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.

The dengue situation in Africa

Abstract: Dengue outbreaks and epidemics have been reported in all regions of Africa, and it is believed that all four dengue virus serotypes are in circulation. Available data suggest that dengue is endemic to 34 African countries and that Aedes aegypti mosquitoes – the primary vector for dengue transmission – are known to be present in all but five countries. Whether populations in Africa are susceptible to dengue at the same rates as in Asia and Latin America is difficult to determine from the available data. Several factors may affect the transmission of dengue in Africa, including vector efficiency, viral infectivity, host vulnerability and environmental factors, such as increasing urbanisation. Current dengue prevention strategies in Africa focus on vector control, although the primary aim of such efforts is typically the prevention of malaria. Further research is needed to characterise the epidemiology of dengue in Africa and to better understand the factors involved in differences in vulnerability to dengue across Africa.

Contribution of HIV-1 Infection to Acquisition of Sexually Transmitted Disease: A 10-Year Prospective Study

Abstract: Background. Sexually transmitted diseases (STDs) enhance human immunodeficiency virus (HIV)-1 susceptibility, but few studies have examined the reciprocal effect of HIV-1 on STD acquisition. Methods. Data from a prospective cohort study conducted among female sex workers in Mombasa, Kenya between 1993 and 2003 were used to determine the effect of HIV-1 infection on STD susceptibility. The cohort included 1215 HIV-1-seronegative women who underwent monthly HIV-1 and STD screening, of whom 238 experienced seroconversion to HIV-1 during follow-up. Andersen-Gill proportional-hazards models were used to compare the incidence rates for genital-tract infections (syphilis, genital ulcer disease [GUD], Neisseria gonorrhoeae infection, Chlamydia trachomatis infection, Trichomonas vaginalis infection, vulvovaginal candidiasis, and bacterial vaginosis) in HIV-1-seropositive versus HIV-1-seronegative women, after controlling for sexual behavior and other potential confounding factors. Results. HIV-1 infection was associated with a significantly higher incidence of GUD (hazard ratio [HR], 2.8; 95% confidence interval [CI], 2.0-3.9), gonorrhea (HR, 1.6; 95% CI, 1.1-2.2), and vulvovaginal candidiasis (HR, 1.5; 95% CI, 1.3-1.8). The risks of GUD and vulvovaginal candidiasis increased with progressive levels of immunosuppression. Conclusions. The increased incidence of genital-tract infections among HIV-1-seropositive women could promote the spread of both HIV-1 and other STDs, particularly in areas where these conditions are highly prevalent.

Decreased incidence of sexually transmitted diseases among trucking company workers in Kenya: results of a behavioural risk-reduction programme

Abstract: Objective: To establish a cohort of high-risk individuals suitable for HIV-prevention trials, and to measure changes in sexual behaviour and sexually transmitted disease (STD) incidence after a behavioural intervention. Design: Prospective cohort study in trucking company depots in Mombasa, Kenya. Participants: A total of 556 male HIV-seronegative employees of trucking companies. Interventions: HIV serological testing, individual counselling, condom promotion, STD diagnosis and management. Main outcome measures: Sexual risk behaviour and symptomatic STD incidence. Results: Using time-trend modelling, significant declines in self-reported high-risk sexual behaviour were demonstrated during a 1-year follow-up. The percentage of men reporting any extramarital sex during the 3-month period prior to a follow-up visit decreased from 49% during the first quarter of follow-up to 36% during the last quarter (P < 0.001). The decline in reported female sex worker contact was from 12% to 6% (P = 0.001). Approximately 30% of men reported consistent condom use during extramarital sex and this percentage remained unchanged during the study period. The incidence of STD declined from 34 per 100 person years (PY) during the first quarter to 10 per 100 PY during the last quarter (P = 0.001). Significant reductions in gonorrhoea (15 to five cases per 100 PY, P = 0.04), non-gonococcal urethritis (10 to two cases per 100 PY, P = 0.05), and genital ulcer disease (nine to two cases per 100 PY, P = 0.02) were observed. Conclusions: Among truck company workers who participated in a cohort study in Mombasa, Kenya, there was a significant decrease in sex with high-risk partners, but no change in condom use. The change in heterosexual risk behaviour was accompanied by a significant decrease in incidence of gonorrhoea, non-gonococcal urethritis, and genital ulcer disease.

Trends in Bloodstream Infections among Human Immunodeficiency Virus-Infected Adults Admitted to a Hospital in Nairobi, Kenya, during the Last Decade

Abstract: Bloodstream infections are a frequent complication in human immunodeficiency virus (HIV)-infected adults in Africa and usually associated with a poor prognosis. We evaluated bloodstream infections across a decade in 3 prospective cross-sectional surveys of consecutive medical admissions to the Kenyatta National Hospital, Nairobi, Kenya. Participants received standard clinical care throughout. In 1988-1989, 29.5% (28 of 95) of HIV-positive patients had bloodstream infections, compared with 31.9% (46 of 144) in 1992 and 21.3% (43 of 197) in 1997. Bacteremia and mycobacteremia were significantly associated with HIV infection. Infections with Mycobacterium tuberculosis, non-typhi species of Salmonella (NTS), and Streptococcus pneumoniae predominated. Fungemia exclusively due to Cryptococcus neoformans was uncommon. Clinical features at presentation remained similar. Significant improvements in the survival rate were recorded among patients with NTS bacteremia (20%-83%; P<.01) and mycobacteremia (0%-73%; P<.01). Standard clinical management can improve outcomes in resource-poor settings.

Mobile phones: exceptional tools for HIV/AIDS, health, and crisis management.

Abstract: The Leading Edge in the August 2008 issue questioned "Does HIV/AIDS still require an exceptional response" in relation to the potential imbalance of global health-care resources? In the midst of the unchecked and deadly pandemic the answer is yes; especially if local resources are used and management of other endemic health problems can also benefit. Perhaps one of the most promising emerging health systems tools which can build capacity around the HIV/AIDS response and filter into the global health response lies increasingly in the palms of our hands. Mobile telephones are reaching people in Africas cities towns villages and countrysides more rapidly than anywhere else in the world (figure 1). The overlap with the global health-care crisis does not go unnoticed. We previously reported that despite very low incomes most clients attending two University of Nairobi clinics (serving sex workers and providing HIV services for the general population in Pumwani district) had access to mobile phones and knew how to use them. Surprisingly mobile phone communication featured in most aspects of patients personal lives and business but not their health management. (excerpt)