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Article ; Online: Leveraging emergency care to reach key populations for 'the last mile' in HIV programming: a waiting opportunity.

Smith-Sreen, Joshua / Bosire, Rose / Farquhar, Carey / Katz, David A / Kimani, Joshua / Masyuko, Sarah / Mello, Michael J / Aluisio, Adam R

AIDS (London, England)

2023 Volume 37, Issue 15, Page(s) 2421–2424

MeSH term(s)	Humans ; HIV Infections/prevention & control ; Emergency Medical Services
Language	English
Publishing date	2023-11-16
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639076-6
ISSN	1473-5571 ; 0269-9370 ; 1350-2840
ISSN (online)	1473-5571
ISSN	0269-9370 ; 1350-2840
DOI	10.1097/QAD.0000000000003709
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Article ; Online: Assessment of cisplatin-induced nephrotoxicity and its associated factors among cervical cancer patients in the leading tertiary hospital in Kenya.

Isaaka, Joshua / Degu, Amsalu / Kimani, Lawrence M

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

2022 Volume 28, Issue 7, Page(s) 1603–1608

Abstract: Introduction: Cisplatin is the widely used antineoplastic agent in managing cervical cancer despite nephrotoxicity being a major concern. In addition, there was a paucity of data about the degree of nephrotoxicity due to cisplatin in the study setting. ... ...

Abstract	Introduction: Cisplatin is the widely used antineoplastic agent in managing cervical cancer despite nephrotoxicity being a major concern. In addition, there was a paucity of data about the degree of nephrotoxicity due to cisplatin in the study setting. Therefore, this study aimed to investigate the prevalence of cisplatin nephrotoxicity among cervical patients. Methods: A retrospective cross-sectional study was conducted at the Cancer Treatment Centre of Kenyatta National Hospital among 100 cervical cancer patients treated with a cisplatin regimen. Simple random sampling was employed to the recruit medical record of patients. This study used a data abstraction tool to extract the patients' relevant socio-demographic and clinical characteristics. The data were analysed using Statistical Package for Social Sciences version 25.0 software. Frequency tables and figures were used to present the findings of the study. Binary logistic regression analysis was used to determine factors associated with cisplatin nephrotoxicity. Results: The study showed a mean age of 52.09 ± 10.44 years. The prevalence rate of cisplatin-induced nephrotoxicity in cervical cancer patients was 45%. Of these patients, 36% and 9% patients had grade 1 and 2 nephrotoxicities, respectively. Comorbidities (crude odd's ratio (COR) = 3.05, 95% confidence interval [CI] = 1.3-7.02, Conclusion: The prevalence of cisplatin-induced nephrotoxicity among cervical cancer patients was high in the study setting. Comorbidities, number of cycles and types of comorbidities were significant factors associated with cisplatin nephrotoxicity.
MeSH term(s)	Adult ; Antineoplastic Agents/adverse effects ; Cisplatin/adverse effects ; Cross-Sectional Studies ; Drug-Related Side Effects and Adverse Reactions/drug therapy ; Female ; Humans ; Kenya/epidemiology ; Kidney Diseases/chemically induced ; Kidney Diseases/epidemiology ; Middle Aged ; Retrospective Studies ; Tertiary Care Centers ; Uterine Cervical Neoplasms/drug therapy
Chemical Substances	Antineoplastic Agents ; Cisplatin (Q20Q21Q62J)
Language	English
Publishing date	2022-08-05
Publishing country	England
Document type	Journal Article
ZDB-ID	1330764-2
ISSN	1477-092X ; 1078-1552
ISSN (online)	1477-092X
ISSN	1078-1552
DOI	10.1177/10781552221119417
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Article: Emergency departments as under-utilized venues to provide HIV prevention services to female sex workers in Nairobi, Kenya.

Poxon, Amanda / Leis, Maria / McDermott, Miranda / Kariri, Antony / Kaul, Rupert / Kimani, Joshua

International journal of emergency medicine

2023 Volume 16, Issue 1, Page(s) 47

Abstract: Background: Female sex workers (FSW) in sub-Saharan Africa are disproportionately affected by HIV and remain a key target population for efforts to reduce transmission. While HIV prevention tools such as PEP and PrEP are available through outpatient FSW ...

Abstract	Background: Female sex workers (FSW) in sub-Saharan Africa are disproportionately affected by HIV and remain a key target population for efforts to reduce transmission. While HIV prevention tools such as PEP and PrEP are available through outpatient FSW clinics, these services are underused. Emergency medicine is a rapidly expanding field in Kenya and may provide a novel venue for initiating or optimizing HIV prevention services. This study examined the characteristics of FSW from Nairobi, Kenya, who had utilized an emergency department (ED) during the past year to broaden our understanding of the patient factors related to usage. Methods: An anonymous questionnaire was administered to a convenience sample of 220 Nairobi FSW attending dedicated clinics from June to July 2019. The participants were categorized into those who attended an ED over the past year (acute care users) and clinic-only users (control). A modified version of the WHO Violence Against Women Instrument assessed gender-based violence. Multivariable negative binomial logistic regressions evaluated predictors of health care use among these populations. Results: Of the total 220 women (median [IQR] age 32 [27-39]), 101 and 116 were acute care and control populations, respectively. Acute care users had 12.7 ± 8.5 healthcare visits over a 12-month period, and the control population had 9.1 ± 7.0 (p < 0.05). ED attendance did not improve the PrEP usage, with 48.5%, and 51% of acute care and clinic users indicated appropriate PrEP use. Patient factors that correlated with health care utilization among acute care users included client sexual violence (OR 2.2 [1.64-2.94], p < 0.01), PrEP use (OR 1.54 (1.25-1.91), < 0.01), and client HIV status (OR 1.35 (1.02-1.69), p < 0.01). Conclusions: Many FSW at high risk for HIV were not accessing HIV prevention tools despite attending a dedicated FSW clinic offering such services. FSW who had attended an ED over the past year had a higher prevalence of HIV risk factors, demonstrating that emergency departments may be important acute intervention venues to prevent HIV transmission in this population. These results can guide policy design, health care provider training, and facility preparedness to support strategies aimed at improving HIV prevention strategies for FSW in Kenyan ED's.
Language	English
Publishing date	2023-08-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2411462-5
ISSN	1865-1380 ; 1865-1372
ISSN (online)	1865-1380
ISSN	1865-1372
DOI	10.1186/s12245-023-00516-x
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Book ; Online: Can systems thinking assist policymakers navigate the complexity of the livestock sector in developing countries?

Mugo, Cynthia / Bahta, Sirak T. / Aboah, Joshua / Chan, Derek / Baltenweck, Isabelle / Kimani, Judy

2023

Keywords	livelihoods ; livestock
Language	English
Publishing date	2023-01-16T11:24:19Z
Publisher	International Livestock Research Institute
Publishing country	fr
Document type	Book ; Online
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Article: Improving

Shiluli, Clement / Kamath, Shwetha / Kanoi, Bernard N / Kimani, Racheal / Maina, Michael / Waweru, Harrison / Kamita, Moses / Ndirangu, Ibrahim / Abkallo, Hussein M / Oduor, Bernard / Pamme, Nicole / Dupaty, Joshua / Klapperich, Catherine M / Lolabattu, Srinivasa Raju / Gitaka, Jesse

Heliyon

2024 Volume 10, Issue 6, Page(s) e27344

Abstract: Background: Curable sexually transmitted infections (STIs), such as : Methods: We identified new diagnostic target biomarker regions for : Results: Our newly developed : Conclusion: Therefore, there is a potential to implement this concept ... ...

Abstract	Background: Curable sexually transmitted infections (STIs), such as Methods: We identified new diagnostic target biomarker regions for Results: Our newly developed Conclusion: Therefore, there is a potential to implement this concept within miniaturized, isothermal, microfluidic platforms, and laboratory-on-a-chip diagnostic devices for highly reliable point-of-care testing.
Language	English
Publishing date	2024-03-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2024.e27344
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Article ; Online: URCHOICE: Preferences for Pre-Exposure Prophylaxis (PrEP) Options for HIV Prevention Among Kenyan men who have sex with men and Transgender Women in Nairobi, Kisumu and the Coast.

Bailey, Robert C / Kimani, Makobu / Kabuti, Rhoda / Gumbe, Edwin / Otieno, George / Kimani, Joshua / Okall, Duncan / Sanders, Eduard J / Otieno, Fredrick O

AIDS and behavior

2022 Volume 27, Issue 1, Page(s) 25–36

Abstract: HIV prevention method preferences were evaluated among Kenyan men who have sex with men (MSM) and transgender women (TW) from three sites: Kisumu, Nairobi and the Coast. Information sessions detailing the attributes, duration of protection, route of ... ...

Abstract	HIV prevention method preferences were evaluated among Kenyan men who have sex with men (MSM) and transgender women (TW) from three sites: Kisumu, Nairobi and the Coast. Information sessions detailing the attributes, duration of protection, route of administration and probable visibility were attended by 464 HIV negative participants, of whom 423 (median age: 24 years) agreed to be interviewed. Across pairwise comparisons daily PrEP was by far the least preferred (1%); quarterly injections (26%) and monthly pills (23%) were most preferred, followed by yearly implant (19%) and condoms (12%). When participants were "forced" to choose their most preferred PrEP option, only 10 (2.4%) chose the daily pill; more (37.1%) chose the quarterly injection than the monthly pill (34.8%) and the yearly implant (25.8%). TW preferred the yearly implant over the quarterly injection. To achieve the rates of PrEP uptake and adherence necessary for protecting large proportions of vulnerable MSM and TW, a variety of long-acting products should be developed and made accessible to appeal to a diversity of preferences.
MeSH term(s)	Male ; Humans ; Female ; Young Adult ; Adult ; Homosexuality, Male ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; HIV Infections/drug therapy ; Kenya/epidemiology ; Transgender Persons ; Anti-HIV Agents/therapeutic use ; Sexual and Gender Minorities ; Pre-Exposure Prophylaxis/methods
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2022-06-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	1339885-4
ISSN	1573-3254 ; 1090-7165
ISSN (online)	1573-3254
ISSN	1090-7165
DOI	10.1007/s10461-022-03741-2
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Article ; Online: Automated brightfield layerwise evaluation in three-dimensional micropatterning via two-photon polymerization.

Sun, Jieliyue / Howes, Andrew M / Jia, Sixian / Burrow, Joshua A / Felzenszwalb, Pedro F / Dawson, Michelle R / Shao, Chenhui / Toussaint, Kimani C

Optics express

2024 Volume 32, Issue 7, Page(s) 12508–12519

Abstract: Two-photon polymerization (TPP) is an advanced 3D fabrication technique capable of creating features with submicron precision. A primary challenge in TPP lies in the facile and accurate characterization of fabrication quality, particularly for structures ...

Abstract	Two-photon polymerization (TPP) is an advanced 3D fabrication technique capable of creating features with submicron precision. A primary challenge in TPP lies in the facile and accurate characterization of fabrication quality, particularly for structures possessing complex internal features. In this study, we introduce an automated brightfield layerwise evaluation technique that enables a simple-to-implement approach for in situ monitoring and quality assessment of TPP-fabricated structures. Our approach relies on sequentially acquired brightfield images during the TPP writing process and using background subtraction and image processing to extract layered spatial features. We experimentally validate our method by printing a fibrous tissue scaffold and successfully achieve an overall system-adjusted fidelity of 87.5% in situ. Our method is readily adaptable in most TPP systems and can potentially facilitate high-quality TPP manufacturing of sophisticated microstructures.
Language	English
Publishing date	2024-04-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1491859-6
ISSN	1094-4087 ; 1094-4087
ISSN (online)	1094-4087
ISSN	1094-4087
DOI	10.1364/OE.521073
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Article ; Online: Hydroxychloroquine reduces T cells activation recall antigen responses.

Kowatsch, Monika M / Lajoie, Julie / Mwangi, Lucy / Omollo, Kenneth / Oyugi, Julius / Hollett, Natasha / Kimani, Joshua / Fowke, Keith R

PloS one

2023 Volume 18, Issue 8, Page(s) e0287738

Abstract: 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 ... ...

Abstract	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.
MeSH term(s)	Humans ; Hydroxychloroquine/pharmacology ; Hydroxychloroquine/therapeutic use ; Leukocytes, Mononuclear ; Tumor Necrosis Factor Receptor Superfamily, Member 7 ; COVID-19 Vaccines ; Pandemics ; COVID-19 ; COVID-19 Drug Treatment ; Cytokines
Chemical Substances	Hydroxychloroquine (4QWG6N8QKH) ; Tumor Necrosis Factor Receptor Superfamily, Member 7 ; COVID-19 Vaccines ; Cytokines
Language	English
Publishing date	2023-08-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0287738
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Article ; Online: Hepatitis B status and associated factors among participants screened for simulated HIV vaccine efficacy trials in Kenya and Uganda.

Mayanja, Yunia / Rida, Wasima / Kimani, Joshua / Ssetala, Ali / Mpendo, Juliet / Nanvubya, Annet / Mutua, Gaudensia / Anzala, Omu / Price, Matt A

PloS one

2023 Volume 18, Issue 7, Page(s) e0288604

Abstract: Introduction: Hepatitis B (HBV) prevalence remains high in Sub Saharan Africa and among some key populations such as those with continued exposure through sexual contact. We assessed the HBV status among potential participants who were screened for ... ...

Abstract	Introduction: Hepatitis B (HBV) prevalence remains high in Sub Saharan Africa and among some key populations such as those with continued exposure through sexual contact. We assessed the HBV status among potential participants who were screened for simulated HIV vaccine efficacy trials in Kenya and Uganda. Methods: We conducted a cross sectional analysis of data collected from individuals who were screened in Kenya (Nairobi) and Uganda (Entebbe and Kampala). The studies followed hypothetical procedures of an HIV vaccine efficacy trial and aimed to enroll HIV negative key and vulnerable populations at elevated risk of HIV acquisition. HBV status was the main outcome categorized using Hepatitis B surface antigen (HBsAg) and total Hepatitis B core antibody (HBcAb). Baseline characteristics potentially associated with never being infected were analyzed using logistic regression. Results: We screened 1,366 participants with mean age (SD) 28.7 (7.3) years. Overall, 46.6% were from Entebbe, 50.7% had secondary or higher level of education, 76.4% had informal high-risk jobs and 56.3% were male. Kampala had only female participants contributing 60.6% of females screened. Of the screened participants, 94.7% and 3.4% were negative and positive for HBsAg respectively. The prevalence on HBV infection was 3.9% among males and 2.8% among females while prevalence by site was: Entebbe (4.9%); Kampala (4.1%) and Nairobi (0.3%). The highest HBV prevalence was found among participants aged 25-29-years (5.2%), those with primary level education (4.5%), and those in informal low risk jobs (6.5%). Considering 1265 participants with complete data on HBsAg and HBcAb-Total, HBV status was never infected (67.9%), past infection (28.5%), chronic infection (3.2%) and acute infection (0.5%). Of 859 who were never infected, 685 (79.7%) were tested for anti-HBs titers of whom 60 (8.8%) had titers >10IU/L (immune due to vaccination). The odds of never being HBV infected were lower among older individuals 25-29 years (AOR 0.51; 95%CI 0.36-0.71) and ≥30 years (AOR 0.35; 95% CI 0.25-0.49). The odds were higher among participants with informal high-risk jobs from Kampala (AOR 2.21; 95% CI 1.41-3.47) and Nairobi (AOR 2.61; 95% CI 1.72-4.00) compared to those from Entebbe. Conclusion: HBV prevalence and immunity due to vaccination were low among HIV negative individuals who are eligible for HIV vaccine trials and prevalence varies by age, education level and main occupation. Younger individuals and those recruited from existing cohorts/ clinics have a higher likelihood of having no prior HBV infection. HIV prevention intervention trials are a platform to identify individuals that need HBV vaccination.
MeSH term(s)	Humans ; Male ; Female ; Adult ; Hepatitis B Surface Antigens ; AIDS Vaccines ; Uganda/epidemiology ; Kenya/epidemiology ; Cross-Sectional Studies ; Vaccine Efficacy ; Hepatitis B/epidemiology ; Hepatitis B/prevention & control ; Hepatitis B/complications ; Hepatitis B virus ; Hepatitis B Vaccines ; Hepatitis B Antibodies ; Prevalence ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; HIV Infections/complications
Chemical Substances	Hepatitis B Surface Antigens ; AIDS Vaccines ; Hepatitis B Vaccines ; Hepatitis B Antibodies
Language	English
Publishing date	2023-07-17
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0288604
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Article ; Online: The epidemiology of HIV infection among female sex workers in Nairobi, Kenya: A structural determinants and life-course perspective.

Beattie, Tara S / Adhiambo, Wendy / Kabuti, Rhoda / Beksinska, Alicja / Ngurukiri, Pauline / Babu, Hellen / Kung'u, Mary / Nyamweya, Chrispo / Mahero, Anne / Irungu, Erastus / Muthoga, Peter / Seeley, Janet / Kimani, Joshua / Weiss, Helen A / Kaul, Rupert

PLOS global public health

2024 Volume 4, Issue 1, Page(s) e0001529

Abstract: High HIV prevalence among female sex workers (FSWs) is heavily influenced by structural determinants (e.g. criminalisation of sex work; violence) and significant life events (e.g. orphanhood, teenage pregnancy). This study aims to understand the ... ...

Abstract	High HIV prevalence among female sex workers (FSWs) is heavily influenced by structural determinants (e.g. criminalisation of sex work; violence) and significant life events (e.g. orphanhood, teenage pregnancy). This study aims to understand the epidemiology of HIV among FSWs in Nairobi, Kenya using a structural determinants and life-course perspective. Baseline cross-sectional survey data were collected June-December 2019 for the Maisha Fiti study with 1003 FSWs (aged 18-45 years). Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression with a hierarchical modelling approach. HIV prevalence was 28.0%, and increased with age (<25 years 5.7%, 25-34 years 19.0%, ≥35 years 40.6%). In adjusted analyses, HIV seroprevalence was associated with childhood and adolescence including violence from militia or soldiers (AOR = 1.60; 95%CI:1.00-2.53), young age at sexual debut (≤15 years old vs. ≥18 years AOR = 0.57; 95%CI:0.39-0.84) and teenage pregnancy (AOR = 1.37; 95%CI:1.00-1.88). For adulthood the factors included lower SES score (lowest vs. highest tertile AOR = 0.63; 95%CI:0.40-0.98); reduced housing insecurity (AOR = 0.52; 95%CI:0.54-0.79); lower alcohol/drug use score (AOR = 0.44; 95%CI:0.31-0.61); and a longer duration of selling sex (0-5 years vs. ≥11 years AOR = 2.35; 95%CI:1.44-3.82). Among HIV-negative FSWs, prevalence of HIV risk factors was high (recent hunger 32.3%; internalised 67.7% and experienced 66.0% sex work stigma; recent police arrest 30.1%; recent physical or sexual violence 65.6%, condomless last sex intimate partner 71.1%; harmful alcohol or substance use 49.1%). Only 24.6% of HIV-negative FSWs reported taking PrEP. Taken together, adverse events in childhood and adolescence were associated with increased odds of living with HIV, and were more strongly associated with HIV serostatus than adulthood structural or behavioural risk factors. HIV-negative FSWs remain at high risk of HIV acquisition. This study highlights the importance of addressing adverse events throughout the life course to reduce HIV risk, and the need to continue multi-level HIV prevention and treatment efforts.
Language	English
Publishing date	2024-01-08
Publishing country	United States
Document type	Journal Article
ISSN	2767-3375
ISSN (online)	2767-3375
DOI	10.1371/journal.pgph.0001529
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