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Search Results: 1 - 10 of 467786 matches for " Zipporah Ng’ang’a "
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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 Nganga, 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.

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. Nganga, 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.

Risk Factors in the Transmission of Tuberculosis in Nairobi: A Descriptive Epidemiological Study  [PDF]
Perpetual Wangui Ndungu, Gunturu Revathi, Samuel Kariuki, Zipporah Nganga
Advances in Microbiology (AiM) , 2013, DOI: 10.4236/aim.2013.32025

Background: Tuberculosis is an infectious disease with an estimated 1.45 million deaths every year. Many patients get infected as a result of ignorance of the risk factors that contribute to disease transmission. Methodology: A descriptive epidemiological study was conducted on 258 patients presenting with pulmonary tuberculosis. Patients’ sputa were collected for laboratory analysis and patients were required to respond to a structured questionnaire on risk factors for transmission. Data among stratified groups were compared using bivariate analysis. Statistical significance was considered at p < 0.05. Results: There were significantly more males than females associated with pulmonary tuberculosis infection (χ2 = 0.963; df = 1; p < 0.05). Monthly income was significant in disease transmission with 222 (86.0%) of the patients earning less than 100$ and 90 (34.9%) earning less than 50$ per month (p < 0.05, 95% CI). One hundred and seventy three patients (67.1%) were unemployed or running small businesses. Only 85 (32.9%) were in formal employment. Results showed 166 (64.3%) patients were living in single rooms with 110 (42.6%) living with more than two people with a maximum of 10 people in a single room. Only 73 (28.3%) were living alone in a single room and only 7 families (2.7%) were living in houses with five or more rooms. Alcohol consumers and smokers were 102 (39.5%) and 93 (36%) respectively. Half of the patients (137 (53.3%)) had not completed secondary education with only 16 (6.2%) having completed tertiary education. Recurrent cases were 54 (21%) while those exposed to the disease either at home or working place were 75 (29.2%). Out of 171 patients who agreed to test for HIV, 46 (26.9%) were positive. Marital status had no effect on incidence of disease. Conclusion: Emphasis should be given to creating awareness of the risk factors associated with transmission of

Acute Plasmodium knowlesi Infection in Olive Baboons (Papio anubis) Is Accompanied by High-Level of Gamma Interferon
Teresia Nyawira,Michael Gicheru,Esther Kagasi,Zipporah Nganga
International Journal of Biology , 2012, DOI: 10.5539/ijb.v4n2p92
Abstract: Malaria is a major and growing threat to economic development and public health in developing countries. There are about 2.7 million malaria deaths annually. Plasmodium knowlesi, the fifth human malaria parasite, is an attractive model for malaria research and is also phylogenetically close to human malaria parasite P. vivax. It shares many vaccine candidate molecules with P. vivax. This study was carried out to determine immunological profiles mounted by Olive baboons during experimental infection with P. knowlesi H strain. Six Olive baboons (Papio Anubis) were infected with 1×106 P. knowlesi blood stage parasites. The infected baboons developed either severe (acute) or mild (chronic) infection. High IgM titres were observed during primary infection in the baboons. Anti-IgG antibodies were raised after two weeks of chronic infection. Circulating IFNg from serum rose fifty fold in acutely infected animals during the first two weeks post infection compared to a tenfold increase in chronically infected baboons. Recall proliferative responses were two fold higher in chronically infected animals by day 14 post infection. The highest stimulation index (10.06 + 2.74) was observed in chronic animals at day 42 post infection. These results demonstrated that baboons infected with P. knowlesi mount an immune response that is characterized by antibody and cytokine responses involving IgG, IgM and IFNr. These studies are important in validation of the P. knowlesi- baboon model for malaria drug and vaccine development.
Improved Pregnancy Outcomes in a Prospective Study of Pregnant Women Enrolling in an Antenatal Clinic in Western Kenya  [PDF]
Ibrahim I. Daud, Fredrick O. Opinya, David Midem, Moses Kigani, Elizabeth A. Bukusi, Zipporah Nganga, Peter O. Sumba, Arlene Dent, Rosemary Rochford
Health (Health) , 2014, DOI: 10.4236/health.2014.619304
Abstract: In areas of sub-Saharan Africa where malaria is endemic, pregnant women are at a greater risk of malaria than non-pregnant women leading to significant adverse consequences including anemia, intrauterine growth retardation, low birth weight (LBW), and pre-term delivery. The Kenya Ministry of Health adopted Intermittent Preventive Treatment (IPT) and use of insecticide-treated nets (ITN) as a National strategy for malaria prevention in pregnancy. In this report, we evaluated the prevalence of malaria, the anthropometric measures of birth outcomes and the reasons for loss to follow up among pregnant women participating in an ongoing cohort study in Western Kenya. A total of 175 HIV-negative pregnant women enrolled at antenatal clinic of Chulaimbo sub-District hospital were longitudinally evaluated in a monthly follow-up visits through antenatal visits (up to 4 per mother) and delivery. Thirty three percent and 15% of the pregnant women were malaria positive by real-time quantitative (Q)-PCR and microscopy respectively at enrolment, while 54% and 23% of the pregnant women had malaria by Q-PCR and microscopy respectively at any time during follow-up. Of the enrolled study participants, 65% delivered at Chulaimbo hospital. Overall, 39% (69) of the pregnant women were lost to follow-up. The major reasons for loss to follow up were relocation from the study area (26%) and delivery at alternative health facilities (25%). The mean birth weight of the newborn infants was 3202 g (range, 2000 g - 4000 g). Only 5.3% of the infants weighed less than 2500 g (low birth weight). The mean head circumference was 34 cm (range, 30 cm - 39 cm) with mean Apgar score (at 10 minutes) ± S.D. of 9.8 ± 0.97. In conclusion, we observed decreased adverse pregnancy outcomes among our study population. We recommend a larger study of all pregnant women attending the Chulaimbo hospital so as to assess whether effectiveness of malaria and anemia control programs lead to improved birth outcomes.
Factors associated with non-adherence to highly active antiretroviral therapy in Nairobi, Kenya
Samwel N Wakibi, Zipporah W Ng'ang'a, Gabriel G Mbugua
AIDS Research and Therapy , 2011, DOI: 10.1186/1742-6405-8-43
Abstract: This is a multiple facility-based cross-sectional study, where 416 patients aged over 18 years were systematically selected and interviewed using a structured questionnaire about their experience taking ART. Additional data was extracted from hospital records. Patients were grouped into adherent and non-adherent based on a composite score derived from a three questions adherence tool developed by Center for Adherence Support Evaluation (CASE). Multivariate regression model was used to determine predictors of non-adherence.Overall, 403 patients responded; 35% males and 65% females, 18% were non-adherent, and main (38%) reason for missing therapy were being busy and forgetting. Accessing ART in a clinic within walking distance from home (OR = 2.387, CI.95 = 1.155-4.931; p = 0.019) and difficulty with dosing schedule (OR = 2.310, CI.95 = 1.211-4.408, p = 0.011) predicted non-adherence.The study found better adherence to HAART in Nairobi compared to previous studies in Kenya. However, this can be improved further by employing fitting strategies to improve patients' ability to fit therapy in own lifestyle and cue-dose training to impact forgetfulness. Further work to determine why patients accessing therapy from ARV clinics within walking distance from their residence did not adhere is recommended.Antiretroviral treatment success depends on sustainable high rates of adherence to medication regimen of ART [1]. However, significant proportions of HIV-infected patients do not reach high levels of adherence and this can lead to devastating public health problems. Mills et al in a meta-analysis study found a combined continental adherence to ART of 64% with 55% adherence in North America and 77% in Africa. Twenty four percent non-adherence has been reported in Southwest Ethiopia [2], 22% in Cote d'Ivore [3] and 13% in Cameroon [4]. Byakika et al [5] reported 68% adherence to HIV treatment in Uganda, 54% in Nigeria [6] and 63% in South Africa [7]. Non-adherence to ART has been
Delivery Practices and Associated Factors among Mothers Seeking Child Welfare Services in Selected Health Facilities in Nyandarua South District, Kenya
Carol Wanjira, Moses Mwangi, Evans Mathenge, Gabriel Mbugua, Zipporah Ng'ang'a
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-360
Abstract: A hospital-based cross-sectional survey among women who had recently delivered while in the study area was carried out between August and October 2009. Binary Logistic regression was used to identify factors that predicted mothers' delivery practice.Among the 409 mothers who participated in the study, 1170 deliveries were reported. Of all the deliveries reported, 51.8% were attended by unskilled birth attendants. Among the deliveries attended by unskilled birth attendants, 38.6% (452/1170) were by neighbors and/or relatives. Traditional Birth Attendants attended 1.5% (17/1170) of the deliveries while in 11.7% (137/1170) of the deliveries were self administered. Mothers who had unskilled birth attendance were more likely to have <3 years of education (Adjusted Odds ratio [AOR] 19.2, 95% confidence interval [CI] 1.7 - 212.8) and with more than three deliveries in a life time (AOR 3.8, 95% CI 2.3 - 6.4). Mothers with perceived similarity in delivery attendance among skilled and unskilled delivery attendants were associated with unsafe delivery practice (AOR 1.9, 95% CI 1.1 - 3.4). Mother's with lower knowledge score on safe delivery (%) were more likely to have unskilled delivery attendance (AOR 36.5, 95% CI 4.3 - 309.3).Among the mothers interviewed, utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified lay persons. There is need to implement cost effective and sustainable measures to improve the quality of maternal health services with an aim of promoting safe delivery and hence reducing maternal mortality.Each year, approximately 536,000 women die from complications related to pregnancy and childbirth, with 99% of these deaths occurring in Africa and Asia. Slightly more than half of these deaths (270 000) occur in sub-Saharan Africa [1]. To make the achievement of the fifth Millennium Development Goal (MDG) a reality, Maternal Mortality Rates (MMR) will have to decrease at a much faster rate
Survey on prevalence and risk factors on HIV-1 among pregnant women in North-Rift, Kenya: a hospital based cross-sectional study conducted between 2005 and 2006
Michael Kiptoo, Solomon Mpoke, Zipporah Ng'ang'a, Jones Mueke, Fredrick Okoth, Elijah Songok
BMC International Health and Human Rights , 2009, DOI: 10.1186/1472-698x-9-10
Abstract: Blood samples were collected from pregnant women attending antenatal clinics in three district hospitals (Kitale, Kapsabet and Nandi Hills) after informed consent and pre-test counseling. The samples were tested for HIV antibodies as per the guidelines laid down by Ministry of Health, Kenya. A structured pretested questionnaire was used to obtain demographic data. Lymphocyte subset counts were quantified by standard flow cytometry.Of the 4638 pregnant women tested, 309 (6.7%) were HIV seropositive. The majority (85.1%) of the antenatal attendees did not know their HIV status prior to visiting the clinic for antenatal care. The highest proportion of HIV infected women was in the age group 21–25 years (35.5%). The 31–35 age group had the highest (8.5%) HIV prevalence, while women aged more than 35 years had the lowest (2.5%).Women in a polygamous relationship were significantly more likely to be HIV infected as compared to those in a monogamous relationship (p = 0.000). The highest HIV prevalence (6.3%) was recorded among antenatal attendees who had attended secondary schools followed by those with primary and tertiary level of education (6% and 5% respectively). However, there was no significant relationship between HIV seropositivity and the level of education (p = 0.653 and p = 0.469 for secondary and tertiary respectively). The mean CD4 count was 466 cells/mm3 (9–2000 cells/mm3). Those that had less than 200 cells/mm3 accounted for 14% and only nine were on antiretroviral therapy.Seroprevalence of HIV was found to be consistent with the reports from the national HIV sentinel surveys. Enumeration of T-lymphocyte (CD4/8) should be carried out routinely in the antenatal clinics for proper timing of initiation of antiretroviral therapy among HIV infected pregnant women.HIV/AIDS is the major health priority in Kenya. Sentinel surveillance in antenatal women has been used to project national HIV seroprevalence in Kenya since 1990 [1]. The system operates within antenata
Factors associated with severity of road traffic injuries, Thika, Kenya
Osoro Mogaka Eric,Nganga Zipporah,Oundo Joseph,Omolo Jared
Pan African Medical Journal , 2011,
Abstract: BACKGROUND: Road traffic injuries continue to exert a huge burden on the health care system in Kenya. Few studies on the severity of road traffic injuries have been conducted in Kenya. We carried out a cross-sectional study to determine factors associated with severity of road traffic injuries in a public hospital in Thika district, Kenya. METHODS: Road crash victims attending the Thika district hospital, a 265-bed public hospital, emergency room were recruited consecutively between 10th August 2009 and 15th November 2009. Epidemiologic and clinical information was collected from medical charts and through interview with the victims or surrogates using a semi-structured questionnaire. Injuries were graded as severe or non-severe based on the Injury Severity Score (ISS). Independent factors associated with injury severity were assessed using multivariate logistic regression. RESULTS: The mean age of participants was 32.4 years, three quarters were between 20-49 years-old and 73% (219) were male. Nineteen percent (56/300) of the victims had severe injury. Five percent (15) had head injury while 38% (115) had fractures. Vulnerable road users (pedestrians and two-wheel users) comprised 33% (99/300) of the victims. Vulnerable road users (OR=2.0, 95%CI=1.0-3.9), road crashes in rainy weather (OR=2.9, 95%CI=1.3-6.5) and night time crashes (OR=2.0, 95%CI=1.1-3.9) were independent risk factors for sustaining severe injury. CONCLUSION: Severe injury was associated with vulnerable road users, rainy weather and night time crashes. Interventions and measures such as use of reflective jackets and helmets by two wheel users and enhanced road visibility could help reduce the severity of road traffic injuries
Alterations on peripheral B cell subsets following an acute uncomplicated clinical malaria infection in children
Amolo S Asito, Ann M Moormann, Chelimo Kiprotich, Zipporah W Ng'ang'a, Robert Ploutz-Snyder, Rosemary Rochford
Malaria Journal , 2008, DOI: 10.1186/1475-2875-7-238
Abstract: Using flow-cytofluorimetric analysis, the B cell phenotypes found in the peripheral blood of children aged 2–5 years were characterized during an episode of acute uncomplicated clinical malaria and four weeks post-recovery and in healthy age-matched controls.There was a significant decrease in CD19+ B lymphocytes during acute malaria. Characterization of the CD19+ B cell subsets in the peripheral blood based on expression of IgD and CD38 revealed a significant decrease in the numbers of naive 1 CD38-IgD+ B cells while there was an increase in CD38+IgD- memory 3 B cells during acute malaria. Further analysis of the peripheral B cell phenotype also identified an expansion of transitional CD10+CD19+ B cells in children following an episode of acute malaria with up to 25% of total CD19+ B cell pool residing in this subset.Children experiencing an episode of acute uncomplicated clinical malaria experienced profound disturbances in B cell homeostasis.There are over 500 million episodes of clinical Plasmodium falciparum malaria annually [1]. The primary burden of infections with P. falciparum occurs mainly in children under five years of age living in the tropical and sub-tropical areas of the world, where malaria transmission is holoendemic [2,3]. Malaria induces many pathophysiological changes including alterations in both T and B cell immunity [4]. In addition, in regions where malaria transmission is holoendemic, immunity is not acquired until after several years of exposure and can be lost rapidly following migration out of a malaria endemic region suggesting poor generation of protective immune memory [5-7]. The mechanism of immune suppression induced by P. falciparum remains an important question to solve in order to achieve protective immunity by means of vaccination.A number of observations clearly indicate that B cells are affected by P. falciparum infection. Hypergammaglobulinaemia has been a well-described feature of Plasmodium infections [8] and persons living
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