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Prevalence and Incidence of HIV Infection among Fishermen along Lake Victoria Beaches in Kisumu County, Kenya  [PDF]
Raphael Omusebe Ondondo, Zipporah Waithera Ng’ang’a, Solomon Mpoke, Michael Kiptoo, Elizabeth A. Bukusi
World Journal of AIDS (WJA) , 2014, DOI: 10.4236/wja.2014.42027

Background: Herpes simplex virus type-2 (HSV-2) and human papillomavirus (HPV) are common sexually transmitted infections (STIs) among fishing communities and are associated with high HIV prevalence in this underserved population. However, there is limited knowledge on HIV incidence among fishermen. This study aimed at determining prevalence, incidence and risk factors associated with HIV infection among fishermen in Kisumu Kenya. Methods: Three hundred fishermen were evaluated for baseline HIV, HSV-2, HPV infection and a structured questionnaire administered. HIV incidence was assessed after 12 months among those initially HIV negative. HIV incidence rate in person-years and prevalence were estimated. Multivariate logistic regression was used to determine factors independently associated with HIV acquisition. Results: HIV prevalence was 23.3% (95% CI: 18.5 - 28.1). Risk factors for baseline HIV prevalence were older age (aOR = 2.13; 95% CI: 1.25 - 5.07), history of STI (aOR 4.21; 95% CI: 2.07 - 9.34), baseline HPV infection (aOR 2.13; 95% CI: 1.05 - 4.77), number of lifetime sexual partners (>5) aOR = 5.76 (95% CI: 1.41 - 13.57) and transactional sex (aOR = 10.98; 95% CI: 1.86 - 19.34). Condom uses with new sexual partner (aOR 0.21, 95% CI: 0.08 - 0.55) and during most recent sexual act (aOR 0.09, 95% CI: 0.03 - 0.61), were negatively associated with HIV prevalence. HIV incidence was 4.2 (95% CI = 1.3 - 7.1) per 100 person-years with being single (aIRR = 8.32; 95% CI: 1.27 - 54.67) as an independent risk factor. Condom use with new sexual partner (aIRR = 0.11; 95% CI: 0.01 - 0.89) and recent sex with wife/regular girlfriend (compared to sex worker/casual partner; aIRR = 0.03; 95% CI: 0.01 - 0.35) were associated with reduced risk of HIV acquisition. Conclusion: Inconsistent condom use and transactional/casual sexual partnerships were the main high-risk sexual behaviors in addition to marital status explaining the high HIV acquisition rate among fishermen. Intensified safer sex promotion is urgently needed in this subpopulation to avert new HIV infections.

Extra-marital sexual partnerships and male friendships in rural Malawi  [cached]
Shelley Clark
Demographic Research , 2010,
Abstract: Extra-marital sexual partnerships (EMSPs) are a major route of HIV/AIDS transmission in sub-Saharan Africa. In this paper, we investigate the roles of two types of male friendships - best friends and friends with whom they talk about AIDS - in determining whether men have EMSPs. Using data from men in rural Malawi, we find that men's current extra-marital sexual behavior is most closely correlated with their best friends', but that the behaviors of both types of friends are associated with men's subsequent EMSPs. These findings suggest that men's friendships could be used to help combat the AIDS epidemic.
Prevalence, Incidence and Risk Factors for Acquisition of Herpes Simplex Virus Type 2 among Fishermen on the Shores of Lake Victoria in Kisumu County, Kenya  [PDF]
Raphael O. Ondondo, Zipporah W. Ng’ang’a, Solomon Mpoke, Michael K. Kiptoo, Elizabeth A. Bukusi
Advances in Infectious Diseases (AID) , 2014, DOI: 10.4236/aid.2014.42016

Background: Herpes simplex virus Type 2 (HSV-2) has been associated with HIV infection. More recently, HSV-2 incidence has been linked to HIV acquisition. A few studies have suggested that the fishing communities have a high HSV-2 prevalence but there is limited knowledge on HSV-2 incidence and associated risk factors among fishermen. Methods: Three hundred fishermen were consented, and evaluated for baseline HSV-2 serology status and again after 12 months among those negative at baseline. Sexual behavior and socio-demographic data were collected at enrolment and exit visits using a structured questionnaire. Baseline HIV serology and Human papillomavirus (HPV) DNA genotyping were also performed. Multivariate logistic regression was used to determine independent factors associated with HSV-2 acquisition. Results: Baseline HSV-2 prevalence was 56.3% (95% CI: 50.7 - 62.0). Factors associated with HSV-2 prevalence were, older age (aOR = 1.96; 95% CI: 1.16 - 2.85), history of STI (aOR 2.12; 95% CI: 1.19 - 3.91), infection with HIV (aOR 2.22; 95% CI: 1.17 - 4.22), ever married (aOR = 3.80; 95% CI: 1.42 - 11.90), most recent sexual act with sex worker/casual partner (OR= 3.56; 95% CI: 1.49 - 8.62) and inconsistent condom use with new sexual partner (aOR = 6.34; 95% CI: 2.24 - 13.04). The HSV-2 incidence was 23.6 (95% CI = 15.4 - 31.8)/100 pyr. Infection with persistent high-risk (HR) HPV (aIRR = 3.35; 95% CI: 1.21 - 11.37), multiple (2) partners in 12 months prior to study participation (aIRR = 4.77; 95% CI: 1.12 - 11.38), inconsistent condom use with new partner (aIRR =2.53; 95% CI: 1.12 - 7.38) and most recent sexual act with sex worker/casual partner (OR = 3.03; 95% CI: 1.17 - 8.58) were independent risk factors for HSV-2 acquisition. Conclusion: The incidence of HSV-2 is very high among fishermen. It is associated with persistent HR HPV infection and high-risk sexual behavior. Intervention strategies targeting these men with high risk sexual behavior are urgently needed to stop new HSV-2 acquisition and subsequently prevent HIV infection.

Fishermen as a Suitable Population for HIV Intervention Trials  [PDF]
Zachary A. Kwena,Craig R. Cohen,Norton M. Sang,Musa O. Ng'ayo,Jeremiah H. Ochieng,Elizabeth A. Bukusi
AIDS Research and Treatment , 2010, DOI: 10.1155/2010/865903
Abstract: Background. Suitable populations to sustain continued evaluation of HIV and sexually transmitted infection (STI) prevention interventions are required. We sought to determine whether fishermen are a suitable population for HIV intervention trials. Methods. In a cross-sectional descriptive survey, we selected 250 fishermen from proportional to size sampled boats. We collected socioeconomic and behavioral information, and specimens for HIV, herpes simplex virus (HSV-2), syphilis, gonorrhea, chlamydia and human papillomavirus (HPV) tests from consenting participants. Results. One third of the fishermen had concurrent sexual partnerships and two thirds were involved in transactional sex. About 70% were involved in extramarital sex with only one quarter using condoms in their three most recent sexual encounters. HIV prevalence was 26% and HSV-2 and HPV was 57%. Over 98% were willing to participate in a future HIV prevention clinical trial. Conclusion. Fishermen are a high-risk group for HIV/STI infections that may be suitable for HIV prevention trials. A cohort study would be useful to measure the incidence of HIV/STIs to ultimately determine the feasibility of enrolling this population in an HIV/STI prevention clinical trial. 1. Introduction There is urgent need to continue evaluating interventions such as microbicide product(s) that have potential to prevent transmission of sexually transmitted infections (STIs) including HIV. These evaluations require suitable populations that not only have high-risk sexual behaviors and STI/HIV incidence, but would also benefit and have interest in study participation [1–4].Issues of low-retention rates in randomized clinical trials hamper trial progress even in populations that have high-risk sexual behavior and HIV prevalence which results in inadequate statistical power to measure the effect of the intervention on the primary outcome, for example, HIV incidence [3]. Sufficiently high risk sexual behaviors that result in HIV acquisition in a population of interest [4, 5] cushions against the likely changes in behavior that result from “the trial effects” of counseling and treatment. These changes in sexual behavior may interfere with generating data that has adequate statistical power to measure the benefits of an intervention [6–9]. However, finding such populations that are suitable for HIV intervention trials remains a big challenge, even as new and more promising interventions emerge [6, 10, 11]. Fishermen in Kenya, like in many other parts of the world, are usually young and highly mobile, often staying away from
The correlates of HIV testing and impacts on sexual behavior: evidence from a life history study of young people in Kisumu, Kenya
Caroline W Kabiru, Nancy Luke, Chimaraoke O Izugbara, Eliya M Zulu
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-412
Abstract: The study uses data from a random sample of youth aged 18-24 years living in Kisumu, Kenya, who were interviewed using a 10-year retrospective life history calendar. Cox regression models were used to examine the correlates of the timing of first HIV test. Variance-correction models for unordered repeated events were employed to examine whether having an HIV test in the previous six months and the cumulative number of tests predict unsafe sexual practices in a given month.Sixty-four percent of females and 55% of males reported at least one HIV test in the last 10 years and 40% of females were pregnant the month of first test. Significant correlates of first HIV test included marital aspirations among non-pregnant females, unprotected sex in the previous six months among pregnant females, and concurrency in the previous six months among males. Having a recent HIV test was associated with a decreased likelihood of unprotected sex among ever-pregnant females, an increased likelihood of unprotected sex and "risky" sexual partnerships among never-pregnant females, and an increased likelihood of concurrency among males. Repeated HIV testing was associated with a lower likelihood of concurrency among males and involvement in "risky" sexual partnerships among males and never-pregnant females.The high rate of pregnancy at first test suggests that promotion of HIV testing as part of prevention of mother-to-child transmission is gaining success. Further research is warranted to examine how and why behavior change is influenced by client- versus provider-initiated testing. The influence of different sexual partnership variables for males and females suggests that interventions to assess risk and promote testing should be gender- and relationship-specific. The findings also suggest that encouraging repeat or routine testing could potentially increase the uptake of safer sexual behaviors.HIV counseling and testing is widely considered an important and cost-effective component of
Malacological survey and geographical distribution of vector snails for schistosomiasis within informal settlements of Kisumu City, western Kenya
Selpha Opisa, Maurice R Odiere, Walter GZO Jura, Diana MS Karanja, Pauline NM Mwinzi
Parasites & Vectors , 2011, DOI: 10.1186/1756-3305-4-226
Abstract: Surveyed sites were mapped using a geographical information system. Cercaria shedding was determined from snails and species of snails identified based on shell morphology. Vegetation cover and presence of algal mass at the sites was recorded, and the physico-chemical characteristics of the water including pH and temperature were determined using a pH meter with a glass electrode and a temperature probe.Out of 1,059 snails collected, 407 (38.4%) were putatively identified as Biomphalaria sudanica, 425 (40.1%) as Biomphalaria pfeifferi and 227 (21.5%) as Bulinus globosus. The spatial distribution of snails was clustered, with few sites accounting for most of the snails. The highest snail abundance was recorded in Nyamasaria (543 snails) followed by Nyalenda B (313 snails). As expected, the mean snail abundance was higher along the lakeshore (18 ± 12 snails) compared to inland sites (dams, rivers and springs) (11 ± 32 snails) (F1, 79 = 38.8, P < 0.0001). Overall, 19 (1.8%) of the snails collected shed schistosome cercariae. Interestingly, the proportion of infected Biomphalaria snails was higher in the inland (2.7%) compared to the lakeshore sites (0.3%) (P = 0.0109). B. sudanica was more abundant in sites along the lakeshore whereas B. pfeifferi and B. globosus were more abundant in the inland sites. Biomphalaria and Bulinus snails were found at 16 and 11 out of the 56 inland sites, respectively.The high abundance of Biomphalaria and Bulinus spp. as well as observation of field-caught snails shedding cercariae confirmed that besides Lake Victoria, the local risk for schistosomiasis transmission exists within the informal settlements of Kisumu City. Prospective control interventions in these areas need to incorporate focal snail control to complement chemotherapy in reducing transmission.Schistosoma mansoni infection continues to be one of the most important and widespread of the neglected tropical diseases in Kenya, especially among communities living around the shor
Low Levels of Awareness Despite High Prevalence of Schistosomiasis among Communities in Nyalenda Informal Settlement, Kisumu City, Western Kenya  [PDF]
Gladys O. Odhiambo ,Rosemary M. Musuva,Vincent O. Atuncha,Elizabeth T. Mutete,Maurice R. Odiere,Rosebella O. Onyango,Jane A. Alaii,Pauline N. M. Mwinzi
PLOS Neglected Tropical Diseases , 2014, DOI: 10.1371/journal.pntd.0002784
Abstract: Introduction Intestinal schistosomiasis is widely distributed around Lake Victoria in Kenya where about 16 million people in 56 districts are at risk of the infection with over 9.1 million infected. Its existence in rural settings has been extensively studied compared to urban settings where there is limited information about the disease coupled with low level of awareness. This study therefore assessed community awareness on existence, signs and symptoms, causes, transmission, control and risk factors for contracting schistosomiasis as well as attitudes, health seeking behaviour and environmental antecedents that affect its control so as to identify knowledge gaps that need to be addressed in order to strengthen schistosomiasis control interventions in informal urban settings. Methods The study was carried out in an informal urban settlement where the prevalence of intestinal schistosomiasis was previously reported to be the highest (36%) among the eight informal settlements of Kisumu city. The study adopted cross-sectional design and purposive sampling technique. Eight focus group discussions were conducted with adult community members and eight key informant interviews with opinion leaders. Data was audio recorded transcribed, coded and thematically analyzed using ATLAS.ti version 6 software. Results Most respondents stated having heard about schistosomiasis but very few had the correct knowledge of signs and symptoms, causes, transmission and control of schistosomiasis. However, there was moderate knowledge of risk factors and at high risk groups. Their attitudes towards schistosomiasis and its control were generally indifferent with a general belief that they had no control over their environmental circumstances to reduce transmission. Discussion/Conclusion Although schistosomiasis was prevalent in the study area, majority of the people in the community had low awareness. This study, therefore, stresses the need for health education to raise community's awareness on schistosomiasis in such settings in order to augment prevention, control and elimination efforts.
Rose Susan RABARE,Roselyne OKECH,George Mark ONYANGO
Theoretical and Empirical Researches in Urban Management , 2009,
Abstract: Urban parks are now viewed as an important part of the broader structure of urban and neighborhood development rather than just recreation and leisure facilities. While most of the world has recognized the multifunctional use of urban parks for development; the parks in Kenya and Kisumu Township in particular are suffering from lack of attention, poor maintenance, lack of development and underutilization. Also evident in most parks of Kisumu Township is lack of activities and basic utilities like public toilets, litterbins, benches and notice boards. The stakeholders of Kisumu Town do not seem to realize that parks can contribute to enormous social, cultural and economic development of the poverty stricken region. The aim of the study was to assess the utilization, investigate the benefits and analyze the factors influencing use of urban parks in Kisumu. Descriptive, cross-section research design was used where multistage cluster sampling technique was applied in sampling households and park users within seven wards of Kisumu Township and seven urban parks respectively. The study indicates that the poor maintenance and lack of adequate facilities had hindered optimal social, economical, environmental and educational benefits of the parks.
Drug abuse in Kisumu town western Kenya
AO Otieno, AVO Ofulla
African Journal of Food, Agriculture, Nutrition and Development , 2009,
Abstract: This was a cross sectional study designed to determine the factors associated with drug abuse among secondary school students in nine schools in Kisumu town, western Kenya. The objective of this study was to determine the effect of age, gender and peer influence on drug abuse and to establish the reasons why students abuse drugs. Nine schools were randomly selected for the study. A total of 458 students (243 males and 215 females) were interviewed using a closed ended questionnaire. The data were then categorized into non-abusers and abusers and the degree of association between the variables was tested using Chi-square test. A total of 458 students (243 males and 215 females), were interviewed using a close-ended questionnaire. The results showed that 265 (57.9%) of the respondents had consumed alcohol at least once in their lives, 159 (34.7%) had abused tobacco, 84 (18.3%) had abused cannabis, 106 (23.1%) had abused khat and 24 (5.2%) had used inhalants and/or cocaine. The age group most at risk was 16-18 years, the age at which most students are in secondary school. The reasons given for the abuse of the drugs were: experimentation 92 (38.2%), enjoyment of the feeling they experience 114 (47.3%), influence from friends 21 (8.7%), influence from relatives 5 (2.1%) and for treating stomach ailments 7 (2.9%). More boys were found to be abusing drugs (36.9%, n = 169) compared to girls (27.3%, p = 0.007). Also, drug abuse was found to be higher in students living in low socioeconomic class areas of the town (30%, n = 122) compared to high-class areas (21.6%, n = 94, p =0.004) and peer influence had no effect on drug abuse (p = 0.249). From this study it was concluded that drug abuse was widespread in secondary schools in Kisumu and although it affected both sexes boys were more involved in the practice than girls. The study therefore recommends that early intervention should target school attendees at early age with the aim of preventing drug abuse in secondary schools in Kisumu town, western Kenya.
Parental Factors Affecting Academic Achievement of Grade Six Pupils in Kisumu City, Kenya  [cached]
Lazarus Ndiku Makewa,Elizabeth Role,Faith Otewa
International Journal of Asian Social Science , 2012,
Abstract: The study sought to investigate selected parental factors that affect the academic achievement of grade six pupils in Kisumu City in Kenya. The study used a causal comparative research design. Two research instruments were used; questionnaires were administered to the grade six pupils and their parents. Document analysis was also used to determine the pupils’ academic performance. These were then analyzed using descriptive and inferential statistics. The investigation targeted both public and private primary schools in the city, selected pupils of grade 6, and their parents. Out of the 115 schools in Kisumu City, a total of 12 public schools and 8 private schools were selected using stratified sampling technique. Four hundred (400) pupils of grade six and 400 parents were selected to participate in the research. The findings revealed that socio-economic status, parental level of education, family size, family type and parental involvement affect the academic performance of pupils.
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