saharan Africa, and up to 80% of new HIV infections in urban men in the region are acquired via transactional sex. The present study aimed to elucidate the mucosal immune interactions between HIV and HSV2 in the genital tract. Methods: Endocervical immune cell populations, cytokine/chemokine protein levels in cervico-vaginal secretions and cervical immune gene expression profiles were measured in a well-defined cohort of HIV-infected and uninfected Kenyan FSWs. Associations between the genital immune milieu and infection by and/or shedding of common genital co-pathogens were examined. Results: HIV-infected FSWs were much more likely to be infected by HSV2, and to shed HSV2 DNA in the genital tract. There was also a profound negative 'mucosal synergy' between these viruses. In HIV uninfected FSWs, HSV2 infection was associated with a ten-fold increase in cervical immature dendritic cells (iDC) expressing DC-SIGN, and a three-fold increase in cervical CD4+ T cells expressing CCR5. HIV infection was associated with iDC depletion in the cervix, and with increased HSV2 genital reactivation, which in turn was associated with HIV shedding levels. Conclusions: The findings suggest a mucosal vicious circle in which HSV2 infection increases HIV target cells in the genital mucosa, subsequent HIV infection impairs HSV2 mucosal immune control, and local HSV2 reactivation enhances both HSV2 and HIV transmission.

Use of δ13C values to determine vegetation selectivity in East African herbivores.

Abstract: The quantitative plant species composition of the rumen contents of a large number of individuals from eight East African herbivores was determined by direct visual analysis. All plant species were classified as either C3 or C4, and an estimated δ13C for the rumen sample was calculated. This estimated value was compared to a measured value determined directly from rumen subsample. The two methods of determining quantitative C3 and C4 composition differed by less than 1%, and the isotopic analysis has the advantage of being rapid and totally objective.

Products derived from the leaves of Ocimum kilimandscharicum (Labiatae) as post-harvest grain protectants against the infestation of three major stored product insect pests

Abstract: The bioactivity of materials from the leaves of Ocimum kilimandscharicum was tested against Sitophilus zeamais Mots chulsky (Coleoptera: Curculionidae), Rhyzopertha dominica (Fabricius) (Coleoptera: Bostrichidae) and Sitotroga cerealella (Olivier) (Lepidoptera: Gelechiidae) in maize and sorghum grains in the laboratory. Exposure of adults of the three insect species to dried ground leaves and essential oil extract of O. kilimandscharicum induced 100% mortality after 48 h. Fresh and dried whole leaves were not toxic to Sitophilus zeamais or R. dominica. Grains treated with dried ground leaves and essential oil extract caused significant reductions in the number of progeny and survival rate of all three pest species tested. There was no adult survival or progeny production in grains treated separately with each of the two materials at doses of 25.0 g (dried ground leaves) and 0.3 g (essential oil) per 250 g of grain, respectively. Unlike R. dominica and Sitotroga cerealella, grains treated with fresh leaves enhanced the feeding activity of Sitophilus zeamais. Ground leaves and the essential oil, however, protected the grains against feeding by all three species, resulting in lower weight loss and number of damaged seeds compared with untreated grains. All the plant materials were repellent to S. zeamais with the essential oil extract applied at 0.3 g/250 g of grain evoking the highest repellent action. There was, however, considerable variation in the repellency of the materials against R. dominica and Sitotroga cerealella. The results are discussed in terms of the efficacy of O. kilimandscharicum for protection against loss due to insects in traditional grain storage in developing countries.