Prevalence Of HIV Infection Research Articles

A national household survey on HIV prevalence and clinical cascade among children aged ≤15 years in Kenya (2018).

We analyzed data from the 2018 Kenya Population-Based HIV Impact Assessment (KENPHIA), a cross-sectional, nationally representative survey, to estimate the burden and prevalence of pediatric HIV infection, identify associated factors, and describe the clinical cascade among children aged < 15 years in Kenya. Interviewers collected information from caregivers or guardians on child's demographics, HIV testing, and treatment history. Blood specimens were collected for HIV serology and if HIV-positive, the samples were tested for viral load and antiretrovirals (ARV). For participants <18 months TNA PCR is performed. We computed weighted proportions with 95% confidence intervals (CI), accounting for the complex survey design. We used bivariable and multivariable logistic regression to assess factors associated with HIV prevalence. Separate survey weights were developed for interview responses and for biomarker testing to account for the survey design and non-response. HIV burden was estimated by multiplying HIV prevalence by the national population projection by age for 2018. Of 9072 survey participants (< 15 years), 87% (7865) had blood drawn with valid HIV test results. KENPHIA identified 57 HIV-positive children, translating to an HIV prevalence of 0.7%, (95% CI: 0.4%-1.0%) and an estimated 138,900 (95% CI: 84,000-193,800) of HIV among children in Kenya. Specifically, children who were orphaned had about 2 times higher odds of HIV-infection compared to those not orphaned, adjusted Odds Ratio (aOR) 2.2 (95% CI:1.0-4.8). Additionally, children whose caregivers had no knowledge of their HIV status also had 2 times higher odds of HIV-infection compared to whose caregivers had knowledge of their HIV status, aOR 2.4 (95% CI: 1.1-5.4)". From the unconditional analysis; population level estimates, 78.9% of HIV-positive children had known HIV status (95% CI: 67.1%-90.2%), 73.6% (95% CI: 60.9%-86.2%) were receiving ART, and 49% (95% CI: 32.1%-66.7%) were virally suppressed. However, in the clinical cascade for HIV infected children, 92% (95% CI: 84.4%-100%) were receiving ART, and of these, 67.1% (95% CI: 45.1%-89.2%) were virally suppressed. The KENPHIA survey confirms a substantial HIV burden among children in Kenya, especially among orphans.

HIV prevalence among transgender women in Northeast Brazil – Findings from two Respondent Driven Sampling studies

BackgroundThe HIV epidemic still high among key-populations in Brazil, especially among transgender women (TGW). The aim of this study was to investigate the prevalence of HIV infection among TGW and to analyze factors associated with HIV seropositivity across two cross-sectional surveys conducted in Salvador, Bahia, one of the largest urban centers of Brazil.MethodsThe studies were conducted between 2014 and 2016 and 2016-2017 and employed Respondent-Driven Sampling (RDS) sampling, comprising 127 and 161 TGW residents of Salvador, Bahia. The outcome was the positive rapid antigen testing for HIV infection. Odds ratios (OR) and 95% confidence intervals (95%CI) were obtained using binomial logistic regression.ResultsThe HIV prevalence was 9.0% (95%CI: 4.2-18.2) and 24.3% (95%CI: 16.2-34.9). In the first study, factors associated with HIV prevalence were experiencing discrimination by the family (OR 8.22; 95%CI: 1.49-45.48) and by neighbors (OR 6.55; 95%CI: 1.12-38.14) as well as having syphilis (OR 6.56; 95%CI:1.11-38.65); in the subsequent study gender-based discrimination (OR 8.65; 95%CI:1.45-51.59) and having syphilis (OR 3.13; 95%CI: 1.45-51.59) were associated with testing positive for HIV.ConclusionWe found disproportionately high HIV prevalence among TGW, which underscores the context of vulnerability for this population. The data point to the urgency for intensification and expansion of access to HIV prevention and strategies to stop discrimination in health care and services for this population.

HIV infection in the homeless in Saint Petersburg in 2021

Introduction. 44 cases of HIV-infection among the homeless were registered in Saint Petersburg in 2021. At the same time, it is known that the case reporting and medical treatment in Russia are limited by the lack of required document minimum among a large number of them — passport and compulsory medical insurance policy. The cohort of the homeless is heterogeneous and in many countries the predominant risk factors of HIV infection and prevalence are different. So far, the studies of HIV spread among the homeless in Russia are rare.Objective. Assess the prevalence of HIV infection among the homeless in Saint Petersburg.Materials and methods. Cross-sectional study was carried out among the homeless in «places of attraction»: heating points, overnight shelters, care services from May, 24th to October, 1st 2021 and involved 199 participants. There was questionnaire and rapid HIV antibody testing in capillary blood by the set «Wondfo HIV 1,2». The study was completed anonymously.Results. When examining HIV infection was detected in 9 out of 199 participants — 4.5% (CI 95% [1.61%, 7.39%]), thus, HIV prevalence among the homeless is on average higher than in Saint Petersburg (0.81%) and the country (0.78%). The factors, associated with HIV infection, are the use of injection drugs: odds ratio of prevalence in the adjusted model adjusted prevalence ratio (APR)=4.3 (p&lt;0.05, CI 95% [1.1, 17.5]) and incarceration: APR=9.4 (CI 95% [1.1, 82.2]).Conclusion. The results obtained and the factors, defined in the study of risk factors for infection, allow to determine the main directions of HIV prevention among the homeless and to highlight the need for attributing the cohort of the homeless to the «key» population group along with others.

Prevalence of HIV and associated risk factors among street-connected children in Mwanza city.

While on the street, HIV infection among street-connected children is a challenging issue due to the nature of transmission, distribution, and prevention. Lack of proper care and protection, insufficient knowledge of the danger of acquiring HIV, and insufficient or absence of health facilities serving street-connected children have left this vulnerable group engaging in high-risk behaviors exposing them to acquiring HIV. This cross-sectional study aimed at estimating the prevalence of HIV infection and its associated risk factors among street-connected children aged between 10 to17 years in Mwanza City. The study was granted ethical clearance all permissions and restrictions to work with street-connected children were adhered to. A total of 131 participants aged 10-17 years were recruited for interviews and HIV testing. Exact logistic regression was used to determine factors associated with having HIV. A total of 111 (85.0%) boys and 20 (15.0%) girls responded to the questionnaire, with the median age being 15years. The overall HIV prevalence was 12.2% (16/131). Street-children using condoms were less likely to be affected by HIV compared to those who were not using (OR = 0.24; 95% CI 0.04-0.97). Females had higher odds of HIV infection compared to males (OR = 5.24; 95% CI of 1.24-24.65). The study shows a significantly higher prevalence of HIV among street-connected children as compared to the general population. Therefore, there should be tailored reproductive and sexual health programs, with the provision of protective materials like condoms.

Prevalence of HIV/AIDS Infection among Sexually Active Women in Ethiopia: Further Analysis of 2016 EDHS.

The issue of HIV/AIDS is prevalent around the world and in Ethiopia as well. The aim of this study was to determine the prevalence and risk factors of HIV/AIDS infection among sexually active women in Ethiopia. For this study, data were obtained from the Ethiopia Demographic and Health Survey conducted in 2016. This study contains 11,729 women who have had at least one episode of sexual intercourse in their lifetime. Interviewers for voluntary HIV testing collected finger-prick blood specimens from women who agreed to be tested for HIV. Based on factors at the individual and community levels, a multilevel logistic regression model was used. The study found that 2% of 11,729 sexually active women tested positive for HIV from all regions who received voluntary counseling and testing. The intraclass correlation coefficient findings showed that 32.844% of HIV/AIDS transmission among sexually active women was the result of community-level factors. Variables at the individual level were women of age 16-24 (AOR = 0.18; 95% CI: 0.11-0.29), women of age 25-34 (AOR = 0.733; 95% CI: 0.55-0.98), women with primary education level (AOR = 1.8; 95% CI: 1.23-2.57), more than one sexual accomplice (AOR = 1.33; 95% CI: 0.613-2.87), and women's age at first sexual intercourse between 25 and 34 (AOR = 0.57, 95% CI: 0.301, 1.06); these were the most significant determinants of HIV/AIDS infection. According to community-level factors, there was a lower HIV prevalence rate among rural women (AOR = 0.22; 95 percent CI: 0.13-0.36), and women in the Gambela region (AOR = 4.1; 95 percent CI: 1.99-8.34) also had higher HIV prevalence rates. The prevalence of HIV infection among sexually active women varies by region, with urban women more likely to contract the virus. Women who had more than one regular sexual partner and had their first sexual encounter at a younger age are at an increased risk of contracting HIV/AIDS. According to the study, the government should focus more support on high-risk clusters, mainly in urban areas, as well as on regions with high rates of HIV/AIDS infection.

Clinical Characteristics and Treatment Outcomes of HIV+ and HIV- Tuberculosis Patients Followed and Treated at the Regional Hospital of Oyem, Northern Gabon: A Two-Year Retrospective Study

Background: The objective of this study was to analyse the clinical characteristics of HIV+ and HIV- tuberculosis patients followed and treated at the Oyem Regional Hospital Centre (ORHC).&#x0D; Materials and Methods: During this study conducted between January 2019 and December 2021, data collection was based on the exploitation of medical records and registers of results from the medical analysis laboratory of the regional hospital of Oyem, in which there were personal data (gender and age) of the patients, the status of HIV infection, clinical characteristics (pulmonary or extra pulmonary TB), and finally, the therapeutic outcomes of the patients after anti-tuberculosis and antiretroviral treatment. Binomial test following the Normal distribution was used to find an association between the percentages of extrapulmonary TB and TB+/HIV+ co-infection.&#x0D; Results: In this study, 128 confirmed TB cases were selected. While 54 (42.19%) were co-infected with TB+/HIV+, 74 patients (57.81%) were monoinfected with TB+/HIV+. Among all these patients, 93 (72.66%) were reported to have extra pulmonary TB and 35 (27.34%) had pulmonary TB. A normal binomial test showed that TB+/HIV+ co-infection was significantly associated with extrapulmonary TB (p=0.04). Patients were put on anti-tuberculosis treatment according to the manufacturers' indications. Despite a total of 15 deaths (8.93%) in both mono- and co-infected patients, there was a favourable outcome, with 35 patients (27.34%) declared cured. With 8 deaths, mortality was higher in the co-infected than in the non-HIV infected TB patients who recorded 7 deaths.&#x0D; Conclusion: By indicating a relatively high prevalence of HIV infection in TB patients, this study showed that TB+/HIV+ co-infection was associated with extra pulmonary TB, the severe form of the disease, and increased mortality in patients, hence the need to strengthen joint activities to control this co-infection.

Chronic kidney disease (CKD) and associated risk in rural South Africa: a population-based cohort study.

Background: In Africa, true prevalence of chronic kidney disease (CKD) is unknown, and associated clinical and genetic risk factors remain understudied. This population-based cohort study aimed toinvestigate CKD prevalence and associated risk factors in rural South Africa. Methods: A total 2021 adults aged 20-79 years were recruited between 2017-2018 from the Agincourt Health and Socio-Demographic Surveillance System in Bushbuckridge, Mpumalanga, South Africa. The following were collected: sociodemographic, anthropometric, and clinical data; venous blood samples for creatinine, hepatitis B serology; DNA extraction; spot urine samples for dipstick testing and urine albumin: creatinine ratio (UACR) measurement. Point-of-care screening determined prevalent HIV infection, diabetes, and hypercholesterolemia. DNA was used to test for apolipoprotein L1 ( APOL1) kidney risk variants. Kidney Disease Improving Global Outcomes (KDIGO) criteria were used to diagnose CKD as low eGFR (<60mL/min/1.73m 2) and /or albuminuria (UACR ≥ 3.0mg/mmol) confirmed with follow up screening after at least three months. eGFR was calculated using the CKD-EPI (creatinine) equation 2009 with no ethnicity adjustment. Multivariable logistic regression was used to model CKD risk. Results: The WHO age-adjusted population prevalence of CKD was 6.7% (95% CI 5.4 - 7.9), mostly from persistent albuminuria. In the fully adjusted model, APOL1 high-risk genotypes (OR 2.1; 95% CI 1.3 - 3.4); HIV infection (OR 1.8; 1.1 - 2.8); hypertension (OR 2.8; 95% CI 1.8 - 4.3), and diabetes (OR 4.1; 95% CI 2.0 - 8.4) were risk factors. There was no association with age, sex, level of education, obesity, hypercholesterolemia, or hepatitis B infection. Sensitivity analyses showed that CKD risk factor associations were driven by persistent albuminuria, and not low eGFR. One third of those with CKD did not have any of these risk factors. Conclusions: In rural South Africa, CKD is prevalent, dominated by persistent albuminuria, and associated with APOL1 high-risk genotypes, hypertension, diabetes, and HIV infection.

Penile Squamous Cell Carcinomas in Sub-Saharan Africa and Europe: Differential Etiopathogenesis.

Penile squamous cell carcinomas (PSCC) are classified by the World Health Organization into two categories based on their relationship with the human papillomavirus (HPV): HPV-associated and HPV-independent. We compared a cohort of PSCC from Mozambique, a sub-Saharan country in southeast Africa with a high prevalence of HPV and HIV infection, and Spain, a country in southwestern Europe with a low prevalence of HPV and HIV, to study the distribution of the etiopathogenic categories of these tumors in both sites. A total of 79 PSCC were included in the study (28 from Mozambique and 51 from Spain). All cases underwent HPV-DNA polymerase chain reaction (PCR) testing, genotyping, and immunohistochemistry for p16 and p53. Any PSCC showing either p16 overexpression or HPV-DNA in PCR analysis was considered HPV-associated. Overall, 40/79 (50.6%) tumors were classified as HPV-associated and 39 (49.4%) as HPV-independent. The two sites showed marked differences: 25/28 (89.3%) tumors from Mozambique and only 15/51 (29.4%) from Spain were HPV-associated (p < 0.001). HPV16 was the most frequent HPV type identified in 64.0% (16/25) of the HPV-associated tumors from Mozambique, and 60.0% (9/15) from Spain (p = 0.8). On average, patients from Mozambique were almost two decades younger than those from Spain (mean age 50.9 ± 14.9 and 69.2 ± 13.3, respectively [p < 0.001]). In conclusion, significant etiopathogenic differences between PSCC in Mozambique and Spain were observed, with a remarkably high prevalence of HPV-associated tumors in Mozambique and a relatively low prevalence in Spain. These data may have important consequences for primary prevention of PSCC worldwide.

Prevalence of HIV-1 infection among foreign applicant to residency in Shanghai, China, 2005-2016

ABSTRACT Shanghai is one of the largest cities in China and has the highest proportion of inbound travelers in the world. The HIV (human immunodeficiency virus) infection status of this population can reflect the global HIV epidemic trend to a certain extent. Therefore, we conducted a retrospective epidemic survey to clarify the prevalence and characteristics of HIV-1 infection among inbound travelers applying for Shanghai residency. The retrospective cohort analysis included a total of 50,830 inbound tourists/travelers who applied for Shanghai residency from 2005 to 2016. HIV-1 infection rates were determined based on HIV-1 antibody testing. Among all the recruited inbound travelers, 245 were HIV-1 positive, with an infection rate of 0.48%. The detection rate of HIV in males was significantly higher than in females (χ2 = 62.584, P < 0.0001). Those aged 18–30 years, 31–40 years, and >40 years accounted for 34.3%, 39.6%, and 26.1% of the infected population, respectively. Although the annual detection rates were different, the trend analysis results showed no increase in HIV-1 prevalence rates among the sampling years (Cochran-Armitage Z = 2.543, P = 0.111). Proportions of individuals infected through homosexual transmission increased over the study period (Cochran-Armitage Z = 5.41, P < 0.001), while the proportion infected through heterosexual declined over time (Cochran-Armitage Z = 3.38, P = 0.001). The rate and characteristics of HIV-1 infection among foreign applicants for residency in Shanghai were identified in the study. The results provide the necessary epidemiological data for monitoring the HIV-1 epidemic among international entry travelers and contribute to establishing relevant policies and regulations for HIV control and prevention.

Effect of Sickle Cell Trait on Human Immunodeficiency Virus Type 1 Infection.

Whereas several studies show that homozygous (HbSS) sickle cell disease protects against human immunodeficiency virus infection, it is not clear if human immunodeficiency virus infection is affected by the heterozygous state of the sickle globin gene (HbAS or sickle cell trait). To evaluate the effects of sickle cell trait on the prevalence and severity of human immunodeficiency virus type 1 infection in a large patient population. Hemoglobin genotype was determined by high performance liquid chromatography (HPLC) in 1,226 HIV-1 patients in Nigeria. Their demographic data were documented. Blood CD4+ cell counts and HIV-1 viral load previously determined on the same blood samples to guide clinical care were used as indices of severity of HIV-1 infection. Statistical analysis of the data was done to evaluate the effects of sickle cell trait on the severity and prevalence of HIV-1 infection, relative to the prevalence of 1.4% in the general population of Nigeria. The distribution of hemoglobin genotypes among the HIV-1 patients was comparable to that in the general population of Nigeria (Chi-squared statistic =1.025; p value = 0.31, not significant). Neither viral load (p = 0.32) nor blood CD4+ cell count (p = 0.30) was significantly different between all HbAS versus all HbAA patients. There was a trend towards lower viral load in females and a significant interaction between gender and HbAS for viral load (P = 0.018), suggesting that sickle cell trait might be associated with the severity of HIV-1 infection in females. The findings suggest that sickle cell trait might be associated with severity of HIV-1 infection in female, but not all, patients. Larger, prospective studies are required to further investigate the effect of sickle cell trait on HIV-1 infection.

Prevalence of syphilis and chlamydia trachomatis infection among men who have sex with men in Jiangsu province, China: A cross-sectional survey.

BackgroundEpidemics of sexually transmitted infections (STIs) among men who have sex with men (MSM) are major global public health concerns. This study aimed to examine the prevalence of syphilis and chlamydia trachomatis (CT) infection and associated factors among MSM in Jiangsu province, China, hoping to provide updated data for the formulation of relevant policies.MethodsA cross-sectional survey was conducted among MSM from April to July 2021 in four cities in the province. Socio-demographic characteristics and behavioral information were collected through a face-to-face questionnaire interview. Venous blood specimens were collected for HIV, hepatitis C (HCV), and syphilis testing using serological testing methods. First-void urine specimens were collected for CT and Neisseria gonorrhoeae (NG) testing using nucleic acid amplification testing (NAAT) methods. Chi-square tests were used to compare differences in syphilis and CT infection between subgroups of variables. Multivariate logistic regression analysis was used to identify factors associated with syphilis and CT infection.ResultsA total of 1,087 participants were enrolled. The prevalence of HIV, HCV, syphilis, CT and NG infection were 6.6, 0.4, 6.3, 4.2, and 0.4%, respectively. MSM recruited online [adjusted odds ratio (aOR) = 2.189, P = 0.020], diagnosed with an STI in the past 12 months (aOR = 3.304, P < 0.001), and living with HIV (aOR = 4.721, P < 0.001) were more likely to have syphilis infection. MSM who were younger than 25 years (aOR = 4.286, P = 0.020), had senior high school level education (aOR = 2.521, P = 0.038), and were recruited via VCT clinics (aOR = 3.455, P = 0.001) were more likely to have CT infection.ConclusionsOur study showed a high prevalence of syphilis and chlamydia among MSM in Jiangsu province, China. STI screening, diagnosis, and treatment services promotion should be a top priority on the prevention agenda.

Lung Injury in COVID-19 and Pneumocystis Pneumonia. Similarities and Differences

In the regions with the high prevalence of HIV infection, it is necessary to perform differential diagnosis of lung injury caused by COVID-19 and pneumocystis pneumonia.The main complaints in COVID-19 and pneumocystis pneumonia are similar and include dyspnea, weakness, cough, fever, and ground glass radiographic syndrome. However, sputum production was more common in pneumocystis pneumonia. The most important differences were frequent anosmia in COVID-19 and its absence in pneumocystis pneumonia, frequent detection of oropharyngeal candidiasis in pneumocystis pneumonia which was not seen in COVID-19.Serum hepcidin concentration has a high diagnostic potential and indicates a greater likelihood of COVID-19 than pneumocystis pneumonia at values ≤ 768.044 pg/ml (ROC AUC 0.977; p &lt; 0.001).

Prevalence and Risk Factors of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Infections among Prisoners Admitted to DMCH

Background: There are approximately 66 thousand prisoners remained in 68 prisons in Bangladesh. (source: Kara Adhidoptar, Bangladesh). So these number of prisoners suffers from different diseases. Prisoners are associates with various high risk of infectious diseases, as a result of the possibility of transmission of infections in prisons surroundings. A high prevalence of blood borne hepatitis viruses and HIV carried out in correctional facilities around the world by investigations have shown. There are limited data on medical disorders among prison inmates in Bangladesh. The study was aimed at confirming prevalence of HIV, hepatitis B and hepatitis C as well to assess knowledge and attitudes related to HIV, HBV and HCV infections among prisoners admitted to DMCH who referred to medicine department and/ or attended out-patient department in DMCH. Objective: To determine the prevalence and risk factors of HIV, HBV and HCV infection among prisoners referred to tertiary care hospital. Methods: This cross sectional study was done with a total number of 100 inmates over a period of one year. Prisoners, imprisonment for more than six months and who gave consent voluntarily were included in the study. After taking consent from the patient’s/guardians history was taken and physical examination was done. Sample was selected from the population by purposive sampling technique. Data were analysis was done using SPSS version 22.0. Result was expressed in tables and graphs. Results: The results showed a significantly higher seroprevalence of HBV (6%) and HCV (4%) though no prisoner was found to be HIV positive compared to the seroprevalence of these virus infections reported in the general Bangladeshi population (5.8% for HBV and 0.3% for HCV). Exposure of risk factors estimated H/O foreign travels 12%, IV drug abuse 14%, extramarital sexual exposure 16%, sharing of needle 10%, H/O blood transfusion 08%, family H/O diseases 05%, immunization of hepatitis B only 8% and homo sexuality 0%. Risk factors for HBV infection was estimated-family h/o disease 20%, IV drug abuse 7.10%, sharing of needles &amp; syringes 10%, sexual exposue12.50%, blood transfusion 12.50%. Risk factors for HCV infection was estimated -IV drug abuse 7.10%, sexual exposue6.25%, sharing of needles &amp; syringes 20%. Risk factors for HIV infection 0% for all risk factors as no one was HIV infected. Among the IDUs 14% was HBV positive and 30% was HCV positive. Conclusion: The results indicate higher prevalence of HBV and HCV infections among prisoners which has proven that HBV and HCV are the emerging public health problem in a developing country like Bangladesh. Various risk factors contribute to raise prevalence of hepatitis B, hepatitis C and HIV in prisoners. So avoidance from these risk factors is essential to prevent transmission of infection in prison. So health education and dissemination of message about the moods of transmission of these diseases is very important in prison.

The World Health Organization targets for cervical cancer control by 2030: a baseline assessment in six African countries-part I.

We present and analyse the findings of a survey of the readiness of the healthcare systems in Eswatini, Guinea, Malawi, Rwanda, Uganda and Zambia, to implement the necessary measures for attaining the targets for cervical cancer control, set by The World Health Organization (WHO), by the year 2030. A questionnaire with 129 questions with preset answer options was completed in 2020, by ministries of health programme coordinators for non-communicable diseases, cancer control and/or reproductive health, and by WHO country offices, in the six countries selected. The findings on demographics, burden of disease, governance and management, laboratory services, equipment, supplies and medicines, as well as on personnel and training are presented here. The burden of cervical cancer in the countries studied is considerable, according to The International Agency for Research on Cancer estimations. The incidence of the disease is augmented by the high prevalence of HIV infection, in most of the countries surveyed. Most of the population live in rural areas, where access to the health services is far from ideal. Facilities for screening with human papilloma virus tests and for histopathology are limited. One pathologist covers the diagnostic needs of between 0.5 and 4 million inhabitants. Most other categories of health professionals are under-represented, and the capacity to train them is inadequate. Strong country commitment and leadership, innovative solutions and extensive international cooperation would be needed to attain the targets of cervical cancer control set by WHO, in these countries.

TB screening, prevention and treatment cascade in a Malawi prison.

BACKGROUND Incarcerated individuals, especially in high HIV and TB burden settings, are at increased risk of latent TB infection and/or TB disease. We implemented a comprehensive HIV-TB intervention in a Malawi prison and studied its feasibility.METHODS Between February and December 2019, consenting individuals underwent screening for HIV, TB infection and TB disease. HIV-positive individuals without TB disease were treated with a fixed-dose combination of isoniazid, cotrimoxazole and vitamin B6 (INH-CTX-B6). HIV-negative persons with TB infection received 12 weeks of isoniazid and rifapentine (3HP).RESULTS Of 1,546 consenting individuals, 1,498 (96.9%) were screened and 1,427 (92.3%) included in the analysis: 96.4% were male, the median age was 31 years (IQR 25-38). Twenty-nine (2.1%) participants were diagnosed with TB disease, of whom 89.7% started and 61.5% completed TB treatment. Of the 1,427 included, 341 (23.9%) were HIV-positive, of whom 98.5% on antiretroviral therapy and 95% were started on INH-CTX-B6. Among 1,086 HIV-negative participants, 1,015 (93.5%) underwent the tuberculin skin test (TST), 670 (65.9%) were TST-positive, 666 (99.4%) started 3HP and 570 (85.5%) completed 3HP treatment.CONCLUSION A comprehensive TB screening and treatment package among incarcerated individuals was acceptable and feasible, and showed high prevalence of HIV, TB disease and TB infection. Treatment uptake was excellent, but treatment completion needs to be improved. Greater investment in comprehensive HIV-TB services, including access to shorter TB regimens and follow-up upon release, is needed for incarcerated individuals.

The clinical characteristics and outcomes of appendicitis in a population with a high HIV-infection prevalence.

In Botswana, the prevalence of HIV-infection is high (20.1%). Literature on characteristics of appendicitis in a high HIV-infection prevalence is limited. A retrospective medical records review was conducted in patients admitted with a diagnosis of appendicitis and known HIV-infection status to adult surgical wards at Princess Marina Hospital from 2013 to 2019. Patients' demographics, clinical characteristics, laboratory data, management and outcomes were analysed. A total of 601 appendicitis patients with known HIV-infection status were identified. Males contributed 51.9%. The overall median age was 29-year: 25-year for HIV-negative patients (HIV-NP) and 36-year for HIV-positive patients. HIV-NP had significantly higher rate of WBC count >10,000/μL, p=0.034. Appendectomy was performed in 92.8% of the cases. Non-operative treatment failure rate in one year was 35.4%. A total of 58 complications were recorded including 20 surgical site infections (SSIs) and one mortality in HIV-NP and 11 SSIs and six mortalities in HIV-positive patients (HIV-PP). HIV-PP had significantly higher mortality than HIV-NP, p=0.010. The overall hospital stay between operated and non-operated patients, p=0.996 and hospital stay between HIV-NP and HIV-PP were not different, p=0.223. Female patients had a significantly higher normal appendix and chronic appendicitis rates than males, p=0.032 and p=0.018 respectively. Complex appendicitis was associated with longer pre-hospital symptom duration, p=0.008 and longer hospital stay, p= 0.001, but it was not related to mortality, p=1.000. Among operated HIV-PP, patients with CD4 count <200 had a significantly higher mortality rate than those with ≥200, p=0.043. In Botswana, the prevalence of HIV-infection in patients with appendicitis was higher than the rate in the general population. HIV-infection and low CD4 count had an adverse effect on the mortality of patients with appendicitis. The higher HIV-infection rate in appendicitis patients and the impact of antiretroviral drug and viral-load on the outcomes in HIV-PP worth investigating.

Prevalence and Spectrum of HIV-1 Resistance Mutations in the Siberian Federal District.

The Siberian Federal District is among the most affected regions with a high prevalence of HIV-infection and is characterized by high HIV-infection incidence rate and high mortality among the HIV-infected population. HIV drug resistance poses a major threat to public health and is associated with increased mortality, HIV incidence, and cost of epidemic control programs. A total of 1281 samples from HIV-infected patients were sequenced and analyzed with the DEONA and HIVdb Program to assess the prevalence of drug resistance mutations in patients in the Siberian Federal District in 2016–2018. The federal surveillance data obtained from 0.5% of HIV-infected patients during the long-term follow-up care in 2021 were also used. The incidence rate of HIV infection in the Siberian Federal District has declined since 2016: from 135.8 per 100 thousand population to 81.1 per 100 thousand population in 2021. Mutations associated with resistance to NRTI and NNRTI were found in 10.3% of the samples in 2016–2018 and in 28.4% of the samples in 2020. The rising prevalence of drug resistance in HIV-infected patients indicates that it is increasingly important to continuously monitor and improve the approaches to the use of effective treatment regimens.

Chronic kidney disease (CKD) and associated risk in rural South Africa: a population-based cohort study.

Background: In Africa, true prevalence of chronic kidney disease (CKD) is unknown, and associated clinical and genetic risk factors remain understudied. This population-based cohort study aimed toinvestigate CKD prevalence and associated risk factors in rural South Africa. Methods: A total 2021 adults aged 20-79 years were recruited between 2017-2018 from the Agincourt Health and Socio-Demographic Surveillance System in Bushbuckridge, Mpumalanga, South Africa. The following were collected: sociodemographic, anthropometric, and clinical data; venous blood samples for creatinine, hepatitis B serology; DNA extraction; spot urine samples for dipstick testing and urine albumin: creatinine ratio (UACR) measurement. Point-of-care screening determined prevalent HIV infection, diabetes, and hypercholesterolemia. DNA was used to test for apolipoprotein L1 ( APOL1) kidney risk variants. Kidney Disease Improving Global Outcomes (KDIGO) criteria were used to diagnose CKD as low eGFR (<60mL/min/1.73m 2) and /or albuminuria (UACR ≥ 3.0mg/mmol) confirmed with follow up screening after at least three months. eGFR was calculated using the CKD-EPI (creatinine) equation 2009 with no ethnicity adjustment. Multivariable logistic regression was used to model CKD risk. Results: The WHO age-adjusted population prevalence of CKD was 6.7% (95% CI 5.4 - 7.9), mostly from persistent albuminuria. In the fully adjusted model, APOL1 high-risk genotypes (OR 2.1; 95% CI 1.3 - 3.4); HIV infection (OR 1.8; 1.1 - 2.8); hypertension (OR 2.8; 95% CI 1.8 - 4.3), and diabetes (OR 4.1; 95% CI 2.0 - 8.4) were risk factors. There was no association with age, sex, level of education, obesity, hypercholesterolemia, or hepatitis B infection. Sensitivity analyses showed that CKD risk factor associations were driven by persistent albuminuria, and not low eGFR. One third of those with CKD did not have any of these risk factors. Conclusions: In rural South Africa, CKD is prevalent, dominated by persistent albuminuria, and associated with APOL1 high-risk genotypes, hypertension, diabetes, and HIV infection.

Male partner age, viral load, and HIV infection in adolescent girls and young women: evidence from eight sub-Saharan African countries.

We aimed to elucidate the role of partnerships with older men in the HIV epidemic among adolescent girls and young women (AGYW) aged 15-24 years in sub-Saharan Africa. Analysis of Population-based HIV Impact Assessments in Eswatini, Lesotho, Malawi, Namibia, Tanzania, Uganda, Zambia, and Zimbabwe. We examined associations between reported partner age and recent HIV infection among AGYW, incorporating male population-level HIV characteristics by age-band. Recent HIV infection was defined using the LAg avidity assay algorithm. Viremia was defined as a viral load of more than 1000 copies/ml, regardless of serostatus. Logistic regression compared recent infection in AGYW with older male partners to those reporting younger partners. Dyadic analysis examined cohabitating male partner age, HIV status, and viremia to assess associations with AGYW infection. Among 17 813 AGYW, increasing partner age was associated with higher odds of recent infection, peaking for partners aged 35-44 (adjusted odds ratio = 8.94, 95% confidence interval: 2.63-30.37) compared with partners aged 15-24. Population-level viremia was highest in this male age-band. Dyadic analyses of 5432 partnerships confirmed the association between partner age-band and prevalent HIV infection (male spousal age 35-44-adjusted odds ratio = 3.82, 95% confidence interval: 2.17-6.75). Most new infections were in AGYW with partners aged 25-34, as most AGYW had partners in this age-band. These results provide evidence that men aged 25-34 drive most AGYW infections, but partners over 9 years older than AGYW in the 35-44 age-band confer greater risk. Population-level infectiousness and male age group should be incorporated into identifying high-risk typologies in AGYW.

Histopathological profile of cervical punch biopsies and risk factors associated with high-grade cervical precancerous lesions and cancer in northwest Ethiopia

Cervical cancer is an important public health problem in Ethiopia. However, the disease is not well characterized and studied in various parts of the country. This study was designed to describe the histopathological profile of cervical biopsies and to identify risk factors associated with high-grade cervical lesions and cancer (CIN2+C). A cross-sectional study was conducted at Felege Hiwot Compressive Specialized Hospital (FHCSH) between 1 March 2019 and 30 October 2021. A structured questionnaire was used to collect data on the participants' demographic, reproductive and gynecologic history. From women presented with different degrees of cervical lesions, a senior gynecologist collected cervical swabs using (Digene HC2 DNA collection device: Qiagen, Hilden, Germany) for detection of high-risk Human papillomaviruses (HR-HPV) and punch biopsy for histopathological examinations. HR-HPVs were detected using the Abbott Alinity m system following the manufacturer protocol at the Institute of Virology, Leipzig University Hospital, Germany. Collected data entered and analyzed using SPSS version 25. A logistic regression model was used for both bivariable & multivariable analysis in order to determine the association between independent variables and CIN2+C. Statistical significance was set at a p-value <0.05. In this study, 335 women were included; the mean age was at 46.5±11.4 years. Most were living in rural settings, 221(66%) and had no formal education, 259 (77.3%). More than half of the participants, 193(57.6%) were unaware of cervical cancer. The prevalence of HIV infection and previous history of cervical screening were 44(13.1%) and 93(27.8%), respectively. HR-HPVs were detected in 178(54.3%) of the participants. The majority of biopsies, 140(41.8%; 95%CI: 36.6-47.1%), were diagnosed as cervical carcinoma. Normal histology, cervicitis, cervical intraepithelial neoplasia (CIN)-1, CIN-2, and CIN-3 accounted for 74(22.1%), 30(9.0%), 40(11.9%), 12(3.6%), and 12(3.6%), respectively. High-grade lesions and cancer (CIN2+C) together accounted 164(49.0%; 95%CI: 43.6-54.2). Cervical cancer increased steadily with the age of the participants (p<0.001) in which women above the age of fifty were approximately four times more likely to develop CIN2+C than the younger ones (AOR: 3.73; 95%CI: 1.80-7.82; p<0.001). Likewise, no screening history in the last five years (AOR: 2.03; 95%CI: 1.05-3.92; p = 0.035) and being infected with HR-HPVs (AOR: 14.23; 95%CI: 7.9-25.64; p<0.001) were found significantly associated with CIN2+C. The findings of this study revealed that cervical cancer continues to be an important women's health challenge in northwest Ethiopia. Postmenopausal women, who had no screening history within a five-year period and those women who tested positive for HR-HPV need special attention. It is important to increase the awareness of women about cervical cancer and actions for early detection of precancerous lesions should be expanded.