Background: Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) remain major public health challenges globally, contributing substantially to morbidity and mortality. The disease ranks sixth among the leading causes of illness and death in developing countries and third in Kenya. The burden of HIV/AIDS remains relatively high among high-risk groups, such as fisherfolk. This study aimed to determine the epidemiology of HIV/AIDS among the fishing community along the shores of Lake Victoria. Methodology: This cross-sectional study enrolled 349 consenting members of the fisherfolk community, including boat crews, boat owners, fishmongers, and fish processors, along the beaches of Lake Victoria in Bondo, Siaya County, from 2023 to 2024. Blood samples were collected, and a detailed sociodemographic questionnaire was administered. HIV positivity was confirmed through polymerase chain reaction (PCR) amplification. Descriptive statistics characterised the population, while logistic regression analysis identified factors associated with HIV infection using STATA. The significance level was set at p ≤ 0.05. Results: Out of the 349 fisherfolk recruited, most, 165 (46.3%), were boat crew, and 41 (11.5%) had completed secondary education. Overall, 108 (71%) were male, and 247 (69.4%) were married. Notably, 152 (43.6%, n = 349) tested positive for HIV. In multivariate analysis, fisherfolk not living with their sexual partner (aOR 0.33; 95% CI 0.12–0.88, p = 0.029) and those on ARV (aOR 0.36; 95% CI 0.13–0.96, p < 0.045) were less likely to test positive for HIV. Conclusions and recommendations: A large portion of the population in the fishing industry continues to test positive for HIV, indicating a high-risk group for infection. Living conditions and early ARV treatment are crucial in driving HIV infection rates among fisherfolk near Lake Victoria in Bonda.

Anemia disproportionately affects women of reproductive age (WRA) and children below the age of five. Iron deficiency is the major cause of anemia followed by other underlying causes such as malaria, chronic kidney disease, and neglected tropical diseases. This study aimed to determine the morphological classes of anemia and their association with schistosomiasis, malaria, and soil transmitted Helminthes (STH) among WRA in Kwale county, Kenya. Using a cross-sectional study design, parasitic infections and anemia were analyzed from 534 WRA. Frequencies and proportions with 95% confidence intervals were determined. Multilevel mixed-effect logistic regression models were performed to identify variables associated with morphological classes of anemia. The prevalence of normocytic, microcytic and macrocytic anemia was 54%, 43% and 2.3% respectively. The prevalence of Schistosomiasis among women with Normocytic and Microcytic anemia was 4.2% and 3.5%, respectively (P-value=0.72). Microcytic (adjusted Odds Ratio (aOR) 0.65 (95%CI 0.15‒2.78)) compared to normocytic were not associated with Schistosomiasis. The prevalence of malaria among women with Normocytic, Microcytic, and Macrocytic was 5.2%, 4.4%, and 8.3% respectively (P-value=0.78). Microcytic (aOR 1.76 (95%CI 0.43‒7.23)) and macrocytic (aOR 1.75 (95%CI 0.11‒28.0)) compared to normocytic were not associated with malaria. The prevalence of STH among women with Normocytic, Microcytic, and Macrocytic was 7.0%, 3.9%, and 8.3% respectively (P-value=0.31). Microcytic (aOR 0.51 (95%CI 0.13‒2.01)) and macrocytic (aOR 0.72 (95%CI 0.06‒9.39)) compared to normocytic were not associated with STH. Anemia severity (P-value<0.001), RBCs (P-value=0.0001), HCT (P-value=0.0001), platelets (P-value=0.006) MCH (P-value=0.0001) and MCHC (P-value=0.0001) were significantly different across the morphological classes of anemia. In conclusion, the prevalences of normocytic and microcytic anemias were high but not associated with parasitic infections, indicating the possibility of other contributing factors for these morphological classes of anemia in this population.

Soil transmitted helminthiasis (STH), Schistosoma haematobium and malaria co-infection lead to increased susceptibility to other infections and poor pregnancy outcomes among women of reproductive age (WRA). This study sought to establish risk factors, burden of co-infection with STH, S. haematobium and Plasmodium sp. among WRA in Kilifi County, Kenya.A mixed method cross-sectional study was conducted on 474 WRA in 2021. Simple random sampling was used to select WRA from four villages in two purposively sampled sub-counties. Study participants were interviewed, and stool samples collected and analysed using Kato-Katz technique for STH. Urine samples were collected for examination of S. haematobium while malaria microscopic test was done using finger prick blood samples. Further, 15 focus group discussions (FGDs) were conducted with purposively selected WRA and qualitative data analyzed thematically using Nvivo software. Quantitative and qualitative methods were triangulated to comprehensively strengthen the study findings. Prevalence of S. haematobium was 22.3% (95%CI: 13.5-36.9), any STH 5.2% (95%CI: 1.9-14.3) and malaria 8.3% (95%: 3.8-18.2). Co-infections between any STH and S. haematobium was 0.8% (95%CI: 0.2-3.2) and between S. haematobium and malaria 0.8% (95%CI: 0.2-3.1). Multivariable analysis showed increased odds of any STH infections among participants in Rabai Sub-County, (aOR = 9.74; p = 0.026), businesswomen (aOR = 5.25; p<0.001), housewives (aOR = 2.78; p = 0.003), and casual laborers (aOR = 27.03; p<0.001). Qualitative analysis showed that the three parasitic diseases were common and responsible for possible causes of low birth weight, susceptibility to other infections and complications such as infertility and cancer later in life.The study demonstrated that STH, S. haematobium and malaria are still a public health problem to WRA. Some of the associated risks of infection were geographical location, socio-economic and WASH factors. Hence the need to implement integrated control efforts of the three parasitic infection.

Introduction: urogenital schistosomiasis is one of the neglected tropical diseases common in developing countries. It is one of the thirteen most common chronic infections that affect poor people in many tropical countries. It is characterized by limited knowledge of the mode of transmission, negative social repercussions, and high morbidity which result in the manifestation of this infection in the female population. This qualitative cross-sectional study assessed knowledge levels, attitudes, and practices about women of reproductive age (WRA), in rural, resource-poor communities in Kwale County, Kenya

Background Schistosoma haematobium , soil transmitted helminthes (STH), and malaria lead to a double burden in pregnancy that eventually leads to poor immunity, increased susceptibility to other infections, and poor pregnancy outcomes. Many studies have been carried out on pre-school and school aged children but very little has been done among the at risk adult population including women of reproductive age (WRA). Our current study sought to establish the risk factors and burden of co-infection with S. haematobium , STH, and Plasmodium sp. among WRA in Kwale County, Coastal Kenya. Methods A total of 534 WRA between the ages of 15–50 were enrolled in this cross-sectional study from four villages; Bilashaka and Mwaluphamba in Matuga sub-County, and Mwachinga and Dumbule in Kinango sub-County. Socio-demographic information was collected using a pre-tested standardized questionnaire. Parasitological examination was done using urine filtration method for Schistosoma haematobium , Kato Katz for STH ( Ascaris lumbricoides , Hookworm, Trichuris trichiura ), and standard slide microscopy for Plasmodium sp. Statistical analyses were carried out using STATA version 15.1. Results The overall prevalence of S. haematobium was 3.8% (95% CI: 2.6–5.4) while that for malaria was 4.9% (95% CI: 2.0–11.7). The prevalence of STH was 5.6% (95% CI: 2.8–11.3) with overall prevalence of 5.3% (95% CI: 2.5–10.9) for hookworm and 0.6% (95% CI: 0.2–1.9) for T. trichiura. The occurrence of co-infection was low and was recorded between S. haematobium and P. falciparum (0.6%), followed by S. haematobium and STH (0.4%). Among pregnant women, 2.6% had co-infection with S. haematobium and P. falciparum. Only 1.3% had co-infection with S. haematobium and hookworm or T. trichiura . Among non-pregnant women, co-infection with S. haematobium and P. falciparum was 0.2%. Similarly, co-infection with S. haematobium and hookworm or T. trichiura was 0.2%. Bed net ownership and usage among pregnant women was 87.8 and 96.6%, respectively. 66.3% of the women reported using improved water sources for drinking while 78.1% reported using improved sanitation facilities. Conclusion The use of improved WASH activities might have contributed to the low prevalence of STHs and S. haematobium infections. Further, bed net ownership and usage might have resulted in the low prevalence of Plasmodium sp. infections observed.

Sand flies are small haematophagous insects that transmit Leishmania parasites through the bite of infected female phlebotomine sand flies. Roots, leaves and seeds of Ricinus communis are extensively used in different ways especially in the treatment of rheumatic arthritis, paralysis, epilepsy and distension of the uterus. This study sought to determine the adulticidal effects of Ricinus communis (Euphorbiaceae) leaf extracts on Phlebotomus duboscqi in the laboratory. A comparative experimental design using extracts obtained from the leaf and bark of Ricinus communis plant was used. The study was carried out at the Kenya Medical Research Institute, Centre for Biotechnology Research and Development, Kenya. Aqueous, methanol and ethyl acetate extracts were prepared from Ricinus communis plant. Thirty-five day old adult Phlebotomus duboscqi flies were aspirated into plastic rearing jars partially filled with plaster of Paris and fitted with screen tops. They were fed on R. communis extract laced with 10% sucrose. Sand flies that fed on 10% sucrose solution soaked in cotton wool pads and placed onto the screen tops were used as controls. There was no significant difference when bark and leaf extracts were compared (P=0.061). R. communis extracts from Narok showed insecticidal effects against adults. At 48 hours post treatment, the LC50 was 121.15 μg/ml and 126.21 μg/ml for bark and leaf extracts respectively. P. duboscqi adults were found to be highly susceptible to methanol extracts. Therefore, R. communis extracts have insecticidal effects on adult P. duboscqi; hence R. communis should be used against sand flies and Leishmania in situ.

Malaria is a protozoan infection of Public health concern with several new cases yearly reported. Control of malaria infections is constrained due to the toxicity of currently available drugs and the emergence of resistant malaria strains. The current study was designed to assess the antiplasmodial activity, cytotoxicity and to partially characterize Kenyan Physalis peruviana extracts in order to determine their utility as a possible source of a new antimalarial drug. Antiplasmodial activity of P. peruviana extracts was evaluated in vitro using Plasmodium falciparum D6 chloroquine-sensitive, and W2 chloroquine-resistant by semi-automated microdilution technique. Cytotoxicity assay was determined using Vero cells; while partial characterization determined using Fourier transformer infra-red spectrophotometer (FTIR) and Gas chromatography-mass spectrophotometer (GC-MS). The antiplasmodial activity (IC50) of P. peruviana extracts against chloroquine-sensitive (D6) P. falciparum strain ranged from 14.719±0.744 to >100 ug/ml. For W2, strain antiplasmodial activity ranged from 8.303±1.062 to >100 ug/ml. All the FTIR and GC-MS analysis of P. peruviana leave extract revealed the presence of biologically active components. There is a need for further studies using purified extracts as a means of coming up with possible novel antiplasmodial drugs. P. peruviana extracts were not toxic to Vero cells. Key words: Antiplasmodial, cytotoxicity, Vero cells, Physalis peruviana extracts.

Human papillomavirus (HPV) is associated with ano-genital and cervical cancer. Persistence of oncogenic HPV genotypes is a requirement for development and progression of malignancies. Although, > 70% of women clear incident HPV infections, data on natural history and HPV immunology among men is limited. To evaluate cellmediated immune responses to natural HPV infections among men, we assessed cytokine responses on PBMCs collected from men with persistent or cleared HPV. Men with HPV clearance and those with HPV persistence had increased odds (6-times and 3-times respectively) of mounting cytokine responses compared to HPV uninfected men. Th1 cytokines IFN-gamma (5.1-fold) and IL-2 (4.2-fold) were significantly (p < 0.0001) upregulated among men with HPV clearance compared to HPV uninfected men. Among men with HPV clearance compared to those with persistent HPV infection, only IFN-gamma (2.4-fold) and IL-2 (3.0-fold) were significantly (p < 0.0001) upregulated. Th1 cell-mediated cytokine response was associated with natural HPV clearance in men.

Women who inject drugs (WWIDs) continue to experience challenges that accumulate their risk to HIV transmission and other co-morbidities. However, data that conceptually link diverse substance use dimensions in WWIDs are lacking particularly in developing countries. We assessed retrospective and current substance use among 306 WWIDs in low-income urban settings in Kenya using mixed methods. Descriptive analyses were performed on quantitative data while qualitative narratives revealed insights from quantitative findings. The mean age of the study participants was 17 (range 11, 30) years. Out of the 306 WWIDs 57% commenced with substance use by combining both licit and illicit drugs. Intimate sexual partners including spouses and casual sex partners introduced seventy-four percent of WWIDs to substance use. Majority of the WWIDs (39.9%) commenced with 2- way substance combination with bhang and cigarette having the highest usage. However, 4-way substance combinations containing heroin, cigarette, bhang, valium, Rohypnol had the highest frequency (12.8%) at the time of the survey. Varied routes of heroin administration were mentioned including injection, smoking and sniffing as separate routes and as 2-way or 3-way mode combinations of these. To inform policies targeting the health and rights of girls and women in low income settings, this study recommends urgent upstream policies targeting the girl adolescent life in form of a multifunctional package composed of identifying girls at risk, substance use interventions, sexual health education, improved educational attainment, and progressive social policies that target low social economic status in the adolescent phase. Harm reduction programs in Kenya should target people who use heroin through both injection and non-injection modes of administration.

Background Influenza A viruses pose a significant risk to human health because of their wide host range and ability to reassort into novel viruses that can cause serious disease and pandemics. Since transmission of these viruses between humans and pigs can be associated with occupational and environmental exposures, we investigated the association between occupational exposure to pigs, occurrence of acute respiratory illness (ARI), and influenza A virus infection. Methods The study was conducted in Kiambu County, the county with the highest level of intensive small-scale pig farming in Kenya. Up to 3 participants (> 2 years old) per household from pig-keeping and non-pig-keeping households were randomly recruited and followed up in 2013 (Sept-Dec) and 2014 (Apr-Aug). Oropharyngeal (OP) and nasopharyngeal (NP) swabs were collected from participants with ARI at the time of study visit. For the animal study, nasal and oropharyngeal swabs, and serum samples were collected from pigs and poultry present in enrolled households. The human and animal swab samples were tested for viral nucleic acid by RT-PCR and sera by ELISA for antibodies. A Poisson generalized linear mixed-effects model was developed to assess the association between pig exposure and occurrence of ARI. Results Of 1137 human participants enrolled, 625 (55%) completed follow-up visits including 172 (27.5%) pig workers and 453 (72.5%) non-pig workers. Of 130 human NP/OP swabs tested, four (3.1%) were positive for influenza A virus, one pig worker, and three among non-pig workers. Whereas none of the 4462 swabs collected from pig and poultry tested positive for influenza A virus by RT-PCR, 265 of 4273 (6.2%) of the sera tested positive for virus antibodies by ELISA, including 11.6% (230/1990) of the pigs and 1.5% (35/2,283) of poultry. The cumulative incidence of ARI was 16.9% among pig workers and 26.9% among the non-pig workers. The adjusted risk ratio for the association between being a pig worker and experiencing an episode of ARI was 0.56 (95% CI [0.33, 0.93]), after adjusting for potential confounders. Conclusions Our findings demonstrate moderate seropositivity for influenza A virus among pigs, suggesting the circulation of swine influenza virus and a potential for interspecies transmission.

Introduction: unsafe transfusion practices can put millions of people at risk of Transfusion Transmissible Infections (TTIs). In Kenya the current blood transfusion scheme involves screening of blood for HIV, Hepatitis B virus (HBV), Hepatitis C virus (HCV) and syphilis. Malaria is also a blood-borne disease which is not currently screened for. In Kenya blood donor selection criteria were reviewed in 2009. Regular review of effectiveness of donor selection criteria can help reduce TTIs prevalence amongst donors and thus make the blood supply safer. Methods: a cross sectional study was conducted between November 2011 to January 2012 among 594 blood donors in the Regional Blood Transfusion Center Nakuru and Tenwek Mission Hospital. Socio-demographic characteristics and associated risk factors were collected using a standard blood transfusion service questionnaire. Donors were obtained through systematic sampling. Each donor sample was screened, for HIV-1 and HIV-2, HBV, HCV, syphilis and malaria parasites. Results: the overall prevalence of TTIs was 14.1%, which ranged from 0.7% for malaria to 5.6% for HBsAg. Blood donors who were married (P=0.0057), had non-formal or just primary education (P=0.0262), had multiple sexual partners (P=0.0144) and in informal occupation (P=0.0176) were at higher risk of HIV positivity. History of blood transfusion/blood products (P=0.0055), being married (P=0.0053) were high risk factors associated with positive syphilis. Being male (P=0.0479) was a high risk factor to HBV infection. Conclusion: the prevalence of TTIs indicates a need to review the questionnaire and apply it strictly for donor selection. The 0.7% prevalence of malaria, poses a serious health risk to non-immune recipients of transfusion. Malaria should be included among mandatory TTI tests in Kenya.

Objective We conducted four cross-sectional studies over 1 year among humans and pigs in three slaughterhouses in Central and Western Kenya (> 350 km apart) to determine infection and exposure to influenza A viruses. Nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected from participants who reported acute respiratory illness (ARI) defined as fever, cough or running nose. Nasal swabs and blood samples were collected from pigs. Human NP/OP and pig nasal swabs were tested for influenza A virus by real-time reverse transcriptase polymerase chain reaction (PCR) and pig serum was tested for anti-influenza A antibodies by ELISA. Results A total of 288 participants were sampled, 91.3% of them being male. Fifteen (5.2%) participants had ARI but the nine swabs collected from them were negative for influenza A virus by PCR. Of the 1128 pigs sampled, five (0.4%) nasal swabs tested positive for influenza A/H1N1/pdm09 by PCR whereas 214 of 1082 (19.8%) serum samples tested for Influenza A virus antibodies. There was higher seroprevalence in colder months and among pigs reared as free-range. These findings indicate circulation of influenza A/H1N1/pdm09 among pigs perhaps associated with good adaptation of the virus to the pig population after initial transmission from humans to pigs.

Introduction: Lack of HIV treatment and loss of follow up measures is associated with high mortality among persons living with HIV (PLHIV) in sub-Saharan Africa. Especially in resource-limited populations. Respondents diagnosed with HIV through a home-based testing and counseling program in an informal settlement in Kenya, were referred to health facilities of their choice for antiretroviral therapy (ART). This qualitative study explored the community’s experiences and perceptions on factors associated with ART uptake and retention. Methodology: Using convenient purposive sampling, we recruited 46 adults (21 women and 25 men) among them HIV infected and non-infected residents of the Kibera informal settlement in Nairobi, Kenya. Using a standardized discussion guide, six focus group discussions of 6-9 individuals were conducted. Discussions were recorded verbatim and complimented by tape recording to ensure accuracy. Transcription was done and coding done using a Priori codes . Thematic content analysis was done using Atlas 3.0 . Results: Availability of many health facilities offering HIV services in Kibera informal settlement facilitated access to and uptake of ART. Respondents preparation procedures that prevented same-day ART enrolment were often perceived as denial of treatment. “They talk too much of treatment and when you go you are turned away” Said one respondent. Reported perceived poor staff attitude, Rudeness, Judgmental behaviours and Delays, were often perceived as lack of respect for Participants were reported to hinder retention in ART services. “He will look at your physical appearance, put your card aside and ask his colleague whether tea is ready” Participants disliked adherence counseling with written commitments after missed appointments and often felt that these measures too reflected lack of respect by health care providers. They wanted to cancel treatment because they said we had to commit ourselves by signing….” Conclusion: Individuals diagnosed with HIV generally accessed HIV treatment facilities following referral after HBTC. Participants perceived some standard treatment procedures. Reckoning Staff behavior and Communication as barriers hindering retention on ART. Supportive interpersonal relationship strategies between Respondents, providers and innovative patientcentered treatment plans and adherence counseling models should be adopted in treatment programs. This will promote uptake and retention of ART in communities. Keywords: HIV infection, retention in ART, adherence counseling, psychosocial and communication barriers, Responded satisfaction

Typhoid and paratyphoid fever continue to be important causes of illness and death, particularly among children and adolescents in developing countries where enteric fever is associated with poor sanitation and unsafe food and water. Quantification of disease burden is crucial for policy making about the deployment of enteric fever prevention measures and vaccines. This cross-sectional study was undertaken to determine the epidemiology and antimicrobial resistance pattern in bacterial aetiologies of enteric fever among patients attending Garissa County Referral Hospital, (GCRH) located in a semi-arid region of North Eastern Kenya. Blood and stool samples were obtained from 379 consenting patients and a detailed sociodemographic questionnaire was administered. Isolation and identification of Salmonella Typhi, S. Paratyphi A and S. Paratyphi B were obtained by convectional culture, PCR and Vitek-2 compact detection method. Antimicrobial susceptibility testing was done using Kirby-Bauer’s disc diffusion method. Multidrug resistance was defined as co-resistance to ampicillin, chloramphenicol and co- trimoxazole. Eight of the 379 (2.1%) participants were positive for Salmonella spp . Of the 8 Salmonella isolates were S. Typhi (n=2; 25%), S. Paratyphi A (n=2; 25%) and S. Paratyphi B (n=4; 50%). Resistance to ampicillin, tetracycline, gentamycin, chloramphenicol, nalidixic acid and trimethoprim-sulfamethoxazole was 100%, 87.5%, 75%, 50%, 25% and 25% respectively. No isolate showed resistance to ciprofloxacin. Half of all S. typhi, S. paratyphi A and B were multidrug-resistant. Risk factors including water and food (such as often eating outside homestead, family eating from a common plate, taking locally prepared cold drinks, family wash hands in common basin), low socio-economic status and availability of a previous laboratory confirmation of typhoid fever were associated with S. Typhi and S. Paratyphi infection . The isolation of a large proportion of MDR S. Typhi , S. Paratyphi A and B is worrying. Although these isolates were susceptible to fluoroquinolones, there is need for routine surveillance to monitor susceptibility to the initial first line antibiotics in clinical settings since the MDR strains have lately shown increased resistance. Addressing issues of contaminated food, water, sanitation and hygiene and low socio-economic status is likely to prevent and reduce the burden on enteric fever in this region. Keywords : Enteric Fever, Molecular Epidemiology, Antimicrobial Resistance Pattern, Semi-Arid Region of North Eastern Kenya DOI : 10.7176/JHMN/60-14 Publication date :March 31 st 2019

Purpose: To assess effect of nutrition support on achievement of motor developmental milestones in HIV-infected children on ART in urban resource-poor settings of Nairobi, Kenya. Methodology: Quasi experimental study design, carried out in eight slum areas of Nairobi. Two hundred and sixty (260) HIV-infected children (aged 6-59 months) on ART were randomly selected from eight comprehensive care centres (CCCs) and followed for a period of up to six months. Findings: Nutritional support did not significantly contribute to attainment of neither gross motor (AOR=2.45; 95% CI: 0.81-7.46; P=0.114) nor fine motor skills milestones (AOR=1.08; 95% CI: 0.33-3.51; P=0.904) in HIV-infcted children. Unique contribution to theory, practice and policy: The study provides insights that are critical in enabling programmes providing support to HIV-infected children consider additional factors such as environmental, treatment and educational interventions to their nutrition interventions. The findings of study can also be used to inform policy with regard to effectiveness of interventions in concretely addressing care and management of HIV and  AIDS among young children in general and in resource poor settings in particular.

This study was funded by Internal Research Grants of the Kenya Medical Research Institute. We acknowledge support from director KEMRI and institutions that participated in this study. Abstract Hepatitis B and C,herpes Simplex Virus 2 and syphilis are important infections that share common modes of transmission. The global burden of these infections and their occurrence as co-infection of HIV in high risk population groups calls for more attention in control and management. While HIV has been a program priority disease in many low resource settings, hepatis B and C have not had as much attention. Yet there is substantial indication that transmission of hepatitis, herpes virus 2 and syphilis is on the increase. This study aimed at determining the prevalence of hepatitis B, hepatitis C, Herpes simples virus 2 and syphilis and their distribution across different regions in Kenya. Samples were collected from HIV positive study participants in 11 counties (out of total 47) distributed in 7 out of the 8 regions (provinces).A total of 1829 samples were tested for the 4 infections and their distribution analysised. Mapping of the infection was presented by study sites and regions . Overall prevalence of HSV2 was the highest (at 50%) followed by that of HBV (29%) and HCV and Syphilis (14% repectively). Majority of study participants (71%) had co-infections while the rest of the study participants (29%) had none of the four infections. Western and Nyanza regions of the country had higher prevalence of HBV (above 31%). Sero-prevalence of HCV across the regions ranged between 8 to 19 percent. Syphilis sero-prevalence was highest in western and Nyanza region (Range 18% to 26%) compared to other regions (4% to15%), the lowest prevalence was in Central region. Distribution of HSV2 indicated Nairobi was leading at 62%, Central at 48.5% and Rift Valley at 47.5%. Lowest prevalence of HSV2 was at eastern region with an average of 29%. There was significant relation between infections and study sites. Since routine testing for HBV, HCV and HSV is not readily available, there is need to develop a strategy for prevention and control of these infections. Integration of services would be an important consideration in this regard. Keywords: HBV, HCV, HSV, Syphilis, prevalence, co-infection, distribution DOI : 10.7176/JBAH/9-12-06 Publication date :June 30 th 2019

Background : HIV antiretroviral treatment [ART] failure increases morbidity and mortality. In Kenya, use of treatment supporter, HIV serostatus disclosure, and support groups are believed to reduce the risk of treatment failure by improving adherence. Methods : We conducted a case-control study to identify factors associated with clinical or immunologic indicators of treatment failures. Cases and controls were adult patients attending a semi-urban HIV clinic who initiated ART at least six months prior to the study. Cases were patients who had a] a decline in CD4 count [below baseline or 30% from highest value since ART initiation] or b] unimproved CD4 counts or c] a World Health Organization [WHO] stage III or IV opportunistic infection. Controls did not meet either immunologic or clinical criteria for treatment failure. Information was obtained through face-to-face interviews medical chart reviews. Results : We enrolled 52 cases and 104 controls. Twenty-eight [53%] cases and 71 [70%] controls were women, and median age was 44 years [range: 38-50 years] among cases and 43 years [range: 38-49 years] among controls. Discontinued ART for 2 weeks or more [adjusted odds ratio [AOR] 8.9, 95% confidence interval [CI] 1.4-57.4] and alcohol use [AOR 7.2, 95% CI 1.1-45.5] were found to significantly increase the risk of ART failure. Compared to men who discontinued ART for less than 2 weeks, women who discontinued ART for less than 2 weeks had reduced risk [AOR 0.4, 95% CI 0.2-0.9] while those who discontinued for two weeks or more had a greater risk [AOR 12.97, 95% CI 1.5-111.8] of developing ART failure. Social support factors were not associated with treatment failure. Conclusions : Discontinuing ART and alcohol use were identified to be modifiable factors associated with clinical or immunologic criteria of ART failure. Interventions with proven efficacy at reducing alcohol use and increasing continuous ART should be implemented. Key words : Antiretroviral treatment failure, HIV, AIDS, adherence, alcohol, Kenya

HIV epidemic in Kenya is geographically diverse ranging from a prevalence of 26 percent and 0.4 percent.Evidence indicates that a higher proportion of HIV infected women are more likely to be associated with unintended pregnancies.Despite this evidence, little is known about determinants of fertility desires and intentions of HIVinfectedand HIV-uninfected women in Kenya.437 HIV-infected and 365 HIV-uninfected women were enrolled in the study.Using a cross-sectional mixed method, the study sought to investigate determinants of fertility desires and intentions among HIV-infected and uninfected women, and further determined factors associated with desire and intention to use contraceptives among HIV-infected women.Focus group discussions and key informant interviews were conducted with HIV-infected and uninfected women and Health providers respectively.Sampling was proportionate to the size based on client volumes at each study hospital.Similar factors including; age, region of residence, place of residence, level of education, employment and marital status were found to significantly influence desire and intention to have children among HIV-infected and uninfected women.Older women were more likely to desire or intend to have more children P<0.001), marital status was the only factor that influenced desire and intention to utilize contraceptives among HIV-infected women.Myths and misconception and poor provider -client interactions on family planning methods were some of the demand and supply system gaps that hinder utilization of family planning methods Innovative approaches are required to promote use of contraceptives among HIV infected women to reduce maternal morbidity, mortality and vertical transmission of HIV.

BACKGROUND:Lymphatic filariasis (LF) is a parasitic infectious disease that is transmitted by several species of mosquitoes. Diagnosis of LF is done in both human hosts and vectors. Effective mosquito collection method(s) is/are required in order to collect large numbers of mosquitoes with high chances of infectivity.METHODS:In this study, 3 mosquito sampling methods were compared. Mosquitoes were collected from 6 randomly selected villages of Tana River County, Kenya. The effectiveness of CDC light traps, gravid traps, and pyrethrum spray methods in collecting mosquitoes were compared. Mosquitoes were morphologically identified into genera and species level, and mosquito dissection was done in search of microfilariae larvae to assess the infection and infectivity rates. Data was analysed by SPSS version 15.0 and analysis of variance (ANOVA).RESULTS:A total of 1632 female mosquitoes were collected belonging to 5 mosquito genera: Culex, Anopheles, Aedes, Mansonia, and Ficalbia. The most abundant mosquito genera was Culex. Light traps obtained the most blood-fed mosquitoes.CONCLUSION:Light traps were found to be the most effective method of mosquito collection in terms of high catches and high infectivities.

Prompt diagnosis and effective treatment of acute malaria in pregnancy (MiP) is important for the mother and fetus; data on health-care provider adherence to diagnostic guidelines in pregnancy are limited. From September to November 2013, a cross-sectional survey was conducted in 51 health facilities and 39 drug outlets in Western Kenya. Provider knowledge of national diagnostic guidelines for uncomplicated MiP were assessed using standardized questionnaires. The use of parasitologic testing was assessed in health facilities via exit interviews with febrile women of childbearing age and in drug outlets via simulated-client scenarios, posing as pregnant women or their spouses. Overall, 93% of providers tested for malaria or accurately described signs and symptoms consistent with clinical malaria. Malaria was parasitologically confirmed in 77% of all patients presenting with febrile illness at health facilities and 5% of simulated clients at drug outlets. Parasitological testing was available in 80% of health facilities; 92% of patients evaluated at these facilities were tested. Only 23% of drug outlets had malaria rapid diagnostic tests (RDTs); at these outlets, RDTs were offered in 17% of client simulations. No differences were observed in testing rates by pregnancy trimester. The study highlights gaps among health providers in diagnostic knowledge and practice related to MiP, and the lack of malaria diagnostic capacity, particularly in drug outlets. The most important factor associated with malaria testing of pregnant women was the availability of diagnostics at the point of service. Interventions that increase the availability of malaria diagnostic services might improve malaria case management in pregnant women.