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Search Results: 1 - 10 of 854 matches for " Zachary Kwena "
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Male Circumcision in the General Population of Kisumu, Kenya: Beliefs about Protection, Risk Behaviors, HIV, and STIs
Matthew Westercamp,Robert C. Bailey,Elizabeth A. Bukusi,Michele Montandon,Zachary Kwena,Craig R. Cohen
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0015552
Abstract: Using a population-based survey we examined the behaviors, beliefs, and HIV/HSV-2 serostatus of men and women in the traditionally non-circumcising community of Kisumu, Kenya prior to establishment of voluntary medical male circumcision services. A total of 749 men and 906 women participated. Circumcision status was not associated with HIV/HSV-2 infection nor increased high risk sexual behaviors. In males, preference for being or becoming circumcised was associated with inconsistent condom use and increased lifetime number of sexual partners. Preference for circumcision was increased with understanding that circumcised men are less likely to become infected with HIV.
Predictors of Extra-Marital Partnerships among Women Married to Fishermen along Lake Victoria in Kisumu County, Kenya
Zachary Kwena, Isaac Mwanzo, Chris Shisanya, Carol Camlin, Janet Turan, Lilian Achiro, Elizabeth Bukusi
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0095298
Abstract: Background The vulnerability of women to HIV infection makes establishing predictors of women's involvement in extra-marital partnerships critical. We investigated the predictors of extra-marital partnerships among women married to fishermen. Methods The current analyses are part of a mixed methods cross-sectional survey of 1090 gender-matched interviews with 545 couples and 12 focus group discussions (FGDs) with 59 couples. Using a proportional to size simple random sample of fishermen as our index participants, we asked them to enrol in the study with their spouses. The consenting couples were interviewed simultaneously in separate private rooms. In addition to socio-economic and demographic data, we collected information on sexual behaviour including extra-marital sexual partnerships. We analysed these data using descriptive statistics and multivariate logistic regression. For FGDs, couples willing to participate were invited, consented and separated for simultaneous FGDs by gender-matched moderators. The resultant audiofiles were transcribed verbatim and translated into English for coding and thematic content analysis using NVivo 9. Results The prevalence of extra-marital partnerships among women was 6.2% within a reference time of six months. Factors that were independently associated with increased likelihood of extra-marital partnerships were domestic violence (aOR, 1.45; 95% CI 1.09–1.92), women reporting being denied a preferred sex position (aOR, 3.34; 95% CI 1.26–8.84) and spouse longer erect penis (aOR, 1.34; 95% CI 1.00–1.78). Conversely, women's age – more than 24years (aOR, 0.33; 95% CI 0.14–0.78) and women's increased sexual satisfaction (aOR, 0.92; 95% CI 0.87–0.96) were associated with reduced likelihood of extra-marital partnerships. Conclusion Domestic violence, denial of a preferred sex positions, longer erect penis, younger age and increased sexual satisfaction were the main predictors of women's involvement in extra-marital partnerships. Integration of sex education, counselling and life skills training in couple HIV prevention programs might help in risk reduction.
Short-Term Mobility and the Risk of HIV Infection among Married Couples in the Fishing Communities along Lake Victoria, Kenya
Zachary A. Kwena, Carol S. Camlin, Chris A. Shisanya, Isaac Mwanzo, Elizabeth A. Bukusi
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0054523
Abstract: Objective Mobility has long been associated with high HIV prevalence. We sought to assess sex differences in the relationship between mobility and risk for HIV infection among married couples in the fishing communities. Methods We conducted 1090 gender-matched interviews and rapid HIV testing with 545 couples proportionally representing all the different sizes of the fish-landing beaches in Kisumu County. We contacted a random sample of fishermen as our index participants and asked them to enrol in the study together with their spouses. The consenting couples were separated into different private rooms for concurrent interviews and thereafter reunited for couple rapid HIV counselling and testing. In addition to socio-economic and behavioural data, we collected information on overnight travels and divided couples in 4 groups as follows both partners not mobile, both partners mobile, only woman mobile, and only man mobile. Other than descriptive statistics, we used X2 and U tests to compare groups of variables and multivariate logistic regression to measure association between mobility and HIV infection. Results We found significant differences in the number of trips women travelled in the preceding month (mean 4.6, SD 7.1) compared to men (mean 3.3, SD 4.9; p<0.01) and when the women did travel, they were more likely to spend more days away from home than their male partners (mean 5.2 [SD 7.2] versus 3.4 SD 5.6; p = 0.01). With an HIV prevalence of 22.7% in women compared to 20.9% among men, mobile women who had non-mobile spouses had 2.1 times the likelihood of HIV infection compared to individuals in couples where both partners were non-mobile. Conclusion The mobility of fishermen’s spouses is associated with HIV infection that is not evident among fishermen themselves. Therefore, interventions in this community could be a combination of sex-specific programming that targets women and combined programming for couples.
Fishermen as a Suitable Population for HIV Intervention Trials
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
Association of Attitudes and Beliefs towards Antiretroviral Therapy with HIV-Seroprevalence in the General Population of Kisumu, Kenya
Craig R. Cohen, Michele Montandon, Adam W. Carrico, Stephen Shiboski, Alan Bostrom, Alfredo Obure, Zachary Kwena, Robert C. Bailey, Rosemary Nguti, Elizabeth A. Bukusi
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0004573
Abstract: Background Since antiretroviral therapy (ART) became available in the developed world, the prevalence of unprotected sex and the incidence of sexually transmitted infections (STIs) and HIV have increased. We hypothesized that a similar phenomenon may be occurring in sub-Saharan Africa concomitant with the scale-up of HIV treatment. Methods We conducted a general population-based survey in Kisumu, Kenya. Participants completed an interview that included demographics as well as ART-related attitudes and beliefs (AB) and then underwent HIV serological testing. Exploratory and confirmatory factor analyses of AB about ART indicated two factors: 1) ART-related risk compensation (increased sexual risk taking now that ART is available); and 2) a perception that HIV is more controllable now that ART is available. Logistic regression was used to determine associations of these factors with HIV-seroprevalence after controlling for age. Findings 1,655 (90%) of 1,844 people aged 15–49 contacted, including 749 men and 906 women, consented to participate in the study. Most participants (n = 1164; 71%) had heard of ART. Of those who had heard of ART, 23% believed ART was a cure for HIV. ART-related risk compensation (Adjusted (A)OR = 1.45, 95% CI 1.16–1.81), and a belief that ART cures HIV (AOR = 2.14, 95% CI 1.22–3.76) were associated with an increased HIV seroprevalence in men but not women after controlling for age. In particular, ART-related risk compensation was associated with an increased HIV-seroprevalence in young (aged 15–24 years) men (OR = 1.56; 95% CI 1.12–2.19). Conclusions ART-related risk compensation and a belief that ART cures HIV were associated with an increased HIV seroprevalence among men but not women. HIV prevention programs in sub-Saharan Africa that target the general population should include educational messages about ART and address the changing beliefs about HIV in the era of greater ART availability.
Protein-energy malnutrition and malaria antibody profiles in pre-school children in western Kenya: a potential diagnostic tool
AM Kwena, J Wakhisi
African Journal of Food, Agriculture, Nutrition and Development , 2012,
Abstract: Protein-energy malnutrition is a serious clinical condition with high prevalence in areas where Plasmodium falciparum is highly endemic such as western Kenya. There is a major need to determine the relationship between PEM and malaria antibody profiles especially in an area where malaria is endemic. The objective of this work, therefore, was to determine the association between PEM and specific malaria antibodies and the potential diagnostic value of the antibodies in children aged between 5 and 59 months. Cross- sectional surveys as well as analysis of sera for specific malaria antibodies were carried out at Asembo Division, Bondo District, Kisumu County, Nyanza Province. A total of sixty villages identified through random sampling with each household as the sampling unit were used for data collection. Two thousand, one hundred and twelve (2112) Children < 5 years of age were sampled in three successive cross- sectional surveys: The first survey included children < 3 years of age while the subsequent two surveys included children < 5 years of age. Anthropometric measurements were carried out followed by finger prick blood sample for assay of antibodies in sera of the study children. Statistical variables (Odds Ratio, at 95% CI) were determined using SPSS 11 and SAS computer packages. Both Multivariate and Bivariate analyses were carried out. Epi-info 2002 package was used to determine anthropometric variables. Demographic variables and malaria parasite counts were determined for all the children sampled. Circumsporozoite Surface Protein (CSP) IgG antibody was found to be significantly associated with stunting and underweight (p<0.05) but not with wasting. Liver Stage Antigen (LSA) IgG antibody was significantly associated with wasting only (p<0.05) while Merozoite Surface Protein (MSP) IgG antibody was not significantly associated with any malnutrition state. The mean concentration of CSP IgG was elevated in stunted, wasted and underweight in comparison to controls. Liverstage antigen 1 IgG was elevated in stunted children only as compared to controls, whereas MSP IgG was low in all PEM cases as compared to controls. Specific Plasmodium falciparum antibody profiles could accurately be used to determine the association between malaria and Protein-Energy Malnutrition.
Nutritional Status of Children Aged 6 to 59 Months in Community Based Education and Service Centres (Cobes) in Western Kenya
AM Kwena, JB Baliddawa
African Journal of Food, Agriculture, Nutrition and Development , 2012,
Abstract: Protein-energy malnutrition remains a major global problem. In Kenya, the prevalence of stunting and underweight has remained stable for over a decade. In Western Kenya the prevalence has remained at 30% stunting, 20% underweight and 6% wasting. Community Based Education and Service (COBES) centres are annually used by Moi University College of Health Sciences for community diagnosis of various health problems including malnutrition. The objective was to determine the prevalence of malnutrition in children aged 5 to 59 months in selected COBES health centres in Western Kenya. Cross-sectional studies were carried out between March and May 2008 in 7 out of 15 COBES centres in Western Kenya. Cluster sampling technique was used with each health centre as the sampling unit. Anthropometric measurements were performed on all children aged 6-59 months within the households sampled. The sample size depended on the number of cases seen in the households within the period of study. A total of 70 households per Health Centre were sampled. Any child between 6 months and 59 months of age in each household was sampled for nutritional status assessment. Anthropometric measurements were done on a total of approximately 700 children in the seven Health Centres: (Stunting- HAZ<-2, Wasting-WHZ <-2, underweight –WAZ<-2 and MUAC, < 12.5mm). The nutritional status of the children was determined using the WHO recommended Zscore values as well as the Kenya Government Ministry of Health recommended charts based on anthropometric measurements . Analysis of the data was carried out using Epi-info 2000 computer software. Meteitei showed the highest malnutrition revalence (53% HAZ, 15% WHZ, 27% WAZ and 18.1 MUAC) whereas Chulaimbo showed the lowest prevalence (7% HAZ, 3% WAZ). The other centres showed mixed prevalence. The reason for high prevalence in Meteitei could not be immediately ascertained but one of the possibilities could be dependence on tea and sugarcane as major cash crops at the expense of food crops. Prevalence of malnutrition in Chulaimbo was the lowest probably due to mixed farming practised in the area or successful health education in the population. The nutritional status of the children studied was within the normal range in the rest of the Centres.
T.J. Kriel (original compiler), D.J. Prinsloo and B.P. Sathekge (compilers revised edition). Popular Northern Sotho Dictionary
Kwena J. Mashamaite
Lexikos , 2011, DOI: 10.5788/10--904
Abstract: The compilers of this new edition have successfully highlighted the important additions to the last edition of the dictionary. It is important to inform prospective users about new information. It is also a marketing strategy to announce the contents of a new product in both the preface and at the back of the cover page, as is the case with this dictionary.
The Compilation of Bilingual Dictionaries between African Languages in South Africa: The Case of Northern Sotho and Tshivenda*
Kwena J. Mashamaite
Lexikos , 2011, DOI: 10.5788/11--843
Abstract: : Bilingual dictionaries between South African languages have existed for more than three centuries (Smit 1996: 232). These dictionaries have English or Afrikaans as the source language and an African language as the target language. There has never been a case of the opposite except for bi-directional bilingual dictionaries. Still more, there seems to be no record of an attempt ever made to date to compile bilingual dictionaries between African languages. This scenario illustrates the trend and history of lexicographic practice in South Africa. It is evident from most lexicographic research and products such as the existing kinds of dictionaries that Africans were never considered to be the first target group of users or prospective beneficiaries of such lexicographic products. The absence of bilingual dictionaries between African languages again provides evidence of who the lexicographers were and which population groups they represented. To fill this void, a model called the hub-and-spoke is proposed in this paper for the compilation of such kind of dictionaries. The model has been chosen for its purported economy of use. Northern Sotho and Tshivenda are the African languages that will be used as examples in the application of the model. A purposive sampling technique will be used to select lexemes that will constitute the entry words which form the central list of the proposed dictionary. Keywords: BI-DIRECTIONAL, CENTRAL LIST, CONCEPTUAL EQUIVALENCE, ENTRY WORDS, HUB-AND-SPOKE MODEL, LEXEMES, LEXICAL ITEM, LEXICAL UNIT, LEXICALISATION STATUS, PRAGMATIC CONTRAST, PURPOSIVE SAMPLING TECHNIQUE, SOURCE LANGUAGE, TARGET LANGUAGE, VARIANT STATUS Opsomming: Die samestelling van tweetalige woordeboeke tussen Afrikatalein Suid-Afrika: Die geval van Noord-Sotho en Tshivenda. Tweetaligewoordeboeke tussen Suid-Afrikaanse tale bestaan vir meer as drie eeue (Smit 1996: 232). Hierdiewoordeboeke het Engels of Afrikaans as brontaal en 'n Afrikataal as doeltaal. Daar was nooit 'n skyn geen rekord te wees van 'n poging tot op hede om tweetalige woordeboeke tussen Afrikatalesaam te stel nie.Hierdie scenario illustreer die verloop en geskiedenis van leksikografiese praktyk in Suid-Afrika. Dit is duidelik uit die meeste leksikografiese navorsing en produkte soos die bestaandewoordeboeksoorte dat Afrikane nooit beskou is as die eerste doelgroep gebruikers of waarskynlikevoordeeltrekkers uit sulke leksikografiese produkte nie. Die afwesigheid van tweetalige woordeboeketussen Afrikatale gee ook 'n aanduiding van wie die leksikograwe was en aan watter bevolkingsgroe
Laboratory Driven, Lean-to-Adaptive Prototyping in Parallel for Web Software Project Identification and Application Development in Health Science Research  [PDF]
Zachary Dwight, Alexa Barnes
Journal of Software Engineering and Applications (JSEA) , 2012, DOI: 10.4236/jsea.2012.52010
Abstract: Clinical research laboratories, bioinformatics core facilities, and health science organizations often rely on heavy planning based software development models to propose, build, and distribute software as a consumable product. Projects in non-agile software life cycles tend to have rigid “plan-design-build” milestones, increasing the amount of time needed for software development completion. Though the classic software development approach is needed for large-scale and organizational projects, clinical research laboratories can expedite software development while maintaining quality by using lean prototyping as a condition of project advancement to a committed adaptive software development cycle. Software projects benefit from an agile methodology due to the active and changing requirements often guided by experimental data driven models. We describe a lean to adaptive method used in parallel with laboratory bench work to develop quality software quickly that meets the requirements of a fast-paced research environment and reducing time to production, providing immediate value to the end user, and limiting unnecessary development practices in favor of results.
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