129 research outputs found
The effect of participant non-response on the HIV prevalence estimates in a population based survey in two informal settlements in Nairobi city
No full textBackground:Participant non-response in an HIV sero-survey can affect estimates of HIV prevalence. Non-response can arise from refusals to provide a blood sample or failure to trace a sampled individual. In a sero-survey conducted by the African Population and Health Research Center and Kenya Medical Research Centre in the slums of Nairobi, 46% of the sampled individuals did not provide a blood sample. This paper describes selective participation in the sero-survey and also estimates bias in HIV prevalence figures.Methods:The paper uses data derived from an HIV sero-survey nested in an ongoing demographic surveillance system. Non-response was assessed using logistic regression and multiple imputation methods to impute missing data for HIV status using a set of common variables available for all sampled participants.Results:Age, residence, high mobility, wealth and ethnicity were independent predictors of a sampled individual not being contacted. Individuals aged 30-34 years, females, individuals from the Kikuyu and Kamba ethnicity, the married and residents of Viwandani were all less likely to accept to be tested. Although men were less likely to be contacted, those found were more willing to be tested compared to females. The overall observed HIV prevalence was overestimated by 2%. The observed prevalence for male participants was underestimated by about 2% and that for females was overestimated by 4%. These differences were small and did not affect the overall estimate substantially as the observed estimates fell within the confidence limits of the corrected prevalence estimate. Conclusions:Non-response to HIV sero-survey in informal settlements is high. The effect on the overall prevalence estimate was however minimal.<br/
Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya
No full textIn 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence
Trends in drug resistance mutations among HIV-1-infected children in Kenya from 2014 to 2018.
No full text金沢大学博士(医学)博士論文 要旨Abstract/本文Full 以下に掲載：Preventive Medicine Research 1(5) pp.64-77 2024. 日本予防医学会. 共著者：Rency J. Lel, Joseph Mwangi, Vincent Okoth, Matilda Saina, Son T. Chu, Matilu M. Mwau, Elijah M. Songok, Masaharu Tokoro, Hiroshi Ichimura Ikeda, Kazuto Kozaka, Satoshi Kobayashi, Shintaro Yagi, Kenichi Haradadoctoral thesi
携帯電話を活用したケニアにおける感染症流行早期警戒システムの有効性
No full textWe conducted a randomized, controlled trial to test the effectiveness of a text-messaging system used for notification of disease outbreaks in Kenya. Health facilities that used the system had more timely notifications than those that did not (19.2% vs. 2.6%), indicating that technology can enhance disease surveillance in resource-limited settings.長崎大学学位論文 学位記番号:博(医歯薬)甲第960号 学位授与年月日:平成29年3月21日Author: Mitsuru Toda, Ian Njeru, Dejan Zurovac, Shikanga O Tipo, David Kareko, Matilu Mwau, and Kouichi MoritaCitation: Emerging Infectious Diseases, 22(4), pp.711-715; 201
黄熱ウイルスに対する単クローン抗体の作製と特異抗原及び抗体検出ELISA法への応用
No full textYellow fever (YF) is an acute hemorrhagic viral infection transmitted by mosquitoes in Africa and South America. The major challenge in YF disease detection and confirmation of outbreaks in Africa is the limited availability of reference laboratories and the persistent lack of access to diagnostic tests. We used wild-type YF virus sequences to generate recombinant envelope protein in an Escherichia coli expression system. Both the recombinant protein and sucrose gradient-purified YF vaccine virus 17D (YF-17D) were used to immunize BALB/c mice to generate monoclonal antibodies (MAbs). Eight MAbs were established and systematically characterized by indirect enzyme-linked immunosorbent assay (ELISA), Western blot analysis, and immunofluorescence assay (IFA). The established MAbs showed strong reactivity with wild-type YF virus and recombinant protein with no detectable
cross-reactivity to dengue virus or Japanese encephalitis virus. Epitope mapping showed strong binding of three MAbs to amino acid positions 1 to 51, while two MAbs mapped to amino acid positions 52 to 135 of the envelope protein. The remaining three MAbs did not show reactivity to envelope fragments. The established MAbs exert no neutralization against wild-type YF and 17D viruses (titer of<10 for both strains). The applicability of MAbs 8H3 and 3F4 was further evaluated using IgM capture ELISA. A total of 49 serum samples were analyzed, among which 12 positive patient and vaccinee samples were correctly identified. Using serum samples that were 2-fold serially diluted, the IgM capture ELISA was able to detect all YF-positive samples. Furthermore, MAb-based antigen detection ELISA enabled the detection of virus in culture supernatants containing titers of about 1,000 focus-forming units.長崎大学学位論文 学位記番号:博(医歯薬)甲第889号 学位授与年月日:平成28年9月20日Author: Ferdinard Adungo, Fuxun Yu, David Kamau, Shingo Inoue, Daisuke Hayasaka, Guillermo Posadas-Herrera, Rosemary Sang, Matilu Mwau, Kouichi MoritaCitation: Clinical and Vaccine Immunology, 23(8), pp.689–697; 201
Emerg Infect Dis
No full textWe conducted a randomized, controlled trial to test the effectiveness of a text-messaging system used for notification of disease outbreaks in Kenya. Health facilities that used the system had more timely notifications than those that did not (19.2% vs. 2.6%), indicating that technology can enhance disease surveillance in resource-limited settings
Experience from a pilot point-of-care CD4 enumeration programme in Kenya
No full textNo abtract available
Performance and usability of Cepheid GeneXpert HIV-1 qualitative and quantitative assay in Kenya
No full textBackgroundIn Kenya, access to early infant diagnosis and viral load monitoring services for HIV patients on ART is significantly hampered by sample transportation challenges and long turnaround times. Near patient care testing technologies have the potential to obviate such constraints. The Cepheid GeneXpert was launched in 2010 as a TB assay and in 2014 as a potential point of care HIV viral load assay. Whereas it is widely is used for TB in Kenya, its utility for HIV testing has not been evaluated.ObjectiveTo investigate the performance and usability characteristics of the GeneXpert HIV-1 qualitative and quantitative assay.MethodsThis was a cross sectional study among 911 HIV Exposed infants and 310 HIV positive adults. Existing machines used for routine TB diagnosis were used in this study. The diagnostic accuracy of the qualitative assay was assessed using Roche CAP/CTM while the quantitative assay was assessed using with Abbott m2000 as the reference assays respectively. Statistical analysis was done using Stata/MP Version 14 for Mac. Concordance values and misclassification were calculated at the clinical cutoff of 1000 cp/ml.ResultsThe sensitivity, specificity and accuracy of the GeneXpert HIV-1 qualitative assay were 99.23% (95% CI 97.24–99.90%), 98.91% (95% CI 97.76–99.55%) and 99.00% respectively. For the quantitative assay, they were 92.50% (95% CI 79.61–98.43%), 100.00% and 97.00% respectively. All 30 (100%) users reported that the GeneXpert machine was easy to use, workflow was simple and TB diagnosis was not negatively affected. In our hands, the median turn-around time for an individual qualitative and quantitative test was 90 minutes. A total of 58 (4.34%) errors and 28 (2.10%) invalid outcomes were experienced; 44 (3.29%) tests did not run to completion due to power outages.ConclusionGeneXpert HIV-1 qualitative and quantitative assay is an accurate test for the diagnosis of HIV in infants and for viral load monitoring. At the point of care, the GeneXpert machine’s simple work flow, ease of use and short test turnaround time present the potential to improve access to HIV testing and viral load monitoring. To integrate HIV diagnosis into the existing GeneXpert platforms for TB Diagnosis, there is need to scale up the infrastructure and to change the way work is done.</div
Performance and usability evaluation of the INSTI HIV self-test in Kenya for qualitative detection of antibodies to HIV.
No full textBACKGROUND:HIV testing is often undermined by lack of confidentiality, stigma, shortage of counselors and long distances to testing centers. Self-testing has the potential to circumvent these constraints. OBJECTIVE:To determine the performance and usability characteristics of the INSTI® HIV-1/HIV-2 Self-Test. METHODS:The performance evaluation was a cross sectional study and the usability a mixed methods study. For method comparison, Bioelisa HIV-1+2 Ag/Ab test was used as the reference test. When the test results were discrepant, results from Alere Determine™ HIV-1/2 and First Response HIV-1-2 Antibody tests were used for confirmation of status. RESULTS:Sensitivity of the INSTI HIV Self-Test was 98.99% (95% CI 96.05-99.75%), and specificity 98.15% (95% CI 95.63-99.23%). The concordance was therefore 97.27%. A total of 354 participants took part in the usability study. Of those, 343 (98.00%) found instructions for use easy to follow, 330 (94.29%) found the finger prick device easy to use, 303 (86.57%) were confident while performing the test, 342 (97.71%) felt result interpretation was easy, while 304 (86.86%) declared results within the recommended five minutes. Three hundred and forty two (342, 97.71%) were willing to use the test again while 344 (98.29%) would recommend the kit to a sexual partner. None of the 350 participants quit the process at any stage. Three hundred and eighteen (318, 91.12%) participants felt the test needed no further improvement. All 91 lay users correctly identified cartridges that showed positive, negative and invalid results. Only 31 (34.07%) participants correctly identified weak positive dummy test results. CONCLUSION:The excellent performance and usability characteristics of INSTI HIV-1/HIV-2 self-test make the kit a viable option for HIV self-testing. To improve the identification of weak positive results, the manufacturer should indicate on the IFU that even a faint test spot should be interpreted as positive
Determination on the Expression of Activated RANTES G 28 in HIV-1 Infection and in Co Infection with Hepatitis B Virus and Hepatitis C Virus and Its Effect on Leukocytes
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