Tuberculosis treatment and factors associated with unsuccessful tuberculosis treatment outcome among TB/HIV co-infected patients in Rwanda: A retrospective cohort study

Introduction Mycobacterium tuberculosis remains the main cause of death as an infectious agent of Tuberculosis in humans, particularly in resource-poor settings. Worldwide, Tuberculosis is one of the top 10 causes of mortality. Objective of the study This study aims to determine the outcomes of TB treatment and assess the factors associated with unsuccessful TB treatment outcome among TB/HIV co-infected patients in Rwanda. Methods This was a retrospective cohort study of all TB/HIV co-infected patients reported in the national electronic TB reporting system (e-TB) by all health facilities from July 2019 to June 2020. Frequencies, proportions, bivariate and multivariate logistic regression were performed to determine factors associated with unsuccessful TB treatment. Results There were 1,144 people reported in the e-TB, however, only 987 were included in the study because 157 patients did not meet the inclusion criteria.The TB/HIV coinfected patients who were not given nutritional support, OR 7.3, 95%CI [1.4, 37.6] and those who were not on ART,OR15.3, 95%CI [3.6, 69.6],were more likely to have unsuccessful treatment outcome than their counterparts. Conclusion Unsuccessful TB treatment outcomes were highly observed among TB/HIV coinfected patients. The study recommended reinforcing nutritional support and early initiation of ART among TB/HIV co-infected patients.

Immediate and early engagement of same-day antiretroviral therapy initiation among newly diagnosed people living with HIV in urban Zambia: a retrospective cohort study

Introduction: as Zambia moves towards attaining human immunodeficiency virus (HIV) epidemic control, it is clear significant efforts are required to facilitate achievement of UNAIDS treatment targets by 2030. To accelerate progress towards global target of 95% of people living with HIV (PLHIV) knowing their status, country is promoting community-based HIV testing and same-day antiretroviral therapy (ART) initiation. However, there are uncertainties of how this strategy affects immediate and early engagement in program settings. To address this research gap, we analysed a programme data of PLHIV newly diagnosed and initiated on ART in community and health facility settings. Study objectives were to estimate the proportion of immediate engagement, to estimate early engagement among newly diagnosed PLHIV and, to examine factors independently associated with immediate and early engagement in care among newly diagnosed PLHIV offered same-day ART initiation. Methods: we included all newly diagnosed PLHIV aged 18 years or older and provided same-day ART initiation between October 2018 and January 2019 in Lusaka District. Immediate engagement was estimated as proportion of newly diagnosed PLHIV who visited the health facility at least once within 14 days after same-day ART initiation, whereas early engagement as proportion of newly diagnosed PLHIV active 6 months after same-day ART initiation. Pearson's chi-squared test was used to assess association of outcomes with key background characteristics. Results: of 12,777 newly diagnosed PLHIV who initiated same day ART 7,943 (62%) were tested and initiated in the community. Overall, 6,257 (49%) engaged within 14 days (median 15, IQR: 13-37). Older individuals (36-49 years) were more likely to be engaged at 14 days (aRR 1.29; 95%CI 1.06 - 1.18; p<0.001) and retained at 6 months (aRR1.27;95%CI 1.21-1.34P<0.001) whilst risk of attrition at 6 months was highest in younger ages (18-24 years) (aRR 0.79;95 %CI 0.76-0.82; p<0.001). Conclusion: to adequately address the HIV epidemic targeted engagement approaches are required particularly in the younger ages.

Predictors of incident heart failure in a cohort of patients with ischemic heart disease

Introduction: heart failure (HF) is a major complication following ischemic heart disease (IHD) and it adversely affects the outcome. The objective of this study was to identify predictors of HF in patients with IHD. Methods: this is a 24-month longitudinal retrospective study of all consecutive patients diagnosed with IHD. Endpoints were incident HF and time to incident HF. Patients with a previous history of HF were excluded. Results: a total of 306 patients with IHD were included in the analysis. The 6-month, 12-month and 18-month cumulative risk of developing incident HF were 18.8%, 28.4%, and 53.5% respectively. Increasing age, female gender, diabetes mellitus (DM), lower hemoglobin, and dilated left atrium were strong predictors of incident HF. Predictors of shorter time to incident HF were coexisting DM and hypertension, and the presence of dilated left atrium in patients with left ventricular ejection fraction < 40%. The strongest predictor of incident HF in patients with DM was a higher level of LDL cholesterol.Conclusion: patients with IHD have a higher risk of incident HF. Strong predictors of incident HF in these patients were increasing age, female gender, DM, lower hemoglobin and dilated left atrium. Such patients need close follow-up and more intensive treatment

Children with hearing impairment in Malawi, a cohort study

To assess the outcomes of children diagnosed with hearing impairment 3 years earlier in terms of referral uptake, treatment received and satisfaction with this treatment, and social participation.Methods: We conducted a population-based longitudinal analysis of children with a hearing impairment in two rural districts of Malawi. Key informants within the community identified the cohort in 2013 (baseline). Informants clinically screened children at baseline, and by questionnaires at baseline and follow-up in 2016. We investigated associations between sociodemographic characteristics and outcomes by multivariate logistic regression. Results : We diagnosed 752 children in 2013 as having a hearing impairment and traced 307 (40.8%) children of these for follow-up in 2016. Referral uptake was low (102/184; 55.4%), more likely among older children (odds ratio, OR: 3.5; 95% confidence interval, CI: 1.2­10.2) and less likely for those with an illiterate caregiver (OR: 0.5; 95% CI: 0.2­0.9). Few of the children who attended hospital received any treatment (33/102; 32.4%) and 63.6% (21/33) of caregivers reported satisfaction with treatment. Difficulty making friends and communicating needs was reported for 10.0% (30/299) and 35.6% (107/301) of the children, respectively. Lack of school enrolment was observed for 29.5% (72/244) of children, and was more likely for older children (OR: 28.6; 95% CI: 10.3­79.6), girls (OR: 2.4; 95% CI: 1.2­4.8) and those with an illiterate caregiver (OR: 2.1; 95% CI: 1.0­4.1).Conclusion More widespread and holistic services are required to improve the outcomes of children with a hearing impairment in Malawi

How accurately do routinely reported HIV viral load suppression proportions reflect progress towards the 90-90-90 target in the population on antiretroviral treatment in Khayelitsha, South Africa?

Background. The Joint United Nations Programme on HIV/AIDS (UNAIDS) third 90-90-90 target requires 90% of patients on antiretroviral treatment (ART) to be virally suppressed (<1 000 copies/mL). In Khayelitsha, Cape Town, South Africa viral load (VL) suppression of <400 copies/mL was reported as 89% in 2016, but only 56% of patients had a result recorded in routine data. We conceived a VL 'cascade' to represent the steps required for an expected VL to be reported as complete in routine data and thus contribute to reported VL suppression: among those for whom a VL is 'expected', a sample must be collected and tested ('done'), a result must be 'filed' in the patient folder, 'noted' by a clinician and electronically 'captured'. The low reported completion suggested gaps along the VL cascade and cast doubt on the validity of reported suppression.Objectives. To assess the validity of routinely reported VL suppression and identify barriers to VL completion. Methods. A retrospective cohort study between 1 July 2015 and 30 June 2016, which included all Khayelitsha patients receiving ART, with a routine VL expected, was conducted. We obtained data routinely captured on site and VL data from the laboratory system. A sample of 1 035 patient folders was reviewed. VL suppression was calculated using laboratory data, including all tests done, and compared with reported suppression based on on-site captured electronic data. Successful progression through each step on the VL cascade was estimated. We used logistic regression to identify factors associated with laboratory data and reported VL testing.Results. Of 22 991 patients for whom a routine VL test was due, 84% were done, 79% filed, 76% noted and 55% captured. Using all laboratory data, VL suppression was estimated as 82%, 87%, 89% and 91% at the 50, 200, 400 and 1 000 copies/mL thresholds, respectively, but reported suppression using captured results was 80%, 86%, 88% and 89% at those thresholds. Routine VL testing is more likely to be done in children <15 years old (adjusted odds ratio (aOR) 1.89, 95% confidence interval (CI) 1.45 - 2.48) and pregnant women (aOR 1.90, 95% CI 1.28 - 2.81) than in men, adjusted for facility. Conclusions. Despite a low reported completion, VL testing completion was high. Reported suppression using captured data was similar to suppression calculated using all laboratory data, which provided an accurate measure of progress towards the 90-90-90 target. More work is needed to reach the 16% of patients missed by routine testing

Prevalence and factors associated with rupture of gravid uterus and feto-maternal outcome: a one-year retrospective cohort study

Background: Uterine rupture remains a significant public health problem contributing to 13% of maternal mortality and 74%-92% for perinatal mortality in developing countries. This study assesses the prevalence and factors associated with rupture of gravid uterus and feto-maternal outcome in Ethiopian mothers with uterine rupture.Methods: A retrospective cohort study was conducted to identify risk factors associated with rupture of gravid uterus and feto-maternal outcomes. The data source included clinical records of patients seen at Dilla University Referral Hospital over a one-year period. The data was collected using a structured data collection form developed for the purposes of the study. The study involved a total 2,498 women with a gravid uterus, gestational age of ≥28 weeks and registered in the labor and delivery registration books in the Obstetrics and Gynecology Department. Bivariate and multivariate regression analyses were carried out at 95% Confidence Interval to identify factors independently associated with uterine rupture.Results: Out of 2,498 reviewed deliveries, 46 cases developed uterine rupture making an overall hospital prevalence of 1.8 % or one in 53 deliveries. Malpresentation (80%), contracted pelvis (47.8%), vertex malposition (10.8%), and previous uterine scar (2.1%) were the causes of uterus ruptures. In multivariate analysis, clients' residence, parity, birth weight, Antenatal Care follow-up and duration of labor were statistically significantly associated with uterine rupture. Maternal and fetal case fatality rates were 8.7% and 97.8%, respectively.Conclusion: Uterine rupture remains an important problem in the study area. Patients with identified risk factor(s) should stay close to the hospital in late pregnancy. Besides, strengthening antenatal care follow-up and referral linkage should be considered

Primary sclerosing cholangitis in a cohort of south african patients with inflammatory bowel disease at charlotte maxeke johannesburg academic hospital

Background: Primary Sclerosing Cholangitis (PSC) is a chronic, progressive cholestatic liver disease of unknown aetiology. Its incidence and prevalence vary considerably in Asian and Western studies.1 The differences in the recorded epidemiological data suggest that the presentation of PSC may vary in different populations. PSC has a strong association with Inflammatory Bowel Disease (IBD). The phenotype in patients with PSC alone can be different to that of patients with both PSC and IBD (PSC-IBD). There is a dearth of information on this topic from African countries in general and more specifically in the Black South African population

Weight-related quality of life in obese, pregnant women in South Africa

Objective: The global obesity pandemic includes pregnant women. Obesity may negatively impact quality of life (QOL). A validated, obesity-specific, QOL assessment tool was used to assess the impact of obesity on five specific domains. Methods: A prospective cohort study was performed at Tygerberg Academic Hospital in South Africa. Morbid obesity was defined as a body mass index (BMI) of 40­49.9 kg/m2 and super-obesity as BMI > 50 kg/m2, using the first recorded weight during the pregnancy. Pregnant women with a BMI ≥ 40 were approached in the high-risk antenatal clinic where written informed consent was taken before recruitment. Using the QOL tool they answered statements about their current experiences.Results: A total of 66 morbidly obese and 46 super-obese women were enrolled across an age range of 18­45 years. Physical function and self-esteem were the domains with the lowest QOL scores. When comparing morbid with super obesity, all scores were significantly lower in the latter group except for the domains of self-esteem and sexual life.Conclusion: Morbid and super-obesity occur across the full spectrum of the adult reproductive period. Physical function and self-esteem are most affected while QOL is linked to the degree of obesity

La polyarthrite rhumatoïde au Maroc : d'hier à aujourd'hui

La polyarthrite rhumatoïde (PR) est le chef de file des rhumatismes inflammatoires chroniques (RIC). Elle touche environ 1% de la population mondiale. C'est une affection invalidante qui conduit plus ou moins rapidement à la destruction cartilagineuse et osseuse et, à long terme, en l'absence de traitement, à l'incapacité fonctionnelle et/ou au handicap sévères. L'importance de son diagnostic et de son traitement précoces est majeure.Au Maroc, le retentissement socio-économique de la maladie est important. Les difficultés à l'accès au traitement des patients, les conséquences sur leur vie personnelle et familiale ont été mises en évidence. Parmi elles, les conséquences négatives sur la scolarisation des petites filles sont significatives. De ce fait, la prévention et l'information sont majeures dans la prise en charge des patients de même que le recours à un traitement à « un coût raisonnable ». Par ailleurs, la comparaison des données, grâce à l'inclusion dans des études internationales mettent en évidence la sévérité de la maladie, essentiellement en raison du retard au diagnostic, du retard à la prise en charge en rhumatologie, du bas niveau socio-économique. La mise en place d'une cohorte de polyarthrites récentes suivies sur une période de deux ans, a mis en évidence l'importance d'un diagnostic et d'une prise en charge très précoces et l'amélioration significative du pronostic de la maladie qui en résulte. Elle a été suivie par la mise en place d'une cohorte de polyarthrites récentes dont l'objectif est un suivi de polyarthrites récentes évoluant depuis moins d'un an sur une période de dix ans et la constitution d'une base de données destinée à permettre des études sur le diagnostic, le pronostic, l'épidémiologie, l'impact socio-économique ainsi que le recours à un traitement économiquement accessible des polyarthrites récentes au Maroc

Concomitant HIV infection in newly diagnosed multiple myeloma patients is hard to recognise and should be tested for routinely in areas of high endemicity

Background. Over the past three decades much has changed in the treatment and outcomes of patients suffering concurrently from both multiple myeloma (MM) and HIV. While the prevalence of MM appears to be higher in HIV-positive individuals than in those who are uninfected, early recognition of patients suffering from both diseases is difficult and little information is available on their demographics and clinical presentation.Objective. To compare the presenting features of HIV-positive patients diagnosed with MM with those of HIV-negative patients.Methods. A single-centre, retrospective cohort study included 16 HIV-positive and 73 HIV-negative patients diagnosed with MM, in order to compare variables related to the clinical presentation of both conditions.Results. HIV-positive patients presented with MM at a significantly younger age, and had fewer osteolytic lesions, less renal impairment and lower neutrophil counts. Disease stage, gender, pathological fractures, bone marrow plasmacytosis, plasmacytomas and lymphocyte counts were comparable, emphasising the difficulty of identifying these patients. The HIV-positive patients had relatively high CD4 counts and a low prevalence of abnormal Freelite kappa/lambda ratios. All HIV-positive patients presented with paraproteins of the immunoglobulin G (IgG) type, implying a possible relationship between MM and an IgG response to HIV antigens.Conclusions. On the basis of our findings and literature on the treatment of both diseases, we suggest that HIV be tested for routinely in younger MM patients, especially in areas with a high prevalence of HIV. The integration of our results into the sparse knowledge on the role of HIV infection-related MM provides possible new insights into the interaction between these diseases

ART experienced patients for tackling attrition from HIV care: a multi-site cohort study

Introduction: Retention of patients on anti-retroviral treatment in Ethiopia is a challenge. Use of anti-retroviral treatment experienced patients to prepare and re-engage them when they miss follow-ups is recommended, but evidence on its effectiveness is limited. This study evaluated its effectiveness.Methods: A retrospective cohort study in 10 randomly selected health facilities was conducted to compare outcomes before and after initiation of the adherence supporters program in HIV care and treatment from September 2001 to August 2013. Data analysis involved Kaplan-Meier survival and Log-rank test analysis on STATA statistical software Version 12 to compare survival experiences.Results: Of 18,835 records that were available, 938 (4.36%) records with missing values were excluded and data from the remaining 17,897 was analyzed. The incidence of first instance lost to follow-up was 22.2 per 100 person-years (95% confidence interval 21.7-22.7). The risk of missing follow-ups after initiation of the program was high (Hazard Ratio ­1.22, P < 0.001). The incidence of restarting after missed follow-ups was 23 per 100 PY (95% CI 22.2-24.0). The likelihood of restarting after missed follow-ups was four times higher during the period adherence supporters were present (P<0.001). Patients who stayed longer in care before missing follow ups were more likely to restart (5.7 times the chance of restarting treatment for those whose first lost to follow-up occurred at≥12 months compared to <3 months, P< 0.001).Time to restarting treatment was shorter after the initiation of the adherence supporters program (median 37 vs. 115 days). The risk of recurrence of being lost to follow-up in the presence of adherence supporters was significantly higher than when there were no adherence supporters; 38.8 (95% CI 36.3-41.6) per 100 PY vs. 26.1 (95% CI 19.8-34.4) per 100 PY, respectively. Conclusion: Adherence supporters were effective in improving re-engagement of patients in treatment and care after they were lost to follow-up. Yet, prevention of lost to follow-up cases has remained a challenge to the program

Planned Health Care Non-Attendance and Asthma Control among Asthma Patients in Real Life Setting in an African Country: a Prospective Cohort Study

BACKGROUND: Compliance with scheduled medical visit is an indirect indicator of the adherence to treatment.The aim of this study was to determine the incidence of non-compliance with scheduled medical visits and investigate the predictors and relationship with disease control among patient with asthma in the sub-Saharan African setting. METHODS: We conducted a prospective study between January 2012 and August 2013. All patients with asthma receiving care at the Yaounde Jamot Hospital and CEDIMER medical practice were included. Planned medical visit occurred at month one; three; six and twelve following baseline evaluation. Regression models were employed to investigate the predictors of non-compliance. RESULTS: 186 patients [121 (65.1%) being female] were included. Their median age (25th-75th percentiles) was 35.5 (20.0-52.3) years. A total of 67 (36%) failed to attend at least one of the scheduled visits. The proportion of patients who failed to comply with scheduled visits was 48.4%; 68.8%; 73.5% and 79.5% at month one; three; six and twelve respectively. The accompanying rates of unacceptable asthma control were 17.2%; 24.4% and 20.8% respectively at three; six and twelve months of follow-up. Inadequate asthma control at baseline was the main predictor of non-compliance with medical visits; with adjusted odds ratio ranging from 2.00 to 4.67. Furthermore; non-sensitisation to non-pollinic aeroallergens was associated with 2.79 (95%CI 1.58-6.07) risk of non-compliance at one month of follow-up. CONCLUSION: Targeting education of patients with poorly controlled disease at baseline can potentially improve adherence to medical visit and anti-asthmatic treatments and outcomes of care

Prevalence of Positive Coeliac Serology in a Cohort of South African Children with Type 1 Diabetes Mellitus

Background. Coeliac disease (CD) is characterised by immune-mediated damage to the mucosa of the small intestine. Both CD and type 1 diabetes (T1D) have common auto-immune origins. Many patients with CD and T1D are asymptomatic or present with only mild symptoms; hence early diagnosis may only be facilitated by serological screening. Distal duodenal biopsy remains the gold standard for confirming the diagnosis. Objective. To describe the prevalence of CD in T1D patients presenting to the paediatric endocrine service at Inkosi Albert Luthuli Central hospital (IALCH) in Durban and document the relationship between positive coeliac serology and small-bowel biopsy results.Methods. A retrospective chart review was done at IALCH; the paediatric tertiary referral centre for KwaZulu-Natal (KZN) Province. The study sample included all patients with newly diagnosed T1D diagnosed between January 2008 and December 2011.Results. A total of 120 newly diagnosed T1D patients were included in the study; of whom 49 (40.8%) were coeliac serology positive and 61 (50.8%) serology negative. There was no significant difference between the two groups regarding mean age of presentation with diabetes; race; sex; urban v. rural origin and baseline anthropometric measurements. Of patients in the serology-positive group; 97.6% had no symptoms suggestive of CD. Of the 49 patients who were coeliac serology positive; 8 (16%) were biopsied: 3 (37.5%) were positive; 1 (12.5%) had intra-epithelial lymphocytes and 4 (50%) were negative. There was a strong positive correlation between biopsy results and titres of endomysial antibody results (p=0.047). Conclusion. There is a high prevalence of coeliac serology positivity in newly diagnosed T1D patients in KZN. This study provides evidence for screening of children with T1D for CD; and also confirms the low prevalence of symptoms

Computational Models as Predictors of HIV Treatment Outcomes for the Phidisa Cohort in South Africa

Background: Selecting the optimal combination of HIV drugs for an individual in resourcelimited settings is challenging because of the limited availability of drugs and genotyping.Objective: The evaluation as a potential treatment support tool of computational models that predict response to therapy without a genotype; using cases from the Phidisa cohort in South Africa.Methods: Cases from Phidisa of treatment change following failure were identified that had the following data available: baseline CD4 count and viral load; details of failing and previous antiretroviral drugs; drugs in new regimen and time to follow-up. The HIV Resistance Response Database Initiative's (RDI's) models used these data to predict the probability of a viral load 50 copies/mL at follow-up. The models were also used to identify effective alternative combinations of three locally available drugs.Results: The models achieved accuracy (area under the receiver-operator characteristic curve) of 0.72 when predicting response to therapy; which is less accurate than for an independent global test set (0.80) but at least comparable to that of genotyping with rules-based interpretation. The models were able to identify alternative locally available three-drug regimens that were predicted to be effective in 69% of all cases and 62% of those whose new treatment failed in the clinic.Conclusion: The predictive accuracy of the models for these South African patients together with the results of previous studies suggest that the RDI's models have the potential to optimise treatment selection and reduce virological failure in different patient populations; without the use of a genotype

Prevalence and Determinants of Lower Urinary Tract Symptoms before and during Pregnancy in a Cohort of Nigerian Women

Background: Pregnancy and childbirth are thought to be associated with development of lower urinary tract symptoms (LUTS). The study aimed at ascertaining prevalence rates of LUTS before and during pregnancy; the determinants and perceived effects of these symptoms on the life of the women. Materials and Methods: Questionnaires in which LUTS were defined according to recommendations of International Continence Society was administered on consecutive women who delivered at ?37 weeks' gestation to ascertain the presence or absence of LUTS before and during pregnancy and perceived effects on their life. Data was also collected on their socio-demographic and obstetric features. Descriptive statistics and relationship between LUTS and other variables were analyzed using SPSS version 16. Results: Prevalence rates of LUTS before and during pregnancy were 52.9 and 89.2; respectively; and mostly included nocturia and stress urinary incontinence. Women were more likely to develop LUTS during pregnancy (P = 0.002; OR 4.99; 95 CI 1.793 - 13.906). Only 14.4 and 41.7 reported any burden on their daily life before and during pregnancy; respectively. Previous vaginal delivery (P = 0.01; OR 3.12; 95 CI 2.91-5.62); grand-multiparity (P = 0.04; OR 4.15; 95 CI 3.82-7.24) were associated with LUTS prior to pregnancy while presence of LUTS before pregnancy (P = 0.001; OR 10.80; 95 CI 4.24-27.52); previous vaginal delivery (P = 0.002; OR 6.38; 95 CI 4.25-12.43) and moderate maternal obesity (P = 0.03; OR 2.56; 95 CI 1.82-3.47) were predictive of LUTS during pregnancy. Conclusion: LUTS are common among women both before and during pregnancy but most of them were not bothered by the LUTS. Those with previous vaginal delivery and are grand-multiparous are more likely to develop LUTS prior to pregnancy while the presence of LUTS before pregnancy; vaginal delivery and maternal obesity are determinants of LUTS during pregnancy

Hypertension in Juba; South Sudan : A Retrospective Cohort Study of Single Blood Pressure Readings among Potential Blood Donors at Juba Teaching Hospital 2010-2012

South Sudan is thought to be undergoing an epidemiological transition with an increasing burden of non-communicable diseases such as hypertension. No current data exist on the prevalence of these diseases. Blood pressure readings of 5660 blood donors during 2010-12 at Juba Teaching Hospital were analysed. Prevalence of hypertension was 19.3; positively associated with older age and being male. This has implications for public health policy; indicating a need for prevention; screening and treatment to prevent complications of hypertension

Baseline Findings of an HIV Incidence Cohort Study to Prepare for Future HIV Prevention Clinical Trials in Kisumu; Kenya

Introduction: In an analysis of baseline findings of an HIV incidence cohort study; an assessment was made of HIV prevalence among persons presenting for enrollment and any differences in demographic characteristics between persons not enrolled compared to those enrolled. We also described and compared HIV risk behaviors in males and females enrolled in the study. Methodology: A computer-assisted survey was administered to collect baseline demographic and HIV risk data from 1;277 men and women aged 18-34 years. Testing for HIV and other sexually transmitted infections (STI) was conducted. Out of 1;277 persons prescreened for eligibility; 625 were enrolled. Results: HIV prevalence of all persons who completed screening was 14.8 (females: 21.1; males: 8.1). The odds of being enrolled in the study were higher for persons 18-24 years compared to those 30-34 years of age [adjusted odds ratio (AOR)=2.18; CI=1.13; 4.21] and males compared to females [AOR=2.07; CI=1.43; 2.99]. Among those enrolled in the study; the most prevalent HIV risk behaviors were unprotected sex (49); alcohol use (45); and transactional sex (30) in the last three months. Compared to females; a significantly greater proportion of males reported using any alcohol or recreational drug in the last three months; a history of oral sex; sex with partner other than a spouse or main partner; ever having a blood transfusion; ever being treated for an STI; and having knowledge of their last HIV test result. Conclusion: The Kisumu Field Station successfully recruited individuals with HIV risk characteristics for the HIV incidence cohort study

Occult HBV Infection among a Cohort of Nigerian Adults

Objective: To determine markers of HBV infection and detect the presence of its occult infection in serum of a cohort of adult Nigerians. Methodology: The study involved 28 adult Nigerians with viral hepatitis (Group 1) and 28 apparently healthy adult Nigerians as controls (Group 2). Their sera were assayed for HBsAg; HBeAg; anti-HBe; anti-HBc; anti-HBs; and anti-HCV; while HBV DNA was determined in 15 patients with chronic hepatitis. Significance of differences between the patients and control subjects was assessed using Chi-square test at a 95confidence level. Results: Sero-detection of HBsAg; HBeAg; anti-HBe and anti-HBc was higher among the patients compared to the controls. HBV infection was diagnosed by HBsAg (89) and a duo of HBsAg and anti-HBc (100) among the patients. Similarly; eleven and four types of different patterns of HBV markers were observed among the respective groups. Anti-HBe (9.5); anti-HBc (14.3); and anti-HBs (9.5) were detected among all the subjects who were sero-negative for HBsAg. HBV DNA was also detected in 86.7of the 15 patients with chronic hepatitis; while occult HBV infection was observed in 7.2of the patients and none (0) of the controls; p 0.05. Furthermore; HCV infection occurred among subjects with all the different patterns of HBV markers; except those with occult HBV infection and natural immunity to HBV. Conclusion: This study shows that occult HBV infection is present among Nigerian adults and determination of HBsAg; anti-HBc; anti-HBe; and HBV DNA will assist in its detection