Infectious diarrhoea in antiretroviral therapy-naive HIV/AIDS patients in Kenya

Wanyiri, Jane W.; Kanyi, Henry; Maina, Samuel; Wang, David E.; Ngugi, Paul; O’Connor, Roberta M.; Kamau, Timothy; Waithera, Tabitha; Kimani, Gachuhi; Wamae, C. N.; Mwamburi, Mkaya; Ward, Honorine

doi:10.1093/trstmh/trt078

Cited by 19 publications

(18 citation statements)

References 27 publications

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“…Demographics and clinical characteristics of the study population have been described previously. 26 Seventy of 164 (43%) of the patients had diarrhea and 94 of 164 (57%) did not have diarrhea.…”

Section: Resultsmentioning

confidence: 99%

“…Between June 2009 and July 2010 a total of 167 HIV-infected adults were consecutively enrolled in the study 26 ; three patients did not provide samples and were therefore not included in the analysis. Demographics and clinical characteristics of the study population have been described previously.…”

Section: Resultsmentioning

confidence: 99%

“…The study enrolled consecutive HIV-infected adults (18 years of age and older) presenting to CCC/KNH and who had not previously received ART. 26 Informed consent was obtained from all participants in the study.…”

Section: Methodsmentioning

confidence: 99%

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Cryptosporidiosis in HIV/AIDS Patients in Kenya: Clinical Features, Epidemiology, Molecular Characterization and Antibody Responses

Wanyiri¹,

Kanyi²,

Maina³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. We investigated the epidemiological and clinical features of cryptosporidiosis, the molecular characteristics of infecting species and serum antibody responses to three Cryptosporidium-specific antigens in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in Kenya. Cryptosporidium was the most prevalent enteric pathogen and was identified in 56 of 164 (34%) of HIV/AIDS patients, including 25 of 70 (36%) with diarrhea and 31 of 94 (33%) without diarrhea. Diarrhea in patients exclusively infected with Cryptosporidium was significantly associated with the number of children per household, contact with animals, and water treatment. Cryptosporidium hominis was the most prevalent species and the most prevalent subtype family was Ib. Patients without diarrhea had significantly higher serum IgG levels to Chgp15, Chgp40 and Cp23, and higher fecal IgA levels to Chgp15 and Chgp40 than those with diarrhea suggesting that antibody responses to these antigens may be associated with protection from diarrhea and supporting further investigation of these antigens as vaccine candidates.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Cryptosporidiosis in HIV/AIDS Patients in Kenya: Clinical Features, Epidemiology, Molecular Characterization and Antibody Responses

Wanyiri¹,

Kanyi²,

Maina³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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“…In Kenya, polyparasitism was more common in patients with diarrhoea than those with single infections of intestinal parasites [137]. Multiple infections could impact on the host’s response to infection, as synergistic interaction between co-infecting pathogens has been shown to enhance diarrhoea pathogenesis.…”

Section: Molecular Detection and Characterisation Of Cryptosporidium mentioning

confidence: 99%

Cryptosporidium and Giardia in Africa: current and future challenges

2017

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Cryptosporidium and Giardia are important causes of diarrhoeal illness. Adequate knowledge of the molecular diversity and geographical distribution of these parasites and the environmental and climatic variables that influence their prevalence is important for effective control of infection in at-risk populations, yet relatively little is known about the epidemiology of these parasites in Africa. Cryptosporidium is associated with moderate to severe diarrhoea and increased mortality in African countries and both parasites negatively affect child growth and development. Malnutrition and HIV status are also important contributors to the prevalence of Cryptosporidium and Giardia in African countries. Molecular typing of both parasites in humans, domestic animals and wildlife to date indicates a complex picture of both anthroponotic, zoonotic and spill-back transmission cycles that requires further investigation. For Cryptosporidium, the only available drug (nitazoxanide) is ineffective in HIV and malnourished individuals and therefore more effective drugs are a high priority. Several classes of drugs with good efficacy exist for Giardia, but dosing regimens are suboptimal and emerging resistance threatens clinical utility. Climate change and population growth are also predicted to increase both malnutrition and the prevalence of these parasites in water sources. Dedicated and co-ordinated commitments from African governments involving “One Health” initiatives with multidisciplinary teams of veterinarians, medical workers, relevant government authorities, and public health specialists working together are essential to control and prevent the burden of disease caused by these parasites.

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“…This compares to multiple studies among hospitals including South Africa where there are concerns with the lack of reporting of ADRs although this is now being addressed [1, 3-5, 14, 16, 17, 52-57]. This is a critical concern given the high prevalence of both infectious and non-communicable diseases across Africa [58][59][60][61][62][63][64]. In addition, there are appreciable differences in patients with HIV in sub-Saharan Africa compared with western countries, with a higher percentage being women, leading to appreciable genetic differences between the populations [63,65].…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes and practices of health care professionals towards adverse drug reaction reporting in public sector primary health care facilities in a South African district

Haines

Meyer

et al. 2020

Eur J Clin Pharmacol

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Purpose Adverse drug reactions (ADRs) have an appreciable impact on patients' health. Little is known however about ADR reporting in ambulatory care environments especially in low-and middle-income countries. Consequently, our aim was to determine knowledge, attitudes and practices (KAP) among health care professionals (HCPs) towards ADR reporting in primary health care (PHC) facilities in South Africa. The findings will be used to direct future activities. Methods Descriptive, cross-sectional design using quantitative methodology among 8 public sector community health care centres and 40 PHC clinics in the Tshwane Health District, Gauteng Province. A self-administered questionnaire was distributed to 218 HCPs, including all key groups. Results A total of 200 responses were received (91.7%). Although an appropriate attitude towards ADR reporting existed, the actual frequency of ADR reporting was low (16.0%). Of the respondents, 60.5% did not know how to report, where to report or when to report an ADR and 51.5% said the level of their clinical knowledge made it difficult to decide whether or not an ADR had occurred. Over 97.5% stated they should be reporting ADRs with 89% feeling that ADR reporting is a professional obligation and over 70% that ADR reporting should be compulsory. When results were combined, the overall mean score in terms of positive or preferred practices for ADR reporting was 24.6% with pharmacists having the highest scores. Conclusion Under-reporting of ADRs with gaps in KAP was evident. There is a serious and urgent need for education and training of HCPs on ADR reporting in South Africa.

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Infectious diarrhoea in antiretroviral therapy-naive HIV/AIDS patients in Kenya

Abstract: Multiple enteric pathogens that are causative agents of diarrhoea were isolated from stools of antiretroviral therapy-naïve HIV/AIDS patients, indicating a need for surveillance, treatment and promotion of hygienic practices.

Cited by 19 publications

References 27 publications

Cryptosporidiosis in HIV/AIDS Patients in Kenya: Clinical Features, Epidemiology, Molecular Characterization and Antibody Responses

Cryptosporidiosis in HIV/AIDS Patients in Kenya: Clinical Features, Epidemiology, Molecular Characterization and Antibody Responses

Cryptosporidium and Giardia in Africa: current and future challenges

Knowledge, attitudes and practices of health care professionals towards adverse drug reaction reporting in public sector primary health care facilities in a South African district

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