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High-risk Human Papillomavirus Messenger RNA Testing in Wet- And Dry- Self-Collected Specimens for High-Grade Cervical Lesion Detection in Mombasa, Kenya
No full textBackground: Self-collection for high-risk HPV (hr-HPV) mRNA testing may improve cervical cancer screening. Hr-HPV mRNA with self-collected specimens stored dry could enhance feasibility and acceptance of specimen collection and storage; however, its performance is unknown. We compared the performance of hr-HPV mRNA testing with dry- as compared to wet-stored self-collected specimens for detecting ≥HSIL.
Methods: A total of 400 female sex workers in Kenya participated (2013-2018), of which 50% were HIV-positive based on enrollment procedures. Participants provided two self-collected specimens: one stored dry (sc-DRY) using a Viba brush (Rovers), and one stored wet (sc-WET) with Aptima media (Hologic) using an Evalyn brush (Rovers). Physician-collected specimens were collected for HPV mRNA testing (Aptima) and conventional cytology. We estimated test characteristics for each hr-HPV screening method using conventional cytology as the reference standard (≥HSIL detection). We also examined participant preference for sc-DRY and sc-WET collection.
Results: HR-HPV mRNA positivity was higher in sc-WET (36.8%) than sc-DRY samples (31.8%). Prevalence of ≥HSIL was 6.9% (10.3% HIV-positive; 4.0% HIV-negative). Sensitivity of hr-HPV mRNA for detecting ≥HSIL was similar in sc-WET (85%, 95% CI: 66-96), sc-DRY specimens (78%, 95% CI: 58-91), and physician-collected specimens (93%, 95% CI: 76-99).Overall, the specificity of hr-HPV mRNA for ≥HSIL detection was similar when comparing sc-WET to physician-collection. However, specificity was lower for sc-WET [66% (61-71)] than sc-DRY [71% (66-76)]. Women preferred sc-DRY specimen collection (46.1%) compared to sc-WET (31.1%). However, more women preferred physician-collection (63.9%) compared to self-collection (36.1%).
Conclusions: Sc-DRY specimens appeared to perform similarly to sc-WET for the detection of ≥HSIL
Socioeconomic Inequality in Hiv Prevention Amongst Female Sex Workers: an Analysis of Pre-exposure Prophylaxis Use
No full textIntroduction: Globally, HIV and AIDS still remains a major health and economic burden with
disproportionate burden in SSA. The global trend of the disease is on a decline, however, SSA has
witnessed slower decline in her indicators. The Key population are reported as major drivers of
the epidemic, accounting for 47% of the new infection globally, with a prevalence rate of 30% in
Kenya. Socioeconomic inequalities amongst FSWs do exist in regards to access and coverage of
health, trade at the sex market and negotiation of safe sex compounded by the illegality of the trade
despite roll out of PrEP, a biomedical intervention drug, with reported 92% effectiveness. It is of
private benefit and confers public health externality to the sex network and the general population.
Objectives: There exist paucity of studies on determinants of demand for PrEP, socioeconomic
inequalities in PrEP use and economic studies of FSWs in Kenya, a gap my study hopes to bridge.
This study sought to understand the socioeconomic determinants of PrEP use; decipher the role of
socioeconomic inequalities in PrEP use among the FSW and further utilize the results to inform
policy change.
Methodology: Using a structured questionnaire 479 HIV negative FSWs in Kisii County were
sampled to a point of saturation. Data was entered and analyzed using STATA version 14. Probit
regression model was conducted to determine associations between the variables and concentration
index was employed to determine the socioeconomic inequality. This study contributed to the
existing literature on PrEP uptake, helped in designing FSW-specific interventions and strategies
to distribute PrEP as well as to inform policy debates related to universal coverage and utilization
of health services, a consideration in assessing the global performance of health systems.
Results: Of the 479 FSWs, 62% reported ever using PrEP. PrEP uptake was highest amongst these
groups of FSWs; aged over 24 years, formerly and currently married, Catholics, have less than 2
children, unemployed, above secondary education, town residence, smaller households of less than
5 and belonged to the richer wealth quantile. The number of children, index scores of risk, service
provision and wealth were found to be statistically significant. Concentration index showed that
PrEP uptake was concentrated among the FSWs from a wealthy class.
Conclusion: Based on the findings, we observed that peer led approaches has demonstrated
favorable outcomes in advocating for PrEP use amongst the FSWs and a structured roll out and
implementation of the same would boost uptake. Policies and strategies aimed at enhancing PrEP
uptake among the FSW may assist reduce the gap between the highest and lowest SES groups in
Kisii
Photocatalytic degradation of 4-chlorophenol by titanium dioxide: role of annealing temperature and morphology
No full textThis work investigates the degradation rate of 4-cholorophenol using Titanium dioxide photocatalysts. Chlorophenols and their compounds are a nuisance as they are recalcitrant to degradation in the environment. Three morphologically different Titanium dioxide catalysts, A, B and C, were immobilized on microscopic glass at a layer of 0.5 mg/cm2 and annealed between 500-700°C. The three different TiO2 powders were characterized using Scanning Electron Microscopy, X-Ray Diffraction and Brunauer Emmett Teller to determine their specific surface area, crystalline and particle sizes. A four–position photocatalytic reactor illuminated by two Ultra violet lamps of wavelength range 320-400 nm and intensity I = 27.87 mW/m2 was used to degrade the 4-Chlorophenol in 2 hrs. Aliquots of the degraded 4- chlorophenol were drawn every 30 minutes and analyzed using UV-Vis spectroscopy at λ=226 nm. The optimum annealing temperature of all TiO2 was found to be 650°C, with type B of hexagonal morphological structure and particle size of 28±2nm having the highest 4-chlorophenol degradation rate, of 71.21%
Enhanced role of private sector through public private partnerships in low income urban housing in Kenya
No full textPurpose – Low income urban housing in Kenya is underdeveloped as a result of uninnovative financing, hence the many slums and informal settlements in the country, hence the need for enhanced participation of the private sector through application of Public Private Partnerships (PPPs), which has been cited as one of the possible solutions. The purpose of this study was to investigate and make predictions of the need for enhanced role of private sector in developing low income urban housing in Kenya through PPPs. Design/methodology/approach – Delphi method of research was used to forecast the enhanced role of private sector through PPPs in the development of low income urban housing in Kenya. Three rounds Delphi iterations using three panels of housing financiers (30 in number), housing developers (28 in number) and housing practitioners (30 in number) were used. Data was collected through questionnaires throughout the three rounds, where the first round was exploratory in nature, the second round built on answers from round one, while round three was based on answers from round two, after which the mean and standard deviation values were calculated to show the level of consensus. Findings – Results showed that PPPs is one of the plausible ways through which low income urban housing in Kenya can be developed to address its shortage. Private sector in PPP transaction brings innovative technology, finance and efficiency, while government brings its assets such as land and other regulations long term contracts. Research limitations/implications – The research was focussed on the Nairobi city county area in analysing the need for enhanced role of the private parties. It focussed on a panel of Housing practitionersofficers in the State Department for housing and Nairobi city county; housing financiers and housing developers, without interviewing the beneficiaries of the method. Practical implications – It was, therefore, found out that PPPs models are applicable in developing low income urban housing because the country has the enabling environment for its effective application going forward. The implication of this study is that low income urban housing can be developed through the model
Synthesis, structural assignments and antiinfective activities of 3-O-benzyl-carvotacetone and 3-hydroxy-2-isopropyl-5-methyl-p-benzoquinone.
No full textIn an attempt to synthesize carvotacetone analogues, new 3-O-benzyl-carvotacetone (10) and previously reported 3-hydroxy-2-isopropyl-5-methyl-p-benzoquinone (11) were synthesized from piperitone (7). In this work, we describe the synthesis of 10 and other analogues from 7. Luche reduction of 7 to cis-piperitol (8), followed by benzylation yielded 3-O-benzyl-piperitol (9). Riley oxidation of 9 afforded corresponding ketone 10, 11 and 3-benzyloxy-4-isopropylcyclohex-1-enecarbaldehyde (12). Structures of these compounds were determined based on NMR, IR and LC-MS spectral data. Compound 11, exhibited antiplasmodial activities against chloroquine-sensitive (D6) and resistant (W2) strains of Plasmodium falciparum with IC50 values of 0.697 and 0.653 µg/mL, respectively. In addition, compound 11 was active against Cryptococcus neoformans with an IC50 value of 3.11 µg/mL, compared to reference standard fluconazole (IC50 value of 1.87 µg/mL), while 10 and 12 were inactive against both organisms. This is the first report of the antiplasmodial and anticryptococcal activity of compound 11
