Incident gonorrhoea and chlamydia among a prospective cohort of men who have sex with men in Kisumu, Kenya

2020 ◽  
Vol 96 (7) ◽  
pp. 521-527 ◽  
Author(s):  
Fredrick Otieno ◽  
George Ng'ety ◽  
Duncan Okall ◽  
Carolyne Aketch ◽  
Eve Obondi ◽  
...  
Keyword(s):  
Cox Regression ◽  
Sub Saharan Africa ◽  
Repeated Testing ◽  
Factors Associated ◽  
Increased Risk ◽  
High Incidence ◽  
Hiv Testing And Counselling ◽  
Sub Saharan ◽  
Sex With Men ◽  
Adjusted Model

ObjectiveSTIs disproportionately affect men who have sex with men (MSM) in sub-Saharan Africa. We identified factors associated with incident Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among MSM in the Anza Mapema cohort study in Kisumu, Kenya.MethodsWe enrolled 711 MSM who underwent HIV testing and counselling, medical history and examination, and collection of demographic and behavioural information. They also provided urine and rectal swab specimens for CT and NG testing by qualitative PCR at baseline and at months 6 and 12. Separate multivariable Cox regression models identified factors associated with first incident urethral or rectal infection.ResultsAmong the 619 men aged 18–54 years included in this analysis, there were 83 first incident urethral CT/NG infections (14.4 cases per 100 person-years (PY)) and 40 first incident rectal infections (6.84 cases per 100 PY), and an overall incidence of 18.0 cases per 100 PY (95% CI 14.8 to 21.8). Most urethral (84%) and rectal (81%) infections were asymptomatic. In the adjusted model, the risk of first incident urethral CT/NG decreased by 4% for each 1-year increase in age and was 41% lower for men who reported their partner used condom at last sexual encounter. Men who were HIV-positive had a 68% less risk of urogenital CT/NG compared with those who were negative. Men who reported being usually receptive or versatile as compared with usually insertive had an 81% increased risk of incident urogenital CT/NG.ConclusionOur study demonstrated a high incidence of urethral CT/NG infection, with somewhat lower incidence of rectal CT/NG infection, despite repeated testing and treatment, highlighting the need for preventive interventions to decrease the burden of CT/NG among Kenyan MSM. Most infections were asymptomatic, and routine aetiological screening for STIs is recommended.

scholarly journals Malaria and risk of lymphoid neoplasms and other cancer: a nationwide population-based cohort study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Katja Wyss ◽  
Fredrik Granath ◽  
Andreas Wångdahl ◽  
Therese Djärv ◽  
Michael Fored ◽  
...  
Keyword(s):  
Cox Regression ◽  
Health Agency ◽  
Malaria Diagnosis ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Lymphoid Neoplasms ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Sub Saharan

Abstract Background Malaria is associated with Burkitt lymphoma among children in Sub-Saharan Africa. No longitudinal studies have assessed the long-term risk of other lymphoma or cancer overall. Here, we investigated the risk of lymphoid neoplasms and other cancer after malaria. Methods We included 4125 patients diagnosed with malaria in Sweden in 1987–2015, identified either through the National Surveillance Database at the Public Health Agency of Sweden, the National Inpatient and Outpatient Register, or by reports from microbiology departments. A comparator cohort (N = 66,997) matched on sex, age and birth region was retrieved from the general population and an additional cohort with all individuals born in Sub-Saharan Africa registered in the Total Population Register in 1987–2015 (N = 171,756). Incident lymphomas and other cancers were identified through linkage with the Swedish Cancer Register. Hazard ratios (HRs) were assessed using Cox regression with attained age as the timescale. Results A total of 20 lymphoid neoplasms and 202 non-haematological cancers were identified among malaria patients during a mean follow-up of 13.3 and 13.7 years, respectively. The overall risk of lymphoid neoplasms was not significantly increased (hazard ratio [HR] 1.24, 95% confidence interval [CI] 0.79–1.94), neither did we find any association with all-site non-haematological cancer (HR 0.89, 95% CI 0.77–1.02). However, in the Sub-Saharan Africa cohort, we observed an increased risk of lymphoid neoplasms after malaria diagnosis (HR 2.39, 95% CI 1.06–5.40), but no difference in the risk of other cancer (HR 1.01, 95% CI 0.70–1.45). The association could not be explained by co-infection with HIV or chronic hepatitis B or C, since the risk estimate was largely unchanged after excluding patients with these comorbidities (HR 2.63, 95% CI 1.08–6.42). The risk became more pronounced when restricting analyses to only including non-Hodgkin and Hodgkin lymphomas (HR 3.49, 95% CI 1.42–8.56). Conclusion Individuals born in malaria-endemic areas and diagnosed with malaria in Sweden had an increased risk of lymphoid neoplasms, especially B cell lymphoma. There was no association with cancer overall nor did single malaria episodes confer an increased risk in travellers.

scholarly journals Transmission clusters, predominantly associated with men who have sex with men, play a main role in the propagation of HIV-1 in Northern Spain (2013-2018)

2021 ◽  
Author(s):  
Horacio Gil ◽  
Elena Delgado ◽  
Sonia Benito ◽  
Leonidas Georgalis ◽  
Vanessa Montero ◽  
...  
Keyword(s):  
Control Measures ◽  
Sub Saharan Africa ◽  
Effective Control ◽  
Main Role ◽  
Northern Spain ◽  
Factors Associated ◽  
Phylogenetic Relations ◽  
Sub Saharan ◽  
Sex With Men ◽  
Hiv 1

Viruses of HIV-1-infected individuals whose transmission is related group phylogenetically in transmission clusters (TCs). The study of the phylogenetic relations of these viruses and the factors associated with these individuals is essential to analyze the HIV-1 epidemic. In this study, we examine the role of TCs in the epidemiology of HIV-1 infection in Galicia and the Basque County, two regions of Northern Spain. A total of 1158 newly HIV-1-diagnosed patients (NDs) from both regions diagnosed in 2013-2018 were included in the study. Partial HIV-1 pol sequences were analyzed phylogenetically by approximately-maximum-likelihood with FastTree 2. In this analysis, 10,687 additional sequences from samples from HIV-1-infected individuals collected in Spain in 1999-2019 were also included to assign and determine the TCs sizes. TCs were defined as those which included viruses from ≤4 individuals, at least 50% of them Spaniards, and with ≤0.95 Shimodaira-Hasegawa-like node support in the phylogenetic tree. Factors associated to TCs were evaluated using odds ratios (OR) and their 95% confidence intervals (CI). Fifty one percent of NDs grouped in 162 TCs. Male patients (OR: 2.6; 95% CI: 1.5-4.7) and men having sex with men (MSM) (OR: 2.1; 95% CI: 1.4-3.2) had higher odds of belonging to a TC compared to female and heterosexual patients, respectively. Individuals from Latin America (OR: 0.3; 95% CI: 0.2-0.4), North Africa (OR: 0.4; 95% CI: 0.2-1.0), and especially Sub-Saharan Africa (OR: 0.02; 95% CI: 0.003-0.2) were inversely associated to belonging to TCs compared to native Spaniards. Differences in distribution and sizes of local TCs were observed in both regions reflecting a different epidemic pattern. Our results show that TCs play an important role in the spread of HIV-1 infection in the two Spanish regions studied, where transmission between MSM is predominant. The majority of migrants were infected with viruses not belonging to TCs that expand in Spain. Molecular epidemiology is essential to identify local peculiarities of HIV-1 propagation. The early detection of TCs and prevention of their expansion, implementing effective control measures, could reduce HIV-1 infections.

scholarly journals Factors associated with unsuppressed viremia in women living with HIV on lifelong ART in a multi-country cohort study: US-PEPFAR PROMOTE study

2019 ◽  
Author(s):  
Patience Atuhaire ◽  
Sherika Hanley ◽  
Nonhlanhla Yende-Zuma ◽  
Jim Aizire ◽  
Lynda Stranix-Chibanda ◽  
...  
Keyword(s):  
Cohort Study ◽  
Scale Up ◽  
Sub Saharan Africa ◽  
African Women ◽  
Targeted Interventions ◽  
Factors Associated ◽  
Women Living With Hiv ◽  
Increased Risk ◽  
Sub Saharan ◽  
Living With Hiv

AbstractBackgroundDespite recent efforts to scale-up lifelong combination antiretroviral therapy (cART) in sub-Saharan Africa, high rates of unsuppressed viremia persist among cART users, and many countries in the region fall short of the UNAIDS 2020 target to have 90% virally suppressed. We sought to determine the factors associated with unsuppressed viremia (defined for the purpose of this study as >200 copies/ml) among African women on lifelong cART.MethodsThis analysis was based on baseline data of the PROMOTE longitudinal cohort study at 8 sites in Uganda, Malawi, Zimbabwe and South Africa. The study enrolled 1987 women living with HIV who initiated lifelong cART at least 1 year previously to assesses long-term safety and effectiveness of cART. Socio-demographic, clinical, and cART adherence data were collected. We used multivariable Poisson regression with robust variance to identify factors associated with unsuppressed viremia.ResultsAt enrolment, 1947/1987 (98%) women reported taking cART. Of these, HIV-1 remained detectable in 293/1934 (15%), while 216/1934 (11.2%) were considered unsuppressed (>200 copies/ml). The following factors were associated with an increased risk of unsuppressed viremia: not having household electricity (adjusted prevalence rate ratio (aPRR) 1.74, 95% confidence interval (CI) 1.28-2.36, p<0.001); self-reported missed cART doses (aPRR 1.63, 95% CI 1.24-2.13, p<0.001); recent hospitalization (aPRR 2.48, 95% CI 1.28-4.80, p=0.007) and experiencing abnormal vaginal discharge in the last three months (aPRR 1.88; 95% CI 1.16-3.04, p=0.010). Longer time on cART (aPRR 0.75, 95% CI 0.64-0.88, p<0.001) and being older (aPRR 0.77, 95% CI 0.76-0.88, p<0.001) were associated with reduced risk of unsuppressed viremia.ConclusionSocioeconomic barriers such as poverty, not being married, young age, and self-reported missed doses remain key predictors of unsuppressed viremia. Targeted interventions are needed to improve cART adherence among women living with HIV with this risk factor profile.

DO THE FACTORS ASSOCIATED WITH FEMALE HIV INFECTION VARY BY SOCIOECONOMIC STATUS IN CAMEROON?

2013 ◽  
Vol 46 (4) ◽  
pp. 431-448 ◽  
Author(s):  
JOYCE N. MUMAH ◽  
DOUGLAS JACKSON-SMITH
Keyword(s):  
Hiv Infection ◽  
Hiv Risk ◽  
Access To Health Care ◽  
Social Epidemiology ◽  
Sub Saharan Africa ◽  
Low Ses ◽  
Factors Associated ◽  
Increased Risk ◽  
Sub Saharan ◽  
Using Data

SummaryOne of the most consistent findings in social epidemiology is an inverse relationship between indicators of SES and most types of illness. However, a growing body of research on HIV in sub-Saharan Africa suggests an intriguing reversal of this pattern, particularly with respect to HIV among women. In Cameroon, specifically, high-SES women have higher rates of HIV infection compared with low-SES women. Using data from the 2004 Cameroon DHS, this study explored the relationships between SES and HIV and tested a multivariate model designed to highlight the distinctive factors associated with increased risk of HIV among women in different SES classes. The results revealed that high-SES women who reported engaging in riskier sexual behaviour had the highest levels of HIV infection. Surprisingly, among this group increased knowledge of HIV, more domestic decision-making authority and access to health care did not reduce vulnerability. Meanwhile, among low-SES women relative gender inequality was significantly related to HIV risk. Specifically, among this group of women, having a partner with higher education was strongly associated with greater HIV risk. The results suggest that different approaches targeting each sub-group are needed to effectively combat the disease.

scholarly journals Resting Heart Rate predicts all-cause mortality in sub-Saharan African Patients with Heart Failure: Insight from the Douala Heart failure registry (Do-HF)

2020 ◽  
Author(s):  
Anastase Dzudie ◽  
Blaise Barche ◽  
Sidick Mouliom ◽  
Ariane Nouko ◽  
Fogue Raissa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Cox Regression ◽  
Sub Saharan Africa ◽  
Resting Heart Rate ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Sub Saharan

AbstractBackgroundHigher resting heart rate (HR) is associated with mortality amongst Caucasians with heart failure (HF), but its significance has yet to be established in sub-Saharan Africans in whom HF differs in terms of characteristics and etiologies.ObjectivesWe assessed the association of HR with all-cause mortality in patients with HF in sub-Saharan Africa.MethodsThe Douala HF registry (Do–HF) is an ongoing prospective data collection on patients with HF receiving care at four cardiac referral services in Douala, Cameroon. Patients included in this report were followed-up for 12 months from their index admission, for all-cause mortality. We used Cox-regression analysis to study the association of HR with all-cause mortality during follow-up.ResultsOf 347 patients included, 343 (98.8%) completed follow-up. The mean age was 64±14 years, 176 (50.7%) were female, and median admission HR was 85 bpm. During a median follow-up of 12 months, 78 (22.7%) patients died. Mortality increased steadily with HR increase and ranged from 12.2% in the lower quartile of HR (≤69 bpm) to 34.1% in the upper quartile of HR (>100 bpm). Hazard ratio of 12-month death per 10 bpm higher heart rate was 1.16 (1.04–1.29), with consistent effects across most subgroups, but a higher effect in participants with hypertension vs those without (interaction p=0.044).ConclusionHeart rate was independently associated with increased risk of all-cause mortality in this study, particularly among participants with hypertension. The implication of this finding for risk prediction or reduction should be actively investigated.

scholarly journals Decomposing the rural–urban gap in factors associated with childhood immunisation in sub-Saharan Africa: evidence from surveys in 23 countries

2021 ◽  
Vol 6 (1) ◽  
pp. e003773
Author(s):  
Edward Kwabena Ameyaw ◽  
Yusuf Olushola Kareem ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Sanni Yaya
Keyword(s):  
Decomposition Analysis ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Childhood Immunisation ◽  
Urban Settings ◽  
Factors Associated ◽  
Rural And Urban ◽  
Full Immunisation ◽  
Sub Saharan

BackgroundAbout 31 million children in sub-Saharan Africa (SSA) suffer from immunisation preventable diseases yearly and more than half a million children die because of lack of access to immunisation. Immunisation coverage has stagnated at 72% in SSA over the past 6 years. Due to evidence that full immunisation of children may be determined by place of residence, this study aimed at investigating the rural–urban differential in full childhood immunisation in SSA.MethodsThe data used for this study consisted of 26 241 children pooled from 23 Demographic and Health Surveys conducted between 2010 and 2018 in SSA. We performed a Poisson regression analysis with robust Standard Errors (SEs) to determine the factors associated with full immunisation status for rural and urban children. Likewise, a multivariate decomposition analysis for non-linear response model was used to examine the contribution of the covariates to the observed rural and urban differential in full childhood immunisation. All analyses were performed using Stata software V.15.0 and associations with a p<0.05 were considered statistically significant.ResultsMore than half of children in urban settings were fully immunised (52.8%) while 59.3% of rural residents were not fully immunised. In all, 76.5% of rural–urban variation in full immunisation was attributable to differences in child and maternal characteristics. Household wealth was an important component contributing to the rural–urban gap. Specifically, richest wealth status substantially accounted for immunisation disparity (35.7%). First and sixth birth orders contributed 7.3% and 14.9%, respectively, towards the disparity while 7.9% of the disparity was attributable to distance to health facility.ConclusionThis study has emphasised the rural–urban disparity in childhood immunisation, with children in the urban settings more likely to complete immunisation. Subregional, national and community-level interventions to obviate this disparity should target children in rural settings, those from poor households and women who have difficulties in accessing healthcare facilities due to distance.

scholarly journals Factors associated with maternal mortality in Sub-Saharan Africa: an ecological study

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Jose Luis Alvarez ◽  
Ruth Gil ◽  
Valentín Hernández ◽  
Angel Gil
Keyword(s):  
Maternal Mortality ◽  
Ecological Study ◽  
Sub Saharan Africa ◽  
Factors Associated ◽  
Sub Saharan

scholarly journals Continuing high levels of HIV diagnoses in men who have sex with men in the United Kingdom

2008 ◽  
Vol 13 (14) ◽  
pp. 3-4
Author(s):  
B Rice ◽  
A Nardone ◽  
N Gill ◽  
V Delpech
Keyword(s):  
United Kingdom ◽  
Confidence Intervals ◽  
Sub Saharan Africa ◽  
Newly Diagnosed ◽  
The United Kingdom ◽  
Reporting Delays ◽  
Sub Saharan ◽  
Sex With Men ◽  
The Uk ◽  
Almost All

The latest HIV data for 2007 has recently been published for the United Kingdom (UK). During the year, an estimated 6,840 (95% confidence intervals 6,600-7,050) persons (adjusted for reporting delays) were newly diagnosed with HIV in the UK. This represents a 12% decline from a peak of new HIV diagnoses reported in 2005 (7,800). Almost all this decline in new HIV diagnoses was in HIV-infected heterosexuals from sub-Saharan Africa who were probably infected in their country of origin.

scholarly journals Factors associated with oral cavity cancers in Sub-Saharan Africa: Summary of the literature

2021 ◽  
Vol 1 (2) ◽  
pp. 34-41
Author(s):  
A Dieng ◽  
AD Faye ◽  
MM Ndiaye ◽  
G Diop ◽  
A Bouazé ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Public Health Problem ◽  
Epidemiological Data ◽  
Sub Saharan Africa ◽  
Factors Associated ◽  
Manual Search ◽  
African Populations ◽  
Localization Strategy ◽  
Sub Saharan ◽  
Oral Cavity Cancers

INTRODUCTION: Oral cavity cancers are now a public health problem according to WHO epidemiological data. There are several risk factors or factors associated with cancers of the oral cavity but they vary according to geographic regions. OBJECTIVE: The objective of this study was to identify factors associated with cancers of the oral cavity in Sub-Saharan African populations through a systematic literature review. METHODOLOGY: Using the data available for the period from January 1980 to December 2019, a synthesis of the literature was carried out. The literature localization strategy included an electronic search of the MEDLINE, EMBASE and GOOGLE SCHOLAR databases from 1980 to 2019 and a manual search of the list of references of articles identified by snowballing. The data were extracted independently by two researchers on an Excel© spreadsheet. Parameters collected from each study were author, country, type of study, period of study, size, age, gender, and factors studied. RESULTS: Out of 1,318 articles found, 24 were selected. The data contained 17,290 patients including 8,229 men, i.e. a male / female sex-ratio of 0.91. Factors studied were tobacco, alcohol, diet, infection, genetics and social factors. CONCLUSION: The results reported showed that several factors are associated with the occurrence of oral cavity cancers in Sub-Saharan Africa. There is a need to conduct further studies with more structured methodologies for more convincing results.

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