113 results on '"Oyugi J"'
Search Results
2. The Price of Adherence: Qualitative Findings From HIV Positive Individuals Purchasing Fixed-Dose Combination Generic HIV Antiretroviral Therapy in Kampala, Uganda
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Crane, J. T., Kawuma, A., Oyugi, J. H., Byakika, J. T., Moss, A., Bourgois, P., and Bangsberg, D. R.
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- 2006
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3. Patterns of variation in waterbird numbers on four Rift Valley lakes in Kenya, 1991–1999
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Owino, A. O., Oyugi, J. O., Nasirwa, O. O., and Bennun, L. A.
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- 2001
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4. High MERS-CoV seropositivity associated with camel herd profile, husbandry practices and household socio-demographic characteristics in Northern Kenya
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Ngere, I., primary, Munyua, P., additional, Harcourt, J., additional, Hunsperger, E., additional, Thornburg, N., additional, Muturi, M., additional, Osoro, E., additional, Gachohi, J., additional, Bodha, B., additional, Okotu, B., additional, Oyugi, J., additional, Jaoko, W., additional, Mwatondo, A., additional, Njenga, K., additional, and Widdowson, M. A., additional
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- 2020
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5. Adherence to HIV antiretroviral therapy in HIV+ Ugandan patients purchasing therapy
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Byakika-Tusiime, J, Oyugi, J H, Tumwikirize, W A, Katabira, E T, Mugyenyi, P N, and Bangsberg, D R
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- 2005
6. ANTIMICROBIAL EFFICACY OF HIBISCUS FUSCUS GARCKE AQUEOUS AND ETHANOL EXTRACTS ON TOOTH ROOT CANAL MICROORGANISMS.
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Maina, S. W., Dimba, E., Oyugi, J. O., and Mwangi, J. W.
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ANTI-infective agents ,ROOT canal treatment ,ETHANOL ,EXTRACTS ,LACTOBACILLUS - Abstract
Objective: To determine the antimicrobial efficacy of Hibiscus fucus extracts against six root canal microorganisms. Design: In-vitro analytical study. Setting: Department of Medical Microbiology, University of Nairobi. Material and Methods: Hibiscus fuscus twigs were collected, dried and ground into coarse powder which was macerated in sterile distilled water and 80% ethanol. The aqueous filtrates were lipolyzed, while the ethanol filtrates were reduced, and oven dried into powder. Tenfold liquid microdilution of 50 mg/ml Hibiscus fuscus extracts against pure strains of Enterococcus faecalis, Streptococcus mutans, Staphylococcus aureus, Fusobacterium nucleatum, Lactobacillus acidophilus and Candida albicans were incubated for 24 and 48 hours. Sodium hypochlorite 5.25% and 2% Chlorhexidine gluconate were the controls. Outcome measures: Percentage growth inhibition measured by changes in growth of microorganism cultures exposed to Hibiscus fuscus extracts. One-way analysis of variance and Tukey's HSD test were used to test for any differences. Results: Fifty mg/ml Hibiscus fuscus aqueous extracts attained 122.01% ± 22.89, at 95% CI [108.79, 135] and (105.73% ± 7.64, at 95% CI [101.32,110.14] growth inhibition against Enterococcus faecalis and Fusobacterium nucleatum for 24 hours incubation similar to those obtained with 5.25% Sodium hypochlorite, and 2% Chlorhexidine gluconate at p=0.899947 (Tukey's HSD). Other bacteria tested and Candida albicans showed resistance. Conclusion: Fifty mg/ml Hibiscus fuscus aqueous extract showed bactericidal efficacy against E. faecalis (ATCC® 29212 ™), and F. nucleatum (ATCC® 25586™) comparable to 5.25% Sodium hypochlorite and 2% Chlorhexidine gluconate. Investigation to test pure Hibiscus fuscus extracts as a potential source of root canal irrigant is needed. [ABSTRACT FROM AUTHOR]
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- 2021
7. Distance learning approach to train health sciences students at the University of Nairobi
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Nyaga, L.W., Gachuno, O.W., Nduati, R.W., Owek, C.J., Ndege, W.M., Sigei, M.C., Oyugi, J., and Kibwage, I.O.
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Background: The University of Nairobi (UoN) College of Health Sciences (CHS) established Partnership for Innovative Medical Education in Kenya (PRIME-K) programmeme to enhance health outcomes in Kenya through extending the reach ofmedical training outside Nairobi to help health sciences students enhance their handson skills. The institution partnered with 18 hospitals in rural and urban centers as the UoN teaching hospitals referred to as decentralised training sites and appointed medical staff from these sites as adjunct faculty of the University of Nairobi to train health sciences students on hands-on skills. Webcasts presentations were conducted by undergraduate students from all the schools at the College of Health Sciences during their elective term and clinical rotations at the decentralised training sites to present on the ground health issues.Objective: To describe how the University of Nairobi (UoN) used the distance learning platform from the Medical Education Partnership Initiative (MEPI) grant to outspread medical education to the underserved communities located in rural and urban surroundings across the country.Design: A cross-sectional studySetting: The University of Nairobi College of Health SciencesSubjects: Health Sciences students of the College of Health Sciences, University of Nairobi and Hospital staff in 18 hospitals in rural and urban centersResults: A total of 670 health sciences students participated in the decentralised learning, a total of 549 health sciences students participated in webcast presentations over a period of four years from 2012 to 2015, and a total of 48 medical consultants and specialists from the decentralised training sites were appointed as Adjunct Faculty of the College of Health Sciences – University of Nairobi.Conclusion: Webcast presentations provided information on priority health conditions afflicting the communities at the decentralised sites which would not be the case in the institution’s teaching hospital. Adjunct faculty at the decentralised training sites provided a platform enabling students to enhance their practical skills in line of health profession and offered mentorship on coping in rural settings where there is scarcity of medical equipment and disposable materials in the health facilities and lack of constant electric power supply and clean water among others
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- 2017
8. Directly observed road safety compliance by Motor Cycle Riders after a 5- Year Road Safety Campaign in Naivasha, Kenya
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Odhiambo, W.A., Hasan, S., Mock, C., Oyugi, J., and Kagereki, E.
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Objective: To assess the extent of compliance with road safety regulations by motorcycle riders following a five year road safety campaign in Naivasha town, Kenya.Design: A cross sectional study.Setting: Naivasha town, Nakuru county, Kenya.Results: A total of 9,280 MCs ferrying 13,733 people were observed. Less than 1% complied with all the four road safety requirements. The overall helmet wearing compliance was 31%. MC driver helmet compliance was 42% which was five timeshigher than passenger helmet compliance. Female passengers were twice less likely to wear helmet than males.Conclusion: Despite the five-year road safety campaign, compliance among MC users remains low particularly among the passengers and more so female passengers. Does Kenya need to rethink the motor cycle road safety policy?
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- 2017
9. Impact of devolution on the trends of paediatric malaria admissions and mortality in Homa-Bay County, Kenya
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Kodhiambo, M O, primary, Amugune, B K, primary, and Oyugi, J O, primary
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- 2018
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10. Potential biomarkers associated with discrimination between latent and active pulmonary tuberculosis
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Kamakia, R., primary, Kiazyk, S., additional, Waruk, J., additional, Meyers, A., additional, Ochanda, J., additional, Ball, T. B., additional, and Oyugi, J., additional
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- 2017
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11. Retaining nurses at rural stes through distance learning, the University of Nairobi experience
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Kibwage, I.O., primary, Bosire, K., additional, Matiangi, M., additional, Omoni, G., additional, Macharia, J., additional, Njiri, F., additional, Nduati, R., additional, Mwanda, W., additional, Oyugi, J., additional, Gachuno, O., additional, and Kiarie, J., additional
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- 2016
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12. Hepatitis B virus genotypes and unique recombinants circulating among outpatients in selected hospitals in Kenya
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Ochwoto, M., primary, Kimotho, J., additional, Oyugi, J., additional, Andonov, A., additional, Songok, E., additional, and Osiowy, C., additional
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- 2016
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13. S14.3 Immune activation, gene expression and hiv acquisition risk
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Fowke, KR, primary, Boily-Larouche, G, additional, Mwangi, L, additional, Mungai, J, additional, Akolo, M, additional, Kimani, M, additional, Oyugi, J, additional, Kimani, J, additional, and Lajoie, J, additional
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- 2015
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14. Detection and Genome Analysis of a Lineage III Peste Des Petits Ruminants Virus in Kenya in 2011
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Dundon, W. G., primary, Kihu, S. M., additional, Gitao, G. C., additional, Bebora, L. C., additional, John, N. M., additional, Oyugi, J. O., additional, Loitsch, A., additional, and Diallo, A., additional
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- 2015
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15. Detection and Genome Analysis of a Lineage III Peste Des Petits Ruminants Virus in Kenya in 2011.
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Dundon, W. G., Kihu, S. M., Gitao, G. C., Bebora, L. C., John, N. M., Oyugi, J. O., Loitsch, A., and Diallo, A.
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PESTE des petits ruminants ,ANIMAL genetics ,REVERSE transcriptase polymerase chain reaction ,WATCHFUL waiting ,DIAGNOSIS - Abstract
In May 2011 in Turkana County, north-western Kenya, tissue samples were collected from goats suspected of having died of peste des petits ruminant ( PPR) disease, an acute viral disease of small ruminants. The samples were processed and tested by reverse transcriptase PCR for the presence of PPR viral RNA. The positive samples were sequenced and identified as belonging to peste des petits ruminants virus ( PPRV) lineage III. Full-genome analysis of one of the positive samples revealed that the virus causing disease in Kenya in 2011 was 95.7% identical to the full genome of a virus isolated in Uganda in 2012 and that a segment of the viral fusion gene was 100% identical to that of a virus circulating in Tanzania in 2013. These data strongly indicate transboundary movement of lineage III viruses between Eastern Africa countries and have significant implications for surveillance and control of this important disease as it moves southwards in Africa. [ABSTRACT FROM AUTHOR]
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- 2017
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16. Identification of preferential CD4+ T-cell targets for HIV infection in the cervix.
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Joag, V R, McKinnon, L R, Liu, J, Kidane, S T, Yudin, M H, Nyanga, B, Kimwaki, S, Besel, K E, Obila, J O, Huibner, S, Oyugi, J O, Arthos, J, Anzala, O, Kimani, J, Ostrowski, M A, and Kaul, R
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- 2016
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17. Surveys of waterbirds in Kenya, 1995: Lake Victoria wetlands, south Kenya coast and Tana River dams
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Nasirwa, O., Oyugi, J., Jackson, C., Lens, L., Bennun, L., and Seys, J.
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ISW, Kenya ,Kenya, Victoria L ,Aquatic birds - Abstract
In February 1995, eight sites around Lake Victoria and beaches, reefs and creeks along the Kenyan coast from Vanga to Sabaki River mouth (around 220 km of shoreline, split into 15 sites) were surveyed and waterbirds counted. In March 1995, waterbirds were counted on the five large dams along the upper Tana River.These represent the first waterbird surveys for almost all of these sites. Five sites (Vanga Creek, Kilifi-Mida Beach, Malindi Marine Park, Sabaki River Mouth and Masinga Dam) qualify as Globally Important Bird Areas on the basis of their waterbird populations (and hence as potential Ramsar sites).
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- 1995
18. Enhancing capacity of research ethics review committees in developing countries: The Kenyan example.
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Omosa-Manyonyi, G., Jaoko, W., Bhatt, K. M., Langat, S. K., Mutua, G., Farah, B., Nyange, J., Olenja, J., Oyugi, J., Wakasiaka, S., Khaniri, M., Fowke, K., Kaul, R., and Anzala, O.
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BIOETHICS ,CLINICAL trials ,ETHICS committees - Abstract
Background. The increased number of clinical trials taking place in developing countries and the complexity of trial protocols mandate that local ethics review committees (ERCs) reviewing them have the capacity to ensure that they are conducted to the highest ethical standards. Methods. The Kenya AIDS Vaccine Initiative (KAVI) Institute of Clinical Research (ICR) (KAVI-ICR) and the Kenyan National Council for Science and Technology (NCST) embarked on an exercise to enhance the capacity of ERCs in Kenya to review such protocols. This process involved conducting an audit of all ERCs in the country, and performing training needs assessments to identify knowledge and capacity gaps. Information obtained was used to develop training materials for ERC members at workshops conducted in different parts of the country. Results. Five accredited and 13 non-accredited ERCs were identified. Four of the accredited ERCs were located in the capital city of Kenya, Nairobi. The most common challenges cited by participants during the needs assessments were excess workload, and a lack of co-ordination and/or communication between the ERCs. Subsequently, 140 ERC members from 17 institutions across the country were trained as follows: 36 from institutions in the western part of Kenya, 38 from institutions in the south-eastern coastal region, 38 from the eastern region and 44 from Nairobi. Conclusion. The KAVI-ICR and the NCST have developed training modules for training ERC members in Kenya and are in the process of developing a manual to train members. The Kenyan experience may be used to enhance the capacity of ERCs in the East African region. [ABSTRACT FROM AUTHOR]
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- 2014
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19. Identification of preferential CD4+T-cell targets for HIV infection in the cervix
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Joag, V R, McKinnon, L R, Liu, J, Kidane, S T, Yudin, M H, Nyanga, B, Kimwaki, S, Besel, K E, Obila, J O, Huibner, S, Oyugi, J O, Arthos, J, Anzala, O, Kimani, J, Ostrowski, M A, and Kaul, R
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A better understanding of the cellular targets of HIV infection in the female genital tract may inform HIV prevention efforts. Proposed correlates of cellular susceptibility include the HIV co-receptor CCR5, peripheral homing integrins, and immune activation. We used a CCR5-tropic pseudovirus to quantify HIV entry into unstimulated endocervical CD4+T cells collected by cytobrush. Virus entry was threefold higher into cervix-derived CD4+T cells than blood, but was strongly correlated between these two compartments. Cervix-derived CD4+T cells expressing CD69, α4β7, or α4β1were preferential HIV targets; this enhanced susceptibility was strongly correlated with increased CCR5 expression in α4β7+and CD69+CD4+T cells, and to a lesser extent in α4β1+CD4+T cells. Direct binding of gp140 to integrins was not observed, integrin inhibitors had no effect on virus entry, and pseudotypes with an env that preferentially binds α4β7still demonstrated enhanced entry into α4β1+cells. In summary, a rapid and sensitive HIV entry assay demonstrated enhanced susceptibility of activated endocervical CD4+T cells, and those expressing α4β7or α4β1. This may relate to increased CCR5 expression by these cell subsets, but did not appear to be due to direct interaction of α4β7or α4β1with HIV envelope.
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- 2016
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20. Cytotoxic T cell responses to multiple conserved HIV epitopes in HIV-resistant prostitutes in Nairobi.
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Rowland-Jones, S L, primary, Dong, T, additional, Fowke, K R, additional, Kimani, J, additional, Krausa, P, additional, Newell, H, additional, Blanchard, T, additional, Ariyoshi, K, additional, Oyugi, J, additional, Ngugi, E, additional, Bwayo, J, additional, MacDonald, K S, additional, McMichael, A J, additional, and Plummer, F A, additional
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- 1998
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21. Risk Factors for Chlamydia trachomatis Pelvic Inflammatory Disease among Sex Workers in Nairobi, Kenya
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Kimani, J., primary, Maclean, I. W., additional, Bwayo, J. J., additional, MacDonald, K., additional, Oyugi, J., additional, Maitha, G. M., additional, Peeling, R. W., additional, Cheang, M., additional, Nagelkerke, N. J. D., additional, Plummer, F. A., additional, and Brunham, R. C., additional
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- 1996
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22. Influence of HLA supertypes on susceptibility and resistance to human immunodeficiency virus type 1 infection.
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MacDonald KS, Fowke KR, Kimani J, Dunand VA, Nagelkerke NJD, Ball TB, Oyugi J, Njagi E, Gaur LK, Brunham RC, Wade J, Luscher MA, Krausa P, Rowland-Jones S, Ngugi E, Bwayo JJ, Plummer FA, MacDonald, K S, Fowke, K R, and Kimani, J
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Certain human leukocyte antigens, by presenting conserved immunogenic epitopes for T cell recognition, may, in part, account for the observed differences in human immunodeficiency virus type 1 (HIV-1) susceptibility. To determine whether HLA polymorphism influences HIV-1 susceptibility, a longitudinal cohort of highly HIV-1-exposed female sex workers based in Nairobi, Kenya, was prospectively analyzed. Decreased HIV-1 infection risk was strongly associated with possession of a cluster of closely related HLA alleles (A2/6802 supertype; incidence rate ratio [IRR], 0.45; 95% confidence interval [CI], 0.27-0.72; P=.0003). The alleles in this supertype are known in some cases to present the same peptide epitopes for T cell recognition. In addition, resistance to HIV-1 infection was independently associated with HLA DRB1*01 (IRR, 0.22; 95% CI, 0.06-0.60; P=.0003), which suggests that anti-HIV-1 class II restricted CD4 effector mechanisms may play an important role in protecting against viral challenge. These data provide further evidence that resistance to HIV-1 infection in this cohort of sex workers is immunologically mediated. [ABSTRACT FROM AUTHOR]
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- 2000
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23. Human leucocyte antigen supertypes and immune susceptibility to HIV-1, implications for vaccine design
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MacDonald, K. S., Matukas, L., Embree, J. E., Fowke, K., Kimani, J., Nagelkerke, N. J., Oyugi, J., Kiama, P., Kaul, R., and Luscher, M. A.
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- 2001
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24. Routine versus clinically driven laboratory monitoring of HIV antiretroviral therapy in Africa (DART): a randomised non-inferiority trial
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DART Trial Team, Mugyenyi, P, Walker, AS, Hakim, J, Munderi, P, Gibb, DM, Kityo, C, Reid, A, Grosskurth, H, Darbyshire, JH, Ssali, F, Bray, D, Katabira, E, Babiker, AG, Gilks, CF, Kabuye, G, Nsibambi, D, Kasirye, R, Zalwango, E, Nakazibwe, M, Kikaire, B, Nassuna, G, Massa, R, Fadhiru, K, Namyalo, M, Zalwango, A, Generous, L, Khauka, P, Rutikarayo, N, Nakahima, W, Mugisha, A, Todd, J, Levin, J, Muyingo, S, Ruberantwari, A, Kaleebu, P, Yirrell, D, Ndembi, N, Lyagoba, F, Hughes, P, Aber, M, Lara, A Medina, Foster, S, Amurwon, J, Wakholi, B Nyanzi, Whitworth, J, Wangati, K, Amuron, B, Kajungu, D, Nakiyingi, J, Omony, W, Tumukunde, D, Otim, T, Kabanda, J, Musana, H, Akao, J, Kyomugisha, H, Byamukama, A, Sabiiti, J, Komugyena, J, Wavamunno, P, Mukiibi, S, Drasiku, A, Byaruhanga, R, Labeja, O, Katundu, P, Tugume, S, Awio, P, Namazzi, A, Bakeinyaga, GT, Katabira, H, Abaine, D, Tukamushaba, J, Anywar, W, Ojiambo, W, Angweng, E, Murungi, S, Haguma, W, Atwiine, S, Kigozi, J, Namale, L, Mukose, A, Mulindwa, G, Atwiine, D, Muhwezi, A, Nimwesiga, E, Barungi, G, Takubwa, J, Mwebesa, D, Kagina, G, Mulindwa, M, Ahimbisibwe, F, Mwesigwa, P, Akuma, S, Zawedde, C, Nyiraguhirwa, D, Tumusiime, C, Bagaya, L, Namara, W, Karungi, J, Kankunda, R, Enzama, R, Latif, A, Robertson, V, Chidziva, E, Bulaya-Tembo, R, Musoro, G, Taziwa, F, Chimbetete, C, Chakonza, L, Mawora, A, Muvirimi, C, Tinago, G, Svovanapasis, P, Simango, M, Chirema, O, Machingura, J, Mutsai, S, Phiri, M, Bafana, T, Chirara, M, Muchabaiwa, L, Muzambi, M, Mutowo, J, Chivhunga, T, Chigwedere, E, Pascoe, M, Warambwa, C, Zengeza, E, Mapinge, F, Makota, S, Jamu, A, Ngorima, N, Chirairo, H, Chitsungo, S, Chimanzi, J, Maweni, C, Warara, R, Matongo, M, Mudzingwa, S, Jangano, M, Moyo, K, Vere, L, Mdege, N, Machingura, I, Ronald, A, Kambungu, A, Lutwama, F, Mambule, I, Nanfuka, A, Walusimbi, J, Nabankema, E, Nalumenya, R, Namuli, T, Kulume, R, Namata, I, Nyachwo, L, Florence, A, Kusiima, A, Lubwama, E, Nairuba, R, Oketta, F, Buluma, E, Waita, R, Ojiambo, H, Sadik, F, Wanyama, J, Nabongo, P, Oyugi, J, Sematala, F, Muganzi, A, Twijukye, C, Byakwaga, H, Ochai, R, Muhweezi, D, Coutinho, A, Etukoit, B, Gilks, C, Boocock, K, Puddephatt, C, Grundy, C, Bohannon, J, Winogron, D, Burke, A, Babiker, A, Wilkes, H, Rauchenberger, M, Sheehan, S, Spencer-Drake, C, Taylor, K, Spyer, M, Ferrier, A, Naidoo, B, Dunn, D, Goodall, R, Peto, L, Nanfuka, R, Mufuka-Kapuya, C, Pillay, D, McCormick, A, Weller, I, Bahendeka, S, Bassett, M, Wapakhabulo, A Chogo, Gazzard, B, Mapuchere, C, Mugurungi, O, Burke, C, Jones, S, Newland, C, Pearce, G, Rahim, S, Rooney, J, Smith, M, Snowden, W, Steens, J-M, Breckenridge, A, McLaren, A, Hill, C, Matenga, J, Pozniak, A, Serwadda, D, Peto, T, Palfreeman, A, and Borok, M
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Male ,Neutrophils ,HIV Infections ,law.invention ,Hemoglobins ,Randomized controlled trial ,law ,Medicine ,Urea ,HIV-Associated Lipodystrophy Syndrome ,Hazard ratio ,Lamivudine ,Anemia ,General Medicine ,Middle Aged ,Viral Load ,Anti-Retroviral Agents ,Creatinine ,Disease Progression ,RNA, Viral ,Female ,Drug Monitoring ,Zidovudine ,medicine.drug ,Glomerular Filtration Rate ,Adult ,medicine.medical_specialty ,Neutropenia ,Adolescent ,Organophosphonates ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,Fast track — Articles ,Humans ,Nevirapine ,Adverse effect ,Tenofovir ,Aged ,Intention-to-treat analysis ,business.industry ,Adenine ,medicine.disease ,Dideoxynucleosides ,CD4 Lymphocyte Count ,Clinical trial ,Clinical research ,Immunology ,Africa ,HIV-1 ,business - Abstract
BACKGROUND: HIV antiretroviral therapy (ART) is often managed without routine laboratory monitoring in Africa; however, the effect of this approach is unknown. This trial investigated whether routine toxicity and efficacy monitoring of HIV-infected patients receiving ART had an important long-term effect on clinical outcomes in Africa. METHODS: In this open, non-inferiority trial in three centres in Uganda and one in Zimbabwe, 3321 symptomatic, ART-naive, HIV-infected adults with CD4 counts less than 200 cells per microL starting ART were randomly assigned to laboratory and clinical monitoring (LCM; n=1659) or clinically driven monitoring (CDM; n=1662) by a computer-generated list. Haematology, biochemistry, and CD4-cell counts were done every 12 weeks. In the LCM group, results were available to clinicians; in the CDM group, results (apart from CD4-cell count) could be requested if clinically indicated and grade 4 toxicities were available. Participants switched to second-line ART after new or recurrent WHO stage 4 events in both groups, or CD4 count less than 100 cells per microL (LCM only). Co-primary endpoints were new WHO stage 4 HIV events or death, and serious adverse events. Non-inferiority was defined as the upper 95% confidence limit for the hazard ratio (HR) for new WHO stage 4 events or death being no greater than 1.18. Analyses were by intention to treat. This study is registered, number ISRCTN13968779. FINDINGS: Two participants assigned to CDM and three to LCM were excluded from analyses. 5-year survival was 87% (95% CI 85-88) in the CDM group and 90% (88-91) in the LCM group, and 122 (7%) and 112 (7%) participants, respectively, were lost to follow-up over median 4.9 years' follow-up. 459 (28%) participants receiving CDM versus 356 (21%) LCM had a new WHO stage 4 event or died (6.94 [95% CI 6.33-7.60] vs 5.24 [4.72-5.81] per 100 person-years; absolute difference 1.70 per 100 person-years [0.87-2.54]; HR 1.31 [1.14-1.51]; p=0.0001). Differences in disease progression occurred from the third year on ART, whereas higher rates of switch to second-line treatment occurred in LCM from the second year. 283 (17%) participants receiving CDM versus 260 (16%) LCM had a new serious adverse event (HR 1.12 [0.94-1.32]; p=0.19), with anaemia the most common (76 vs 61 cases). INTERPRETATION: ART can be delivered safely without routine laboratory monitoring for toxic effects, but differences in disease progression suggest a role for monitoring of CD4-cell count from the second year of ART to guide the switch to second-line treatment. FUNDING: UK Medical Research Council, the UK Department for International Development, the Rockefeller Foundation, GlaxoSmithKline, Gilead Sciences, Boehringer-Ingelheim, and Abbott Laboratories.
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25. Broadly cross-reactive HIV-specific cytotoxic T-lymphocytes ill highly-exposed persistently seronegative donors
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Rowland-Janes, S. L., Dong, T., Darrell, L., Ogg, G., Hansasuta, P., Krausa, P., Kimani, J., Sabally, S., Ariyoshi, K., and Oyugi, J.
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- 1999
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26. Impact of second-line antiretroviral regimens on lipid profiles in an African setting: The DART trial sub-study
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Gomo, Z. A. R., Hakim, J. G., Walker, S. A., Tinago, W., Mandozana, G., Kityo, C., Munderi, P., Katabira, E., Reid, A., Gibb, D. M., Gilks, C. F., Grosskurth, H., Kabuye, G., Nsibambi, D., Kasirye, R., Zalwango, E., Nakazibwe, M., Kikaire, B., Nassuna, G., Massa, R., Fadhiru, K., Namyalo, M., Zalwango, A., Generous, L., Khauka, P., Rutikarayo, N., Nakahima, W., Mugisha, A., Todd, J., Levin, J., Muyingo, S., Ruberantwari, A., Kaleebu, P., Yirrell, D., Ndembi, N., Lyagoba, F., Hughes, P., Aber, M., Lara, A. M., Medina, A., Foster, S., Amurwon, J., Wakholi, B. N., Nyanzi, B., Wangati, K., Amuron, B., Kajungu, D., Nakiyingi, J., Omony, W., Mugyenyi, P., Ssali, F., Tumukunde, D., Otim, T., Kabanda, J., Musana, H., Akao, J., Kyomugisha, H., Byamukama, A., Sabiiti, J., Komugyena, J., Wavamunno, P., Mukiibi, S., Drasiku, A., Byaruhanga, R., Labeja, O., Katundu, P., Tugume, S., Awio, P., Namazzi, A., Bakeinyaga, G. T., Abaine, D., Tukamushaba, J., Anywar, W., Ojiambo, W., Angweng, E., Murungi, S., Haguma, W., Atwiine, S., Kigozi, J., Namale, L., Mukose, A., Mulindwa, G., Atwiine, D., Muhwezi, A., Nimwesiga, E., Barungi, G., Takubwa, J., Mwebesa, D., Kagina, G., Mulindwa, M., Ahimbisibwe, F., Mwesigwa, P., Akuma, S., Zawedde, C., Nyiraguhirwa, D., Tumusiime, C., Bagaya, L., Namara, W., Karungi, J., Kankunda, R., Enzama, R., Latif, A., Robertson, V., Chidziva, E., Bulaya-Tembo, R., Musoro, G., Taziwa, F., Chimbetete, C., Chakonza, L., Mawora, A., Muvirimi, C., Svovanapasis, P., Simango, M., Chirema, O., Machingura, J., Mutsai, S., Phiri, M., Bafana, T., Chirara, M., Muchabaiwa, L., Muzambi, M., Chigwedere, E., Pascoe, M., Warambwa, C., Zengeza, E., Mapinge, F., Makota, S., Jamu, A., Ngorima, N., Chirairo, H., Chitsungo, S., Chimanzi, J., Maweni, C., Warara, R., Matongo, M., Mudzingwa, S., Jangano, M., Moyo, K., Vere, L., Machingura, I., Ronald, A., Kambungu, A., Lutwama, F., Mambule, I., Nanfuka, A., Walusimbi, J., Nabankema, E., Nalumenya, R., Namuli, T., Kulume, R., Namata, I., Nyachwo, L., Florence, A., Kusiima, A., Lubwama, E., Nairuba, R., Oketta, F., Buluma, E., Waita, R., Ojiambo, H., Sadik, F., Wanyama, J., Nabongo, P., Oyugi, J., Sematala, F., Muganzi, A., Twijukye, C., Byakwaga, H., Ochai, R., Muhweezi, D., Coutinho, A., Etukoit, B., Boocock, K., Puddephatt, C., Grundy, C., Bohannon, J., Winogron, D., Darbyshire, J., Burke, A., Bray, D., Babiker, A., Wilkes, H., Rauchenberger, M., Sheehan, S., Spencer-Drake, C., Taylor, K., Spyer, M., Ferrier, A., Naidoo, B., Dunn, D., Ruth Goodall, Nanfuka, R., Mufuka-Kapuya, C., Pillay, D., Goodall, R., Kapaata, A., Katuramur, M., Magala, R., Magambo, B., Mataruka, K., Mccormick, A., Mugarura, L., Musunga, T., Nabankkema, M., Nkalubo, J., Nkurunziza, P., Parry, C., Weller, I., Bahendeka, S., Bassett, M., Chogo Wapakhabulo, A., Gazzard, B., Mapuchere, C., Mugurungi, O., Burke, C., Distel, M., Jones, S., Loeliger, E., Naidoo, P., Newland, C., Pearce, G., Rahim, S., Rooney, J., Smith, M., Snowden, W., Steens, J. -M, Breckenridge, A., Mclaren, A., Hill, C., Matenga, J., Pozniak, A., Serwadda, D., Peto, T., Palfreeman, A., and Borok, M.
27. Training needs assessment for clinicians at antiretroviral therapy clinics: evidence from a national survey in Uganda
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Namagala Elizabeth, Lule Frank, Kaye Richard, Sebuyira Lydia, Oyugi Jessica H, Weaver Marcia R, Schneider Gisela, Lutalo Ibrahim M, Scheld W, McAdam Keith PWJ, and Sande Merle A
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Medicine (General) ,R5-920 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background To increase access to antiretroviral therapy in resource-limited settings, several experts recommend "task shifting" from doctors to clinical officers, nurses and midwives. This study sought to identify task shifting that has already occurred and assess the antiretroviral therapy training needs among clinicians to whom tasks have shifted. Methods The Infectious Diseases Institute, in collaboration with the Ugandan Ministry of Health, surveyed health professionals and heads of antiretroviral therapy clinics at a stratified random sample of 44 health facilities accredited to provide this therapy. A sample of 265 doctors, clinical officers, nurses and midwives reported on tasks they performed, previous human immunodeficiency virus training, and self-assessment of knowledge of human immunodeficiency virus and antiretroviral therapy. Heads of the antiretroviral therapy clinics reported on clinic characteristics. Results Thirty of 33 doctors (91%), 24 of 40 clinical officers (60%), 16 of 114 nurses (14%) and 13 of 54 midwives (24%) who worked in accredited antiretroviral therapy clinics reported that they prescribed this therapy (p < 0.001). Sixty-four percent of the people who prescribed antiretroviral therapy were not doctors. Among professionals who prescribed it, 76% of doctors, 62% of clinical officers, 62% of nurses and 51% of midwives were trained in initiating patients on antiretroviral therapy (p = 0.457); 73%, 46%, 50% and 23%, respectively, were trained in monitoring patients on the therapy (p = 0.017). Seven percent of doctors, 42% of clinical officers, 35% of nurses and 77% of midwives assessed that their overall knowledge of antiretroviral therapy was lower than good (p = 0.001). Conclusion Training initiatives should be an integral part of the support for task shifting and ensure that antiretroviral therapy is used correctly and that toxicity or drug resistance do not reverse accomplishments to date.
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- 2009
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28. Testing for trends in waterbird numbers in the southern Rift Valley of Kenya, 1991-2000.
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Owino, A., Bennun, L.A., Nasirwa, O., and Oyugi, J.
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ORNITHOLOGY ,WATER birds - Abstract
Presents an abstract on the article 'Testing for Trends in Waterbird Numbers in the Southern Rift Valley of Kenya, 1991-2000.'
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- 2001
29. Acetylsalicylic acid inhibition of the lipoxygenase pathway: Implications for HIV prevention.
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Kowatsch MM, Winter T, Oyugi J, Kimani J, Lajoie J, Aukema HM, and Fowke KR
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- Humans, Female, Adult, Lipoxygenase metabolism, Lipoxygenase Inhibitors pharmacology, HIV Infections drug therapy, HIV Infections prevention & control, Aspirin pharmacology, Oxylipins metabolism, Oxylipins blood
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Background: 1.5 million new HIV infections occurred in 2021, suggesting new prevention methods are needed. Inflammation increases the risk for HIV acquisition by attracting HIV target cells to the female genital tract (FGT). In a pilot study, acetylsalicylic acid (ASA/Aspirin) decreased the proportion of FGT HIV target cells by 35 %. However, the mechanism remains unknown., Methods: Women from Nairobi, Kenya took low-dose ASA (81 mg) daily for 6-weeks. Free oxylipins in the plasma were quantified by high-performance liquid chromatography-tandem mass spectroscopy., Results: Oxylipins from 9 fatty acid substrates were detected, with more than one analyte from 4 substrates reduced post-ASA. Summary analysis found ASA downregulated cyclooxygenase and lipoxygenase but not cytochrome P450 activity with a lower n-6/n-3 oxylipin profile, reflecting reduced inflammation post-ASA., Conclusions: Inflammation is associated with increased lipoxygenase activity and HIV risk. Our data suggests ASA reduces inflammation through downregulation of oxylipins. Understanding how ASA reduces inflammation may lead to novel HIV prevention approaches., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare., (Copyright © 2024. Published by Elsevier Inc.)
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- 2024
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30. Transmission of SARS-CoV-2 among underserved pastoralist communities in Kajiado County, Kenya: 2020-2022.
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Macharia Z, Ogoti B, Otieno M, Gitonga P, Bosco-Lauth A, Maritim M, Lemarkoko E, Keya A, Sankok J, Gitao G, Onono J, Oyugi J, and Bowen RA
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- Humans, Female, Male, Kenya epidemiology, Adult, Middle Aged, Adolescent, Young Adult, Immunoglobulin G blood, Child, Aged, Child, Preschool, Retrospective Studies, Enzyme-Linked Immunosorbent Assay, Infant, COVID-19 epidemiology, COVID-19 transmission, COVID-19 diagnosis, SARS-CoV-2 immunology, SARS-CoV-2 isolation & purification, Antibodies, Viral blood
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Initial transmission of severe acute respiratory syndrome virus-2 (SARS-CoV-2) was highest in densely populated regions of Kenya. Transmission gradually trickled down to the less densely populated, remote and underserved regions such as the pastoral regions of Kajiado County which are characterized by poor healthcare systems. Molecular assays that were pivotal for COVID-19 diagnosis were not available in these regions. Serology is an alternative method for retrospectively tracking the transmission of SARS-CoV-2 in such populations. Dry blood spots (DBS) were prepared from consenting patients attending six health facilities in Kajiado County from March 2020 to March 2022. Upon elution, we conducted an enzyme-linked immunosorbent assay (ELISA) for the detection of SARS-Cov-2 IgG antibodies. Of the 908 DBSs we analyzed, 706 (78%) were from female participants. The overall seropositivity to SARS-Cov-2 antibodies was 7.3% (95% CI 5.7-9.1). The elderly (over 60 years) and male participants had a high likelihood of testing positive for SAR-CoV-2 infections. Mashuru (15.6%, 14/90) and Meto (15%, 19/127) health facilities registered the highest proportion of seropositive participants. Evidence of SARS-CoV-2 transmission among pastoralists in the remote and underserved regions of Kajiado County was established by DBS sampling and serologic testing., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Macharia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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31. Biphasic MERS-CoV Incidence in Nomadic Dromedaries with Putative Transmission to Humans, Kenya, 2022-2023.
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Ogoti BM, Riitho V, Wildemann J, Mutono N, Tesch J, Rodon J, Harichandran K, Emanuel J, Möncke-Buchner E, Kiambi S, Oyugi J, Mureithi M, Corman VM, Drosten C, Thumbi SM, and Müller MA
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- Humans, Animals, Kenya epidemiology, Incidence, Abattoirs, Camelus, Middle East Respiratory Syndrome Coronavirus
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Middle East respiratory syndrome coronavirus (MERS-CoV) is endemic in dromedaries in Africa, but camel-to-human transmission is limited. Sustained 12-month sampling of dromedaries in a Kenya abattoir hub showed biphasic MERS-CoV incidence; peak detections occurred in October 2022 and February 2023. Dromedary-exposed abattoir workers (7/48) had serologic signs of previous MERS-CoV exposure.
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- 2024
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32. The Livestock for Health Study: A Field Trial on Livestock Interventions to Prevent Acute Malnutrition Among Women and Children in Pastoralist Communities in Northern Kenya.
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Thumbi SM, Muema J, Mutono N, Njuguna J, Jost C, Boyd E, Tewoldeberhan D, Mutua I, Gacharamu G, Wambua F, Allport R, Olesambu E, Osman AM, Souza D, Kimani I, Oyugi J, Bukania Z, Oboge H, Palmer GH, and Yoder J
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- Animals, Female, Humans, Infant, Family Characteristics, Kenya epidemiology, Mothers, Child, Preschool, Livestock, Malnutrition prevention & control
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Background: Livestock-dependent communities in Africa's drylands disproportionately experience acute malnutrition, especially during drought seasons. We detail the design and implementation of the Livestock for Health (L4H) study aimed at determining the effect of providing livestock feed and nutritional counselling to prevent seasonal spikes of acute malnutrition., Methods: The L4H study employed a 3-arm cluster randomized controlled trial to compare households in pastoralist settings in northern Kenya receiving livestock feeds during critical dry periods, with or without nutritional counseling, with control households. Over 4 dry seasons, 2019 to 2021, the study collected data on household milk production, consumption patterns, mothers'/children's nutritional status, household socioeconomic status, herd dynamics, and human and animal health status every 6 weeks., Results: L4H recruited 1734 households, with 639, 585, and 510 households assigned to intervention arms 1 and 2 and control arm 3, respectively. From these households, 1734 women and 1748 children younger than 3 years were recruited. In total, 19 419 household visits were completed, obtaining anthropometric measures 9 times on average for each child and mother. Eighty-one households (5%) were lost from the study due to the mother's death, child's death, migration, and withdrawal for other reasons., Discussion: L4H's success in a challenging environment was possible due to strong community engagement, formative studies to inform trial design, collaboration with local authorities, and effective interdisciplinary collaboration. Subsequent manuscripts will report the study findings., Trial Registration: The study was registered October 29, 2020, and is online at ClinicalTrials.gov (ID: NCT04608656)., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2023
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33. Hydroxychloroquine reduces T cells activation recall antigen responses.
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Kowatsch MM, Lajoie J, Mwangi L, Omollo K, Oyugi J, Hollett N, Kimani J, and Fowke KR
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- Humans, Leukocytes, Mononuclear, Tumor Necrosis Factor Receptor Superfamily, Member 7, COVID-19 Vaccines, Pandemics, COVID-19 Drug Treatment, Cytokines, Hydroxychloroquine pharmacology, Hydroxychloroquine therapeutic use, COVID-19
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Background: In the context of the current COVID-19 pandemic, there is still limited information about how people suffering from autoimmune diseases respond to the different COVID vaccines. The fact that they are taking an immunosuppressant or other drugs that aim to decrease the immune system activities, such as hydroxychloroquine (HCQ), could also impact their ability to respond to a COVID vaccine and vaccines in general., Methods: Heathy donors were given 200mg of HCQ daily for 6-weeks to assess HCQs impact on the systemic T cells and humoral immune response. Peripheral blood mononuclear cells (PBMC) and plasma were obtained at baseline and 6-weeks after starting daily HCQ. Flow cytometry assays were designed to determine changes in T cell activation and T cell responses. Bead array multiplex were used to analyse antibodies and cytokine levels before and after HCQ intake., Results: As anticipated, HCQ treatment decreased ex vivo T cell activation. We observed a decrease in CD4+CD161- expressing CCR5 (p = 0.015) and CD69 (p = 0.004) as well as in CD8+CCR5+ (p = 0.003), CD8+CD161+CCR5+ (p = 0.002) and CD8+CD161+CD95+ (p = 0.004). Additionally, HCQ decreased the proportion of Th17 expressing CD29 (p = 0.019), a subset associated with persistent inflammation. The proportion of T regulatory cells expressing the inhibitory molecule TIGIT was also reduced by HCQ (p = 0.003). As well, T cells from people on HCQ were less responsive to activation and cytokine production following stimulation with recall antigens and memory T cells were less likely to produce both IFNγ and TNFα following stimulation., Conclusion: This study shows HCQ is associated with lower T cell activation and decreased T cell cytokine production. While this study was not performed with the intent of looking at COVID vaccine response, it does provide important information about the changes in immune response that may occur in patient taking HCQ as a treatment for their autoimmune disease., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Kowatsch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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34. The impact of livestock interventions on nutritional outcomes of children younger than 5 years old and women in Africa: a systematic review and meta-analysis.
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Muema J, Mutono N, Kisaka S, Ogoti B, Oyugi J, Bukania Z, Daniel T, Njuguna J, Kimani I, Makori A, Omulo S, Boyd E, Osman AM, Gwenaelle L, Jost C, and Thumbi SM
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Background: Nutrition-sensitive livestock interventions have the potential to improve the nutrition of communities that are dependent on livestock for their livelihoods by increasing the availability and access to animal-source foods. These interventions can also boost household income, improving purchasing power for other foods, as well as enhance determinants of health. However, there is a lack of synthesized empirical evidence of the impact and effect of livestock interventions on diets and human nutritional status in Africa., Objective: To review evidence of the effectiveness of nutrition-sensitive livestock interventions in improving diets and nutritional status in children younger than 5 years old and in pregnant and lactating women., Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of published studies reporting on the effect of livestock interventions on maternal and child nutrition in Africa. Data were extracted, synthesized, and summarized qualitatively. Key outcomes were presented in summary tables alongside a narrative summary. Estimation of pooled effects was undertaken for experimental studies with nutritional outcomes of consumption of animal-source foods (ASFs) and minimum dietary diversity (MDD). Fixed effects regression models and pooled effect sizes were computed and reported as odds ratios (ORs) together with their 95% confidence intervals (CI)., Results: After the screening, 29 research papers were included in the review, and of these, only 4 were included in the meta-analysis. We found that nutrition-sensitive livestock interventions have a significant positive impact on the consumption of ASFs for children < 5 years (OR = 5.39; 95% CI: 4.43-6.56) and on the likelihood of meeting minimum dietary diversity (OR = 1.89; 95% CI: 1.51-2.37). Additionally, the impact of livestock interventions on stunting, wasting, and being underweight varied depending on the type of intervention and duration of the program/intervention implementation. Therefore, because of this heterogeneity in reporting metrics, the pooled estimates could not be computed., Conclusion: Nutrition-sensitive livestock interventions showed a positive effect in increasing the consumption of ASFs, leading to improved dietary diversity. However, the quality of the evidence is low, and therefore, more randomized controlled studies with consistent and similar reporting metrics are needed to increase the evidence base on how nutrition-sensitive livestock interventions affect child growth outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Muema, Mutono, Kisaka, Ogoti, Oyugi, Bukania, Daniel, Njuguna, Kimani, Makori, Omulo, Boyd, Osman, Gwenaelle, Jost and Thumbi.)
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- 2023
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35. Latent tuberculosis is associated with heightened levels of pro-and anti-inflammatory cytokines among Kenyan men and women living with HIV on long-term antiretroviral therapy.
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Temu TM, Polyak SJ, Wanjalla CN, Mandela NA, Dabee S, Mogaka JN, Masyuko S, Longernecker C, Shakil S, Chohan B, Page ST, Lacourse SM, Gitura B, Crothers K, Oyugi J, Jaspan H, Farquhar C, and Zifodya JS
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- Adult, Male, Humans, Female, Cytokines, Interleukin-17, Interleukin-15 therapeutic use, Kenya, Tumor Necrosis Factor-alpha, Interleukin-13, Interleukin-4, Interleukin-5 therapeutic use, Interleukin-6, Lipopolysaccharide Receptors, Biomarkers, Anti-Inflammatory Agents, Latent Tuberculosis diagnosis, Latent Tuberculosis drug therapy, HIV Infections complications, HIV Infections drug therapy
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Background: Persons with HIV (PWH) on antiretroviral therapy (ART) have persistent immune activation associated with increased risk for non-AIDS related diseases. Latent tuberculosis infection (LTBI), endemic in Africa, may contribute to this immune dysregulation. We evaluated the impact of HIV and TB co-infection on plasma pro- and anti-inflammatory cytokines among Kenyan adults., Methods: We compared data from 221 PWH on long-term ART and 177 HIV-negative adults examining biomarkers of pro-[sCD14, interleukin (IL)-2, IL-6, interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), IL-12p70, IL-17A] and anti(IL-4, IL-5, IL-13) inflammatory cytokines, by HIV/LTBI status (HIV+LTBI+, HIV+LTBI-, HIV-LTBI+, HIV-LTBI-). LTBI was diagnosed based on a positive QuantiFERON TB Gold-Plus test in the absence of active TB symptoms. Linear regression was used to evaluate the associations of HIV, LTBI, and HIV/LTBI status with biomarkers adjusting for clinical factors including HIV-specific factors., Results: Half of the participants were women and 52% had LTBI. HIV was independently associated with higher sCD14, IL-15, IL-6, IL-4, IL-5. LTBI was independently associated with higher TNF-α, IL-12p70, IL-17A, IL-4, IL-13 in adjusted models ( P < 0.05). LTBI status was associated with higher IL-4 and IL-12p70 only among PWH, but not HIV-negative participants ( P < 0.05 for interactions). In multivariate analysis, only HIV+LTBI+ demonstrated elevated levels of TNF-α, IL-6, IL-12p70, IL-15, IL-17A, IL4, IL-5, IL-13 in comparison to the HIV-LTBI- ( P < 0.05 for all). The effect of LTBI on cytokines among PWH was independent of CD4 + T-cell count and ART duration., Conclusions: Despite viral suppression, persons with HIV and LTBI exhibit abnormal cytokine production accompanied by high concentrations of pro- and anti-inflammatory cytokines., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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36. Distinct cervical tissue-adherent and luminal microbiome communities correlate with mucosal host gene expression and protein levels in Kenyan sex workers.
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Edfeldt G, Kaldhusdal V, Czarnewski P, Bradley F, Bergström S, Lajoie J, Xu J, Månberg A, Kimani J, Oyugi J, Nilsson P, Tjernlund A, Fowke KR, Kwon DS, and Broliden K
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- Female, Humans, Vagina microbiology, Kenya, Bacteria genetics, Lactobacillus genetics, RNA, Ribosomal, 16S genetics, Gene Expression, Sex Workers, Microbiota genetics
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Background: The majority of studies characterizing female genital tract microbiota have focused on luminal organisms, while the presence and impact of tissue-adherent ectocervical microbiota remain incompletely understood. Studies of luminal and tissue-associated bacteria in the gastrointestinal tract suggest that these communities may have distinct roles in health and disease. Here, we performed a multi-omics characterization of paired luminal and tissue samples collected from a cohort of Kenyan female sex workers., Results: We identified a tissue-adherent bacterial microbiome, with a higher alpha diversity than the luminal microbiome, in which dominant genera overall included Gardnerella and Lactobacillus, followed by Prevotella, Atopobium, and Sneathia. About half of the L. iners-dominated luminal samples had a corresponding Gardnerella-dominated tissue microbiome. Broadly, the tissue-adherent microbiome was associated with fewer differentially expressed host genes than the luminal microbiome. Gene set enrichment analysis revealed that L. crispatus-dominated tissue-adherent communities were associated with protein translation and antimicrobial activity, whereas a highly diverse microbial community was associated with epithelial remodeling and pro-inflammatory pathways. Tissue-adherent communities dominated by L. iners and Gardnerella were associated with lower host transcriptional activity. Tissue-adherent microbiomes dominated by Lactobacillus and Gardnerella correlated with host protein profiles associated with epithelial barrier stability, although with a more pro-inflammatory profile for the Gardnerella-dominated microbiome group. Tissue samples with a highly diverse composition had a protein profile representing cell proliferation and pro-inflammatory activity., Conclusion: We identified ectocervical tissue-adherent bacterial communities in all study participants of a female sex worker cohort. These communities were distinct from cervicovaginal luminal microbiota in a significant proportion of individuals. We further revealed that bacterial communities at both sites correlated with distinct host gene expression and protein levels. The tissue-adherent bacterial community could possibly act as a reservoir that seed the lumen with less optimal, non-Lactobacillus, bacteria. Video Abstract., (© 2023. The Author(s).)
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- 2023
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37. Sero - epidemiology of brucellosis in people and their livestock: A linked human - animal cross-sectional study in a pastoralist community in Kenya.
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Muema J, Oboge H, Mutono N, Makori A, Oyugi J, Bukania Z, Njuguna J, Jost C, Ogoti B, Omulo S, and Thumbi SM
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Background: Brucellosis is associated with massive livestock production losses and human morbidity worldwide. Efforts to control brucellosis among pastoralist communities are limited by scarce data on the prevalence and risk factors for exposure despite the high human-animal interactions in these communities. This study simultaneously assessed the seroprevalence of brucellosis and associated factors of exposure among pastoralists and their livestock in same households., Methods: We conducted a cross-sectional study in pastoralist communities in Marsabit County - Kenya. A total of 1,074 women and 225 children participated and provided blood samples. Blood was also drawn from 1,876 goats, 322 sheep and 189 camels. Blood samples were collected to be screened for the presence of anti-Brucella IgG antibodies using indirect IgG Enzyme-Linked Immunosorbent Assay (ELISA) kits. Further, Individual, household and herd-level epidemiological information were captured using a structured questionnaire. Group differences were compared using the Pearson's Chi-square test, and p -values < 0.05 considered statistically significant. Generalized mixed-effects multivariable logistic human and animal models using administrative ward as the random effect was used to determine variables correlated to the outcome., Results: Household-level seropositivity was 12.7% (95% CI: 10.7-14.8). The individual human seroprevalence was 10.8% (9.1-12.6) with higher seroprevalence among women than children (12.4 vs. 3.1%, p < 0.001). Herd-level seroprevalence was 26.1% (23.7-28.7) and 19.2% (17.6-20.8) among individual animals. Goats had the highest seroprevalence 23.1% (21.2 - 25.1), followed by sheep 6.8% (4.3-10.2) and camels 1.1% (0.1-3.8). Goats and sheep had a higher risk of exposure OR = 3.8 (95% CI 2.4-6.7, p < 0.001) and 2.8 (1.2-5.6, p < 0.007), respectively relative to camels. Human and animal seroprevalence were significantly associated (OR = 1.8, [95%CI: 1.23-2.58], p = 0.002). Herd seroprevalence varied by household head education (OR = 2.45, [1.67-3.61, p < 0.001]) and herd size (1.01, [1.00-1.01], p < 0.001)., Conclusions: The current study showed evidence that brucellosis is endemic in this pastoralist setting and there is a significant association between animal and human brucellosis seropositivity at household level representing a potential occupational risk. Public health sensitization and sustained human and animal brucellosis screening are required., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Muema, Oboge, Mutono, Makori, Oyugi, Bukania, Njuguna, Jost, Ogoti, Omulo and Thumbi.)
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- 2022
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38. Endemicity of Coxiella burnetii infection among people and their livestock in pastoral communities in northern Kenya.
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Muema J, Nyamai M, Wheelhouse N, Njuguna J, Jost C, Oyugi J, Bukania Z, Oboge H, Ogoti B, Makori A, Fernandez MDP, Omulo S, and Thumbi SM
- Abstract
Background: Coxiella burnetti can be transmitted to humans primarily through inhaling contaminated droplets released from infected animals or consumption of contaminated dairy products. Despite its zoonotic nature and the close association pastoralist communities have with their livestock, studies reporting simultaneous assessment of C. burnetti exposure and risk-factors among people and their livestock are scarce., Objective: This study therefore estimated the seroprevalence of Q-fever and associated risk factors of exposure in people and their livestock., Materials and Methods: We conducted a cross-sectional study in pastoralist communities in Marsabit County in northern Kenya. A total of 1,074 women and 225 children were enrolled and provided blood samples for Q-fever testing. Additionally, 1,876 goats, 322 sheep and 189 camels from the same households were sampled. A structured questionnaire was administered to collect individual- and household/herd-level data. Indirect IgG ELISA kits were used to test the samples., Results: Household-level seropositivity was 13.2% [95% CI: 11.2-15.3]; differences in seropositivity levels among women and children were statistically insignificant ( p = 0.8531). Lactating women had higher odds of exposure, odds ratio (OR) = 2.4 [1.3-5.3], while the odds of exposure among children increased with age OR = 1.1 [1.0-1.1]. Herd-level seroprevalence was 83.7% [81.7-85.6]. Seropositivity among goats was 74.7% [72.7-76.7], while that among sheep and camels was 56.8% [51.2-62.3] and 38.6% [31.6-45.9], respectively. Goats and sheep had a higher risk of exposure OR = 5.4 [3.7-7.3] and 2.6 [1.8-3.4], respectively relative to camels. There was no statistically significant association between Q-fever seropositivity and nutrition status in women, p = 0.900 and children, p = 1.000. We found no significant association between exposure in people and their livestock at household level (p = 0.724) despite high animal exposure levels, suggesting that Q-fever exposure in humans may be occurring at a scale larger than households., Conclusion: The one health approach used in this study revealed that Q-fever is endemic in this setting. Longitudinal studies of Q-fever burden and risk factors simultaneously assessed in human and animal populations as well as the socioeconomic impacts of the disease and further explore the role of environmental factors in Q-fever epidemiology are required. Such evidence may form the basis for designing Q-fever prevention and control strategies., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)
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- 2022
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39. Outbreak of Middle East Respiratory Syndrome Coronavirus in Camels and Probable Spillover Infection to Humans in Kenya.
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Ngere I, Hunsperger EA, Tong S, Oyugi J, Jaoko W, Harcourt JL, Thornburg NJ, Oyas H, Muturi M, Osoro EM, Gachohi J, Ombok C, Dawa J, Tao Y, Zhang J, Mwasi L, Ochieng C, Mwatondo A, Bodha B, Langat D, Herman-Roloff A, Njenga MK, Widdowson MA, and Munyua PM
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- Animals, Antibodies, Viral, Camelus, Disease Outbreaks, Humans, Kenya epidemiology, Zoonoses, Coronavirus Infections epidemiology, Coronavirus Infections veterinary, Middle East Respiratory Syndrome Coronavirus
- Abstract
The majority of Kenya’s > 3 million camels have antibodies against Middle East respiratory syndrome coronavirus (MERS-CoV), although human infection in Africa is rare. We enrolled 243 camels aged 0−24 months from 33 homesteads in Northern Kenya and followed them between April 2018 to March 2020. We collected and tested camel nasal swabs for MERS-CoV RNA by RT-PCR followed by virus isolation and whole genome sequencing of positive samples. We also documented illnesses (respiratory or other) among the camels. Human camel handlers were also swabbed, screened for respiratory signs, and samples were tested for MERS-CoV by RT-PCR. We recorded 68 illnesses among 58 camels, of which 76.5% (52/68) were respiratory signs and the majority of illnesses (73.5% or 50/68) were recorded in 2019. Overall, 124/4692 (2.6%) camel swabs collected from 83 (34.2%) calves in 15 (45.5%) homesteads between April−September 2019 screened positive, while 22 calves (26.5%) recorded reinfections (second positive swab following ≥ 2 consecutive negative tests). Sequencing revealed a distinct Clade C2 virus that lacked the signature ORF4b deletions of other Clade C viruses. Three previously reported human PCR positive cases clustered with the camel infections in time and place, strongly suggesting sporadic transmission to humans during intense camel outbreaks in Northern Kenya.
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- 2022
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40. Multi-omics analysis of the cervical epithelial integrity of women using depot medroxyprogesterone acetate.
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Bradley F, Franzén Boger M, Kaldhusdal V, Åhlberg A, Edfeldt G, Lajoie J, Bergström S, Omollo K, Damdimopoulos A, Czarnewski P, Månberg A, Oyugi J, Kimani J, Nilsson P, Fowke K, Tjernlund A, and Broliden K
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- Cervix Uteri, Female, Humans, Kenya, Medroxyprogesterone Acetate adverse effects, Contraceptive Agents, Female adverse effects, HIV Infections, Serpins
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Depot medroxyprogesterone acetate (DMPA) is an injectable hormonal contraceptive used by millions of women worldwide. However, experimental studies have associated DMPA use with genital epithelial barrier disruption and mucosal influx of human immunodeficiency virus (HIV) target cells. We explored the underlying molecular mechanisms of these findings. Ectocervical biopsies and cervicovaginal lavage (CVL) specimens were collected from HIV-seronegative Kenyan sex workers using DMPA (n = 32) or regularly cycling controls (n = 64). Tissue samples were assessed by RNA-sequencing and quantitative imaging analysis, whereas protein levels were measured in CVL samples. The results suggested a DMPA-associated upregulation of genes involved in immune regulation, including genes associated with cytokine-mediated signaling and neutrophil-mediated immunity. A transcription factor analysis further revealed DMPA-associated upregulation of RELA and NFKB1 which are involved in several immune activation pathways. Several genes significantly downregulated in the DMPA versus the control group were involved in epithelial structure and function, including genes encoding keratins, small proline-rich proteins, and cell-cell adhesion proteins. Pathway analyses indicated DMPA use was associated with immune activation and suppression of epithelium development, including keratinization and cornification processes. The cervicovaginal microbiome composition (Lactobacillus dominant and non-Lactobacillus dominant) had no overall interactional impact on the DMPA associated tissue gene expression. Imaging analysis verified that DMPA use was associated with an impaired epithelial layer as illustrated by staining for the selected epithelial junction proteins E-cadherin, desmoglein-1 and claudin-1. Additional staining for CD4+ cells revealed a more superficial location of these cells in the ectocervical epithelium of DMPA users versus controls. Altered protein levels of SERPINB1 and ITIH2 were further observed in the DMPA group. Identification of specific impaired epithelial barrier structures at the gene expression level, which were verified at the functional level by tissue imaging analysis, illustrates mechanisms by which DMPA adversely may affect the integrity of the genital mucosa., Competing Interests: The authors have declared that no competing interests exist.
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- 2022
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41. Regular Use of Depot Medroxyprogesterone Acetate Causes Thinning of the Superficial Lining and Apical Distribution of Human Immunodeficiency Virus Target Cells in the Human Ectocervix.
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Edfeldt G, Lajoie J, Röhl M, Oyugi J, Åhlberg A, Khalilzadeh-Binicy B, Bradley F, Mack M, Kimani J, Omollo K, Wählby C, Fowke KR, Broliden K, and Tjernlund A
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- Cervix Uteri metabolism, Female, HIV, Humans, Medroxyprogesterone Acetate adverse effects, Contraceptive Agents, Female adverse effects, HIV Infections
- Abstract
Background: The hormonal contraceptive depot medroxyprogesterone acetate (DMPA) may be associated with an increased risk of acquiring human immunodeficiency virus (HIV). We hypothesize that DMPA use influences the ectocervical tissue architecture and HIV target cell localization., Methods: Quantitative image analysis workflows were developed to assess ectocervical tissue samples collected from DMPA users and control subjects not using hormonal contraception., Results: Compared to controls, the DMPA group exhibited a significantly thinner apical ectocervical epithelial layer and a higher proportion of CD4+CCR5+ cells with a more superficial location. This localization corresponded to an area with a nonintact E-cadherin net structure. CD4+Langerin+ cells were also more superficially located in the DMPA group, although fewer in number compared to the controls. Natural plasma progesterone levels did not correlate with any of these parameters, whereas estradiol levels were positively correlated with E-cadherin expression and a more basal location for HIV target cells of the control group., Conclusions: DMPA users have a less robust epithelial layer and a more apical distribution of HIV target cells in the human ectocervix, which could confer a higher risk of HIV infection. Our results highlight the importance of assessing intact genital tissue samples to gain insights into HIV susceptibility factors., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.)
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- 2022
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42. Association between human leukocyte antigen class II (HLA-DRB and -DQB) alleles and outcome of exposure to Mycobacterium tuberculosis : a cross-sectional study in Nairobi, Kenya.
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Odera S, Mureithi M, Aballa A, Onyango N, Kazungu S, Ogolla S, Kaiyare G, Anzala O, and Oyugi J
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- Adult, Alleles, Cross-Sectional Studies, Gene Frequency, HLA-DRB1 Chains genetics, Humans, Kenya, HIV Infections, Latent Tuberculosis epidemiology, Latent Tuberculosis genetics, Mycobacterium tuberculosis genetics, Tuberculosis, Lymph Node, Tuberculosis, Pulmonary epidemiology, Tuberculosis, Pulmonary genetics
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Introduction: human leukocyte antigen (HLA) class II alleles play an important role in the early immune response to tuberculosis (TB) by presenting antigenic peptides to CD4+ T cells, hence polymorphisms in those genes can influence the efficiency of the immune response to infection and progression to active disease., Methods: an analytical cross-sectional study of adult pulmonary tuberculosis (PTB) patients at Mbagathi County Hospital, Nairobi and their HHCs. Sociodemographic data were captured on questionnaires and clinical data extracted from patient files. Intravenous blood samples were drawn for interferon-gamma release assay (IGRA) to determine latent tuberculosis infection (LTBI) among HHCs, and for extraction of DNA used in typing of HLA-DQB1 and HLA-DRB1 alleles by PCR sequence specific primer amplification. Chi-square and Fisher's exact test were used to compare the HLA type II allele frequencies of LTBI negative HHCs, LTBI positive HHCs and active TB patients. Logistic regression was used to adjust for HIV status., Results: the HLA-DQB1 and HLA-DRB1 alleles were analyzed in 17 PTB and 37 HHCs. Nineteen (19) HHCs were LTBI positive, while 18 were LTBI negative. The frequency of DRB3*1 was 0.17-fold lower [95% CI=0.03-0.83] among PTB patients compared to HHCs before adjustment for HIV status (p=0.048). The frequency of the DRB5*2 allele was significantly higher (p=0.013) among PTB patients (23.5%) compared to HHCS (0.00%). After adjusting for HIV status, the frequency of DRB1*14 was 12-fold higher [95% CI=1.11-138.2] among PTB patients compared to HHCs (p=0.040)., Conclusion: the higher frequencies of HLA-DRB5*2 and HLA-DRB1*14 alleles in PTB patients suggest a likely association with progression to active PTB. The higher frequency of HLA-DRB3*1 allele among LTBI negative HHCs shows its likely protective role against M. tuberculosis infection in this population., Competing Interests: The authors declare no competing interest., (Copyright: Susan Odera et al.)
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- 2022
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43. Spatial and Spatio-Temporal Distribution of Human Respiratory Syncytial Virus, Human Parainfluenza Virus, and Human Adenoviruses Cases in Kenya 2007-2013.
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Umuhoza T, Oyugi J, Mancuso JD, and Bulimo WD
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Background: Human Respiratory Syncytial Virus (HRSV), Human Parainfluenza Virus (HPIV), and Human Adenovirus (HAdV) epidemics differ in geographical location, time, and virus type. Regions prone to infections can be identified using geographic information systems (GIS) and available methods for detecting spatial and time clusters. We sought to find statistically significant spatial and time clusters of HRSV, HPIV, and HAdV cases in different parts of Kenya., Methods: To analyse retrospective data, we used a geographical information system (GIS) and the spatial scan statistic. The information was gathered from surveillance sites and aggregated at the county level in order to identify purely spatial and Spatio-temporal clusters. To detect the presence of spatial autocorrelation, the local Moran's I test was used. To detect the spatial clusters of HRSV, HPIV, and HAdV cases, we performed the purely spatial scan statistic. Furthermore, space-time clusters were identified using space-time scan statistics. Both spatial and space-time analyses were based on the discrete Poisson model with a pre-specified statistical significance levelof p<0.05., Results: The findings showed that HRSV, HPIV, and HAdV cases had significant autocorrelation within the study areas. Furthermore, in the Western region of the country, the three respiratory viruses had local clusters with significant positive autocorrelation (p<0.05). Statistically, the Western region had significant spatial clusters of HRSV, HPIV, and HAdV occurrence. Furthermore, the space-time analysis revealed that the HPIV primary cluster persisted in the Western region from 2007 to 2013. However, primary clusters of HRSV and HAdV were observed in the Coastal region in 2009-11 and 2008-09, respectively., Conclusion: Human respiratory syncytial virus (HRSV), human parainfluenza virus (HPIV), and human adenovirus (HAdV) hotspots (clusters) occurred in Kenya's Western and Coastal regions from 2007 to 2013. The Western region appeared to be more prone to the occurrence of allthree respiratory viruses throughout the study period. Strategic mitigation should focus on these locations to prevent future clusters of HRSV, HPIV, and HAdV infections that could lead to epidemics., (© The East African Health Research Commission 2022.)
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- 2022
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44. Low-Dose Acetylsalicylic Acid Reduces T Cell Immune Activation: Potential Implications for HIV Prevention.
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Lajoie J, Kowatsch MM, Mwangi LW, Boily-Larouche G, Oyugi J, Chen Y, Kimani M, Ho EA, Kimani J, and Fowke KR
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- Adult, Anti-Inflammatory Agents pharmacology, Biomarkers, Cytokines metabolism, Female, HIV Infections epidemiology, HIV Infections immunology, HIV Infections prevention & control, HIV Infections virology, Humans, Immunity, Mucosal, Kenya epidemiology, Leukocytes, Mononuclear, Male, Middle Aged, Mucous Membrane immunology, Mucous Membrane metabolism, Mucous Membrane virology, T-Lymphocytes metabolism, Young Adult, Aspirin administration & dosage, Lymphocyte Activation drug effects, Lymphocyte Activation immunology, T-Lymphocytes drug effects, T-Lymphocytes immunology
- Abstract
Introduction: Acetylsalicylic acid (ASA) is a well-known and safe anti-inflammatory. At low-dose, it is prescribed to prevent secondary cardiovascular events in those with pre-existing conditions and to prevent preeclampsia. Little is known about how low-dose ASA affects the immune response. In this study, we followed women to assess how ASA use modifies T cells immune phenotypes in the blood and at the genital tract., Methods: HIV uninfected women from Kenya were enrolled in this study and followed for one month to assess baseline responses including systemic/mucosal baseline immune activation. Participants then received 81mg of ASA daily for 6 weeks to assess changes to T cell immune activation (systemic and mucosal) relative to baseline levels., Results: The concentration of ASA measured in the blood was 58% higher than the level measured at the female genital tract. In the blood, the level of ASA was inversely correlated with the following: the proportion of Th17 expressing HLA-DR (p=0.04), the proportion of effector CD4
+ T cells expressing CCR5 (p=0.03) and the proportion of CD8+ Tc17 expressing CCR5 (p=0.04). At the genital tract, ASA use correlated with a decreased of activated CD4+ T cells [CD4+ CCR5+ CD161+ (p=0.02) and CD4+ CCR5+ CD95+ (p=0.001)]., Conclusion: This study shows that ASA use impacts the immune response in both the systemic and genital tract compartments. This could have major implications for the prevention of infectious diseases such as HIV, in which the virus targets activated T cells to establish an infection. This could inform guidelines on ASA use in women., Clinical Trial Registration: ClinicalTrials.gov, identifier NCT02079077., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Lajoie, Kowatsch, Mwangi, Boily-Larouche, Oyugi, Chen, Kimani, Ho, Kimani and Fowke.)- Published
- 2021
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45. Morbidity burden, seasonality and factors associated with the human respiratory syncytial virus, human parainfluenza virus, and human adenovirus infections in Kenya.
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Umuhoza T, Oyugi J, Mancuso JD, Ahmed A, and Bulimo WD
- Abstract
Background: Human respiratory syncytial viruses (HRSV), human parainfluenza viruses (HPIV), and human adenoviruses (HAdVs) cause a substantial morbidity burden globally., Objective: We sought to estimate morbidity burden, assess seasonality, and determine factors associated with these respiratory viruses in Kenya., Methods: The data were obtained from Kenyan sites included in the Köppen-Geiger climate classification system. We defined the proportion of morbidity burden by descriptive analysis and visualized time-series data for January 2007-December 2013. Logistic regression was used to identify factors associated with infection outcomes., Results: The morbidity burden for HRSV was 3.1%, HPIV 5.3% and HAdVs 3.3%. Infants were more likely to be infected than other age groups. HRSV exhibited seasonality with high occurrence in January-March (odds ratio[OR] = 2.73) and April-June (OR = 3.01). Hot land surface temperature (≥40 °C) was associated with HRSV infections (OR = 2.75), as was warmer air temperature (19-22.9 °C) (OR = 1.68), compared with land surface temperature (<30) and cooler air temperature (<19 °C) respectively. Moderate rainfall (150-200 mm) areas had greater odds of HRSV infection (OR = 1.32) than low rainfall (<150 mm)., Conclusion: HRSV, HPIV and HAdVs contributed to morbidity burden, and infants were significantly affected. HRSV had a clear seasonal pattern and were associated with climate parameters, unlike HPIV and HAdVs., Competing Interests: The authors declare that they have no financial or personal relationships which may have an inappropriate influence on conducting this study., (© 2021 The Author(s).)
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- 2021
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46. Impact of livestock interventions on maternal and child nutrition outcomes in Africa: A systematic review and meta-analysis protocol.
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Muema J, Oyugi J, Bukania Z, Nyamai M, Jost C, Daniel T, Njuguna J, and Thumbi SM
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The challenge of undernutrition (stunting and wasting) still remains a major health concern in children below 5 years of age in Africa, with the continent accounting for more than one third of all stunted children and more than one quarter of all wasted children globally. Despite the growing evidence on the role of agriculture interventions in improving nutrition, empirical evidence on the impact of livestock intervention on nutrition in Africa is scant. This review is aimed at determining whether livestock interventions are effective in reducing undernutrition in children below five years of age and in pregnant and lactating women in Africa. The review will be conducted according to PRISMA guidelines. Major electronic databases will be searched and complemented with grey and non-indexed literature from google and google scholar, and expert consultation for additional articles and reports. PICO criteria will be used while employing search strategies including MeSH, Boolean search operators and truncation/wildcard symbol to narrow or broaden the search. Articles on effect of livestock interventions on maternal and child nutrition conducted in Africa that meet the set inclusion criteria will be included in the review after critical appraisal by two independent reviewers. A standardized form will be used to extract data from included studies. The extracted data will be summarized and synthesized both qualitatively and quantitatively and key outcomes presented. Evidence generated from the systematic review and meta-analysis will be important for guiding nutrition sensitive livestock interventions and policies on nutrition programming, specifically on how to leverage on livestock interventions to reduce the burden of undernutrition., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 Muema J et al.)
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- 2021
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47. Central obesity is a contributor to systemic inflammation and monocyte activation in virally suppressed adults with chronic HIV in Kenya.
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Temu TM, Wagoner J, Masyuko S, O'Connor A, Zifodya JS, Macharia P, Wanjalla CN, Mogaka JN, Chohan B, Omodi VM, Gervassi AL, Oyugi J, Page ST, Farquhar C, and Polyak SJ
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- Adult, Biomarkers, Cross-Sectional Studies, Female, Humans, Inflammation, Kenya epidemiology, Male, Monocytes, Obesity complications, HIV Infections complications, Obesity, Abdominal complications, Obesity, Abdominal epidemiology
- Abstract
Objectives: Heightened systemic inflammation is common in obese individuals and persons with HIV (PWH) and is independently associated with an increased risk of cardiovascular diseases (CVDs). We investigated the combined effect of central obesity, a surrogate measure of visceral fat and HIV on circulating levels of inflammatory cytokines among Kenyan adults., Design: A cross-sectional study., Methods: We analysed and compared data from 287 virally suppressed PWH and 277 noninfected Kenyan adults, including biomarkers of gut epithelial dysfunction (intestinal fatty acid binding protein), monocyte activation (soluble CD163 and CD14) and inflammation [interleukin (IL)-1β, IL-6, TNF-α and hsCRP] by HIV/central obesity status (HIV-positive/obese, HIV-negative/obese, HIV-positive/nonobese and HIV-negative/nonobese). Central obesity was defined as waist circumference more than 80 cm for women and more than 94 cm for men. We assessed the association of HIV/obesity status with elevated biomarkers (>75th percentile) using logistic regression., Results: Median age for participants was 44 years and 37% were centrally obese. Levels of all biomarkers were higher among the HIV-positive/obese compared with the HIV-negative/nonobese (P < 0.05 for all comparisons). The HIV-positive/obese group had the greatest odds of having elevated inflammatory biomarkers compared with other groups even after adjustment of age, BMI and other conventional CVD risk factors (P < 0.05 for all). Additional adjustment for sCD163 in the multivariate model substantially attenuated the association for HIV-positive/obesity with IL-1β, IL-6 and TNF-α but not hsCRP. The contribution of HIV-positive/obesity to inflammation was independent of the degree of immunosuppression., Conclusion: Central obesity is prevalent among virally suppressed African PWH and is associated with greater inflammation and monocyte activation independent of other comorbidities and HIV-specific factors., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2021
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48. Prevalence of human respiratory syncytial virus, parainfluenza and adenoviruses in East Africa Community partner states of Kenya, Tanzania, and Uganda: A systematic review and meta-analysis (2007-2020).
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Umuhoza T, Bulimo WD, Oyugi J, Musabyimana JP, Kinengyere AA, and Mancuso JD
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- Adenovirus Infections, Human pathology, Databases, Factual, Humans, Kenya epidemiology, Prevalence, Respiratory Syncytial Virus Infections pathology, Respiratory Tract Infections pathology, Tanzania epidemiology, Uganda epidemiology, Adenovirus Infections, Human epidemiology, Respiratory Syncytial Virus Infections epidemiology, Respiratory Tract Infections epidemiology, Respirovirus Infections epidemiology
- Abstract
Background: Viruses are responsible for a large proportion of acute respiratory tract infections (ARTIs). Human influenza, parainfluenza, respiratory-syncytial-virus, and adenoviruses are among the leading cause of ARTIs. Epidemiological evidence of those respiratory viruses is limited in the East Africa Community (EAC) region. This review sought to identify the prevalence of respiratory syncytial virus, parainfluenza, and adenoviruses among cases of ARTI in the EAC from 2007 to 2020., Methods: A literature search was conducted in Medline, Global Index Medicus, and the grey literature from public health institutions and programs in the EAC. Two independent reviewers performed data extraction. We used a random effects model to pool the prevalence estimate across studies. We assessed heterogeneity with the I2 statistic, and Cochran's Q test, and further we did subgroup analysis. This review was registered with PROSPERO under registration number CRD42018110186., Results: A total of 12 studies met the eligibility criteria for the studies documented from 2007 to 2020. The overall pooled prevalence of adenoviruses was 13% (95% confidence interval [CI]: 6-21, N = 28829), respiratory syncytial virus 11% (95% CI: 7-15, N = 22627), and parainfluenza was 9% (95% CI: 7-11, N = 28363). Pooled prevalence of reported ARTIs, all ages, and locality varied in the included studies. Studies among participants with severe acute respiratory disease had a higher pooled prevalence of all the three viruses. Considerable heterogeneity was noted overall and in subgroup analysis., Conclusion: Our findings indicate that human adenoviruses, respiratory syncytial virus and parainfluenza virus are prevalent in Kenya, Tanzania, and Uganda. These three respiratory viruses contribute substantially to ARTIs in the EAC, particularly among those with severe disease and those aged five and above., Competing Interests: The authors have declared that no competing interests exist.
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- 2021
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49. HIV-Exposed Seronegative Sex Workers Express Low T-Cell Activation and an Intact Ectocervical Tissue Microenvironment.
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Röhl M, Tjernlund A, Lajoie J, Edfeldt G, Bradley F, Bergström S, Kaldhusdal V, Åhlberg A, Månberg A, Omollo K, Boily-Larouche G, Asghar M, Kwon DS, Oyugi J, Kimani J, Nilsson P, Fowke KR, and Broliden K
- Abstract
Immunological correlates of natural resistance to HIV have been identified in HIV-exposed seronegative (HESN) individuals and include a low-inflammatory genital mucosal status. The cervicovaginal epithelium has not been studied for such correlates despite constituting an important barrier against sexual HIV transmission. To fill this gap in knowledge, we collected samples of blood, cervical mononuclear cells, cervicovaginal lavage, and ectocervical tissue from Kenyan HESN sex workers (n = 29) and controls (n = 33). The samples were analyzed by flow cytometry, protein profiling, 16S rRNA gene sequencing, in situ image analysis, and tissue-based RNA sequencing. A significantly higher relative proportion of regulatory T cells in blood (B7
+ CD25hi FoxP3+ CD127lo CD4+ and B7+ Helios+ FoxP3+ CD4+ ), and a significantly lower proportion of activated cervical T cells (CCR5+ CD69+ CD4+ and CCR5+ CD69+ CD8+ ), were found in the HESN group compared with the controls. In contrast, there were no statistically significant differences between the study groups in cervicovaginal protein and microbiome compositions, ectocervical epithelial thickness, E-cadherin expression, HIV receptor expression, and tissue RNA transcriptional profiles. The identification of an intact ectocervical microenvironment in HESN individuals add new data to current knowledge about natural resistance to sexual transmission of HIV.- Published
- 2021
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50. Differential Elevation of Inflammation and CD4 + T Cell Activation in Kenyan Female Sex Workers and Non-Sex Workers Using Depot-Medroxyprogesterone Acetate.
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Omollo K, Lajoie J, Oyugi J, Wessels JM, Mwaengo D, Kimani J, Kaushic C, and Fowke KR
- Subjects
- Adolescent, Adult, Biomarkers, CD4-Positive T-Lymphocytes drug effects, CD4-Positive T-Lymphocytes metabolism, Contraceptive Agents administration & dosage, Cytokines blood, Cytokines metabolism, Female, Humans, Immunophenotyping, Inflammation blood, Kenya epidemiology, Medroxyprogesterone administration & dosage, Mucous Membrane drug effects, Mucous Membrane immunology, Mucous Membrane microbiology, Public Health Surveillance, Young Adult, CD4-Positive T-Lymphocytes immunology, Contraceptive Agents adverse effects, Inflammation epidemiology, Inflammation etiology, Lymphocyte Activation immunology, Medroxyprogesterone adverse effects, Sex Workers
- Abstract
Background: Depot Medroxyprogesterone (DMPA) is one of the most widely used contraceptives in Sub-Saharan Africa where HIV incidence is high. We explored the effect of DMPA on the activation of HIV cellular targets and inflammation as a possible mechanism of increased HIV risk with DMPA use. Since sex work is known to affect the immune system, this study aimed to understand the effect of DMPA on the immune system among sex workers and non-sex worker women., Methods: Twenty-seven DMPA-using HIV seronegative female sex workers (FSW) and 30 DMPA-using HIV seronegative non-sex worker (SW) women were enrolled in the study. Twenty-four FSWs and 30 non-sex workers who were not using any hormonal contraception (no HC) were recruited as controls. Blood and cervico-vaginal samples were collected from all participants and assayed for T cell activation and proinflammatory cytokines., Results: Among no HC users, sex workers had lower expression of CD38 and CD69 on blood-derived CD4
+ T cells along with lower CD4+ CCR5+ cells frequency in the endocervix. Plasma MCP-1, TNFα and IL-17 also had reduced expression in FSW not using HC. Non-sex workers using DMPA had elevated proportions of blood-derived CD4+ CD38+ , CD4+ CD69+ and CD4+ HLA-DR+ T cells relative to non-sex workers who were not taking any HC. DMPA-using non-sex workers also had an increased level of plasma interferon gamma (IFN- γ ), monokine induced by interferon- γ (MIG) and sCD40L, alongside higher proportion of CD4+ CD38+ and CD4+ CD69+ T cells at the cervix compared to non-sex workers no-HC controls., Finally, non-sex workers and FSWs using DMPA had similar levels of genital and peripheral CD4+ T cell activation and inflammation., Conclusion: DMPA increased inflammation and expression of activation markers on potential HIV target cells in non-sex workers. These data show that DMPA is a strong immune modulator and its use counteracts the decreased immune activation associated with sex work. These findings suggest that inflammation and increased HIV target cells in blood and at the genital tract may be mechanisms by which DMPA increases susceptibility to HIV., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Omollo, Lajoie, Oyugi, Wessels, Mwaengo, Kimani, Kaushic and Fowke.)- Published
- 2021
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