Department of Medical Sciences

Adapting methods of key population programmatic mapping and enumeration to inform HIV prevention programs for adolescent girls and young women

2024-06-11T00:01:00Z

Adapting methods of key population programmatic mapping and enumeration to inform HIV prevention programs for adolescent girls and young women Cheuk, Eve; Isac, Shajy; Musyoki, Helgar K; Pickles, Michael; Bhattacharjee, Parinita; Gichangi, Peter; Lorway, Robert R; Mishra, Sharmistha; Blanchard, James F; Becker, Marissa L Background: Standard programmatic mapping involves identifying locations where key populations meet, profiling of these locations (hotspots) and estimating the key population size. Information gained from this method has been used for HIV programming – resource allocation, program planning, service delivery, and monitoring and evaluation – for people who inject drugs, men who has sex with men, and female sex workers (FSW). With an increasing focus on adolescent girls and young women (AGYW) as a priority population for HIV prevention, programs need to know where and how to effectively reach individuals that are at increased risk for HIV but were conventionally considered part of the general population. We hypothesize that AGYW who engage in transactional and casual sex also congregate at sex work hotspots to meet sex partners. Therefore, we adapted the standard programmatic mapping approach to understand the geographic distribution and population size of AGYW in Mombasa County, Kenya. Objective: The objectives are several-fold: (1) to detail and compare the modified programmatic mapping approach used in this study to the standard approach; (2) to estimate the number of young FSW; (3) to estimate the number of AGYW who congregate in sex work hotspots to meet sex partners other than clients; (4) to estimate the overlap in sexual network in hotspots; (5) to describe the distribution of sex work hotspots across Mombasa and its four sub-counties; and (6) to compare the distribution of hotspots that were known to the local HIV prevention program prior to this study and those newly identified. Methods: The standard programmatic mapping approach was modified to estimate the population of young women aged 14-24 years who visit sex work hotspots in Mombasa to meet partners for commercial, transactional and casual sex. Results: We estimated that there were 11,777 FSW (range 9,265-14,290) in Mombasa in 2014; among whom, 6,127 (52.0%) were 14-24 years old. The population estimate for women aged 14-24 years who engaged in transactional and casual sex and congregated at the hotspots were 5,348 (range 4,185-6,510) and 4,160 (range 3,194-5,125), respectively. Of the 1,025 validated sex work hotspots, 856 (83.5%) were locations also visited by women engaged in both transactional and casual sex. Only 48 (4.7%) hotspots were exclusive sex work locations. The geographic and typological distribution of hotspots were significantly different between the four sub-counties (P < .001). Of the 1,025 hotspots, 419 (40.9%) were already known to the local HIV prevention program and 606 (59.1%) were newly identified. Conclusions: Using the adapted programmatic mapping approach detailed in this study, our results show that HIV prevention programs tailored to AGYW can focus delivery of their interventions to traditional sex work hotspots to reach subgroups that may be at increased risk for HIV. DOI: https://doi.org/10.2196/preprints.11196

Rationale and design of a multi-center, open-label, randomised clinical trial comparing HIV incidence and contraceptive benefits in women using three commonly-used contraceptive methods (the ECHO study)

2024-06-08T00:00:39Z

Rationale and design of a multi-center, open-label, randomised clinical trial comparing HIV incidence and contraceptive benefits in women using three commonly-used contraceptive methods (the ECHO study) Hofmeyr, G. Justus; Morrison, Charles S.; Baeten, Jared M.; Chipato, Tsungai; Donnell, Deborah; Gichangi, Peter; Mugo, Nelly; Nanda, Kavita; Rees, Helen; Steyn, Petrus; Taylor, Douglas; ECHO Trial Team Background: In vitro, animal, biological and observational clinical studies suggest that some hormonal methods, particularly depot medroxyprogesterone acetate – DMPA, may increase women’s risk of HIV acquisition. DMPA is the most common contraceptive used in many countries worst affected by the HIV epidemic. To provide robust evidence for contraceptive decision-making among women, clinicians and planners, we are conducting the Evidence for Contraceptive Options and HIV Outcomes (ECHO) study in four countries with high HIV incidence and DMPA use: Kenya, South Africa, Swaziland, and Zambia (Clinical Trials.gov identifier NCT02550067). Study design: We randomized HIV negative, sexually active women 16-35 years old requesting effective contraception and agreeing to participate to either DMPA, the copper T 380A intrauterine device or levonorgestrel implant. Participants attend a contraception support visit after 1 month and quarterly visits thereafter for up to 18 months. Participants receive a standard HIV prevention package and contraceptive side-effect management at each visit. The primary outcome is HIV seroconversion. Secondary outcomes include pregnancy, serious adverse events and method discontinuation. The sample size of 7800 women provides 80% power to detect a 50% relative increase in HIV risk between any of the three method pairs, assuming 250 incident infections per comparison. Ethical considerations: Several WHO consultations have concluded that current evidence on HIV risk associated with DMPA is inconclusive and that a randomized trial is needed to guide policy, counselling and choice. Previous studies suggest that women without a specific contraceptive preference are willing to accept randomization to different contraceptive methods. Stringent performance standards are monitored by an independent data and safety monitoring board approximately every 6 months. The study has been conducted with extensive stakeholder engagement. Conclusions: The ECHO study is designed to provide robust evidence on the relative risks (HIV acquisition) and benefits (pregnancy prevention) between three effective contraceptive methods. https://doi.org/10.12688/gatesopenres.12775.2

Purification and characterization of a midgut lectin-trypsin complex from the tsetse fly Glossina Iongipennis

2024-02-25T00:00:27Z

Purification and characterization of a midgut lectin-trypsin complex from the tsetse fly Glossina Iongipennis Osir, E. O.; Abubakar, L.U; Imbuga, M. O. A blood-meal-induced lectin (agglutinin) with proteolytic activity was isolated from midgut extracts ofGlossina longipennis by a two-step procedure involving anion-exchange chromatography. It is a glycoprotein [native molecular weight (Mr, 61000±3000 da) composed of two noncovalently-linked subunits designated α (Mr, ∼27000 da) and β (Mr, ∼33000 da). The trypsin activity and the glycosyl residues were present on the α- and β-subunits, respectively. The native protein was capable of agglutinating both bloodstream-form and procyclic trypanosomes as well as rabbit red blood cells. This activity was strongly inhibited byD-glucosamine and weakly inhibited byN-acetyl-D-glucosamine. Similarly, soybean trypsin inhibitor abrogated agglutination of bloodstream-form parasites, whereas the procyclics were unaffected. The agglutination activity was sensitive to temperatures above 40° C but was unaffected by chelators of metal ions. Antibodies raised against the protein were used in immunoblotting experiments to show the presence of a similar protein in several members of theGlossina species. However, no cross-reactivity was detected with midgut extracts prepared from sandflies, mosquitoes, or stable flies. It is proposed that this molecule might play an important role in differentiation of bloodstream-form trypanosomes into procyclic (midgut) forms. https://doi.org/10.1007/BF00931530

CHARACTERIZATION OF ALGAE OIL (OILGAE) AND ITS POTENTIAL AS BIOFUEL IN KENYA

2024-02-24T09:28:40Z

CHARACTERIZATION OF ALGAE OIL (OILGAE) AND ITS POTENTIAL AS BIOFUEL IN KENYA MUTIE, A.M; ABUBAKAR, LEILA U.; MUHOHO, A A survey of microalgae biodiversity in three Kenyan Rift valley lakes identified high oil yielding species abundantly distributed naturally. The species were cultured in BBM and BG-11 media to obtain pure clones and lipids (oil) extracted by the Bligh and Dyer method. The peak lipid content ranged from 1.5 – 10.5% of algal biomass with Chlorella species showing the highest yields (10.5%), followed by Euglena acus (5.88), Nitzschia (3.68%), Ankistrodesmus falcatus (1.58%) and Scenedesmus acuminatus (1.56 %). The algae oil extracted from Chlorella spp contained significantly higher polyunsaturated long chain fatty acids with docosatetraenoate (C22:4) and octadecatetraenoate (C18:4) to be the major components. On the other hand, algae oil from Euglena spp exhibited higher mono-unsaturated long chain fatty acids with erucate (C22:1) and eicosenoate (18:1) being the major components. This implies that algae oil from Euglena spp has a much higher degree of oxidative stability compared to Chlorella spp and has can be cultivated for biofuel. http://hdl.handle.net/123456789/200