A5046257954- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- HIV Research and Treatment
- Global Maternal and Child Health
- HIV/AIDS Impact and Responses
- Reproductive tract infections research
- Sex work and related issues
- Healthcare Systems and Reforms
- LGBTQ Health, Identity, and Policy
- Healthcare Policy and Management
- Ethics in Clinical Research
- Global Health Care Issues
- Primary Care and Health Outcomes
- Blood Pressure and Hypertension Studies
- African Sexualities and LGBTQ+ Issues
- Pharmaceutical Economics and Policy
- Antiplatelet Therapy and Cardiovascular Diseases
- COVID-19 epidemiological studies
- Pneumocystis jirovecii pneumonia detection and treatment
- Antibiotic Use and Resistance
- Parvovirus B19 Infection Studies
- HIV/AIDS drug development and treatment
- COVID-19 Pandemic Impacts
- Pharmaceutical Practices and Patient Outcomes
Aga Khan University Nairobi
2025
Aga Khan University Hospital Nairobi
2025
Kenya Medical Research Institute
2016-2025
Wellcome Trust
2025
Aga Khan University Hospital
2024
Barts Health NHS Trust
2020
Kenyatta University
2020
University of Washington
2020
Institute of Social and Preventive Medicine
2020
University of Bern
2019-2020
Background Little is known about safety of and adherence to intermittent HIV PrEP regimens, which may be more feasible than daily dosing in some settings. We present data from the first trial an regimen among Kenyan men who have sex with (MSM) female workers (FSW). Methods/Principal Findings MSM FSW were randomized oral FTC/TDF or placebo, (Monday, Friday within 2 hours after sex, not exceed one dose per day) placebo a 2∶1∶2∶1 ratio; volunteers followed monthly for 4 months. Adherence was...
Background While HIV testing and counselling is a key entry point for treatment as prevention, over half of HIV-infected adults in Kenya are unaware they infected. Offering self-testing (HST) at community pharmacies may enhance detection undiagnosed infections. We assessed the feasibility pharmacy-based HST Coastal Kenya. Methods Staff five pharmacies, supported by on-site research assistants, recruited adult clients (≥18 years) seeking services indicative risk. Participants were offered...
Health systems in low- and middle-income countries face the challenge of addressing growing burden non-communicable diseases (NCDs) with scarce resources to do so. There are cost-effective interventions that can improve management most common NCDs, but many remain poorly implemented. One example is fixed dose combinations (FDCs) medications for hypertension. Included WHO's Essential Medicines List, FDCs combine two or more blood pressure lowering agents into one pill reduce on patients...
Young men who have sex with (MSM), are a key population at higher risk of HIV infection yet they underrepresented in research. We conducted bio-behavioral survey to estimate prevalence and associated factors among tertiary student MSM (TSMSM) Nairobi, Kenya.Between February March 2021, 248 TSMSM aged ≥ 18 years reported another man the past year participated respondent-driven sampling (RDS) based cross-sectional survey. Participants completed an electronically self-administered behavioral...
Abstract Background Globally, young gay, bisexual and other men who have sex with (YMSM) experience a disproportionate burden of disease compared to heterosexual older MSM. However, YMSM major inequities in access use health services. We sought gain detailed understanding YMSM’s healthcare engagement experiences across public, private, tertiary institution-based MSM-friendly facilities Nairobi, Kenya, inform development interventions improve services by YMSM. Methods In September 2021,...
African men who have sex with (MSM) face significant stigma and barriers to care. We investigated antiretroviral therapy (ART) adherence among high-risk adults, including MSM, participating in a clinic-based cohort. Survival analysis was used compare attrition across patient groups. Differences adherence, weight gain, CD4 counts after ART initiation were assessed. Among 250 HIV-1-seropositive 108 15 heterosexual men, 127 women, group not associated attrition. 58 participants followed on ART,...
HIV-positive Kenyan men who have sex with (MSM) are a highly stigmatized group facing barriers to care engagement and antiretroviral therapy (ART) adherence. Because providers' views important in improving outcomes, we sought the perspective of those serving MSM patients on how optimize ART adherence setting where same-sex behavior is criminalized. We conducted 4 focus discussions total 29 healthcare workers (HCWs) experienced providing HIV MSM. The semistructured, open-ended topic guide...
Following HIV-1 acquisition, many individuals develop an acute retroviral syndrome and a majority seek care. Available antibody testing cannot detect HIV infection, but repeat after 2-4 weeks may seroconversion. We assessed the effect of appointment reminders on attendance for testing.We enrolled, in randomized controlled trial, 18-29 year old patients evaluated infection at five sites Coastal Kenya (ClinicalTrials.gov NCT01876199). Participants were allocated 1:1 to either standard (a dated...
A qualitative assessment of Kenyan men who have sex with taking daily and intermittent oral HIV pre-exposure prophylaxis (PrEP) found stigma, work, mobility, alcohol impacted adherence. We analyzed quantitative data from the same cohort to explore different definitions Volunteers were randomized emtricitabine/tenofovir or placebo, (prescription: Mondays/Fridays/after sex, maximum 1 dose/day) placebo (2:1:2:1), followed for 4 months. By electronic monitoring, median adherence dosing was 80 %....
Abstract To achieve their conservation goals individuals, communities and organizations need to acquire a diversity of skills, knowledge information (i.e. capacity). Despite current efforts build maintain appropriate levels capacity, it has been recognized that there will be significant scaling-up these activities in sub-Saharan Africa. This is because the rapid increase number extent environmental problems region. We present range socio-economic contexts relevant four key areas African...
Viral nucleic acids present in the plasma of 498 Kenyan adults with unexplained fever were characterized by metagenomics analysis 51 sample pools. The highest to lowest fraction pools was positive for parvovirus B19 (75 %), pegivirus C (GBV-C) (67 alpha anellovirus (59 gamma (55 beta (41 dengue virus genotype 2 (DENV-2) (16 human immunodeficiency type 1 (6 herpesvirus 6 HBV (4 rotavirus hepatitis B rhinovirus (2 Merkel cell polyomavirus (MCPyV; %) and Kadipiro %). Ranking overall percentage...
Febrile adults are usually not tested for acute HIV-1 infection (AHI) in Africa. We assessed a strategy to diagnose AHI among young adult patients seeking care.Young (<30 years) who met predefined criteria at care seeking, including fever, sexually transmitted disease symptoms, diarrhoea, body pains or multiple partners were referred from five pharmacies and screened health facilities. Prevalent was diagnosed by nationally recommended serial rapid testing. Willing HIV-1-negative evaluated...
Objectives: In many African settings, MSM are a stigmatized group whose access to and engagement in HIV care may be challenging. Our aim was design targeted, culturally appropriate intervention promote antiretroviral therapy (ART) adherence for coastal Kenya, describe safety, feasibility, acceptability based upon small pilot study. Design: Based on qualitative work including in-depth interviews with HIV-positive focus groups providers, we developed tailored conducted test refine materials...
We evaluated the University of North Carolina-Malawi Risk Screening Score (UMRSS) for detection acute and early HIV-1 infection (AEHI) in a cohort Kenyan MSM with approximately 8% annual incidence. Three components UMRSS (fever, diarrhea, discordant rapid HIV tests) were also independent predictors AEHI our cohort. The predictive ability (area under receiver operating characteristic curve, AUC) was 0.79. A cohort-derived risk score consisting six characteristics tests, fatigue, age <30...
Primary health care (PHC) is central to attainment of the Sustainable Development Goals, yet comparable cross-country data on key aspects primary have not been widely available. This study analysed from People's Voice Survey, which was conducted in 2022 and 2023 14 countries. We documented usual source across countries examined associations with core PHC services, quality ratings, system confidence. found that 75% respondents had a care, 40% accessed public sector at level. 44% rated their...
Dual Antiplatelet Therapy (DAPT) plays an important role in the secondary prevention of ischemic events after treatment for acute coronary syndrome (ACS). The long-term use DAPT is associated with increased risk bleeding, which affects morbidity and mortality. Risk stratification scores have been developed to predict this provide a balance against events. aim study was determine incidence bleeding cohort patients Kenya on assess performance PRECISE-DAPT Score predicting bleeding. This...
The use of advanced analytics in public health policy remains hindered by a disconnect between researchers, policymakers, and technical experts. Bridging this gap requires intentional knowledge translation strategies that facilitate interdisciplinary collaboration real-world application research findings. Hackathons, which bring together diverse stakeholders time-bound, solution-oriented format, offer an approach to addressing challenge. In January 2025, the MRC Centre for Global Infectious...
Fixed-dose combinations (FDCs) – 2-3 anti-hypertensive medications in a single pill - have the potential to improve hypertension treatment and outcomes. Yet, they are not widely implemented. Factors undermining implementation remain unknown, particularly sub–Saharan Africa, where is major cause of disease burden poorly controlled. This study explored acceptability FDCs among patients, caregivers, healthcare workers. We conducted semi-structured in-depth interviews with 58 participants from...
<title>Abstract</title> <bold>Background</bold>: Kenya has identified Primary Health Care Networks (PCNs) as a key reform to strengthen (PHC) delivery. It enacted the Act of 2023 facilitate their implementation. PCNs were piloted in Kisumu and Garissa counties 2020 rolled out nationally 2023. This study examined implementation experience PCN Kenya. <bold>Methods</bold>: We used cross-sectional qualitative process evaluation design. collected data at national level five purposefully selected...
Fever is common among patients seeking care in sub-Saharan Africa (sSA), but causes other than malaria are rarely diagnosed. We assessed dengue and chikungunya virus infections young febrile adults evaluated for acute HIV infection (AHI) coastal Kenya.We tested plasma samples obtained a cross-sectional study from adult aged 18-35 years AHI at urgent seven health facilities Kenya 2014-2015. Dengue (DENV) (CHIKV) were amplified using quantitative real-time reverse-transcription polymerase...