Medicine and Health Sciences Commons^™

Effects Of Hazardous And Harmful Alcohol Use On Hiv Incidence And Sexual Behaviour: A Cohort Study Of Kenyan Female Sex Workers, Matthew F. Chersich, Wilkister Bosire, Nzioki King’Ola, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Aims: To investigate putative links between alcohol use, and unsafe sex and incident HIV infection in sub-Saharan Africa.

Methods: A cohort of 400 HIV-negative female sex workers was established in Mombasa, Kenya. Associations between categories of the Alcohol Use Disorders Identification Test (AUDIT) and the incidence at one year of unsafe sex, HIV and pregnancy were assessed using Cox proportional hazards models. Violence or STIs other than HIV measured at one year was compared across AUDIT categories using multivariate logistic regression.

Results: Participants had high levels of hazardous (17.3%, 69/399) and harmful drinking (9.5%, 38/399), while 36.1% abstained from alcohol. …

Clinical Features, Proximate Causes, And Consequences Of Active Convulsive Epilepsy In Africa, Symon M. Kariuki, William Matuja, Albert Akpalu, Angelina Kakooza-Mwesige, Martin Chabi, Ryan G. Wagner, Myles Connor, Eddie Chengo, Anthony K. Ngugi, Rachael Odhiambo, Christian Bottomley, Steven White, Josemir W. Sander, Brian G. R. Neville, Charles R. J. C. Newton

Internal Medicine, East Africa

Purpose: Epilepsy is common in sub-Saharan Africa (SSA), but the clinical features and consequences are poorly characterized. Most studies are hospital-based, and few studies have compared different ecological sites in SSA. We described active convulsive epilepsy (ACE) identified in cross-sectional community-based surveys in SSA, to understand the proximate causes, features, and consequences.

Methods: We performed a detailed clinical and neurophysiologic description of ACE cases identified from a community survey of 584,586 people using medical history, neurologic examination, and electroencephalography (EEG) data from five sites in Africa: South Africa; Tanzania; Uganda; Kenya; and Ghana. The cases were examined by clinicians to …

Exploring The Potential For Advanced Nursing Practice Role Development In Kenya: A Qualitative Study, Linda Anne East, John Arudo, Martha Loefler, Catrin Mai Evans

School of Nursing & Midwifery, East Africa

Background: Definitions of advanced nursing practice abound, yet little has been published concerning the context for advanced nursing in sub-Saharan Africa. This study set out to explore the existence of, and potential for, advanced nursing practice in Kenya.

Methods: Ten nurses were invited to participate in semi-structured qualitative interviews. Participants were purposively selected to provide insight into the practice of experienced nurses in urban, rural, community, hospital, public and private health care settings. Interview narratives were recorded, transcribed and subsequently analysed using a thematic approach.

Results: All participants reported that they were engaged in the delivery of expert, evidence-based care. …

Exposure To Multiple Parasites Is Associated With The Prevalence Of Active Convulsive Epilepsy In Sub-Saharan Africa, Gathoni Kamuyu, Christian Bottomley, James Mageto, Brett Lowe, Patricia Wilkins, John C. Noh, Thomas B. Nutman, Anthony Ngugi, Rachael Odhiambo, Ryan Wagner, Angelina Kakooza-Mwesige, Seth Owusu-Agyei, Kenneth Ae-Ngibise, Honorati Masanja, Faith Osier, Peter Odermatt, Charles Newton

Family Medicine, East Africa

Background: Epilepsy is common in developing countries, and it is often associated with parasitic infections. We investigated the relationship between exposure to parasitic infections, particularly multiple infections and active convulsive epilepsy (ACE), in five sites across sub-Saharan Africa.

Methods and Findings: A case-control design that matched on age and location was used. Blood samples were collected from 986 prevalent cases and 1,313 age-matched community controls and tested for presence of antibodies to Onchocerca volvulus, Toxocara canis, Toxoplasma gondii, Plasmodium falciparum, Taenia solium and HIV. Exposure (seropositivity) to Onchocerca volvulus (OR = 1.98; 95%CI: 1.52-2.58, p

Conclusion: This study investigates how …