Publications by authors named "Noel Kayange"

Background: Oral pre-exposure prophylaxis has been introduced in more than 70 countries, including many in sub-Saharan Africa, but women experience considerable barriers to daily pill-taking, such as stigma, judgement, and the fear of violence. Safe and effective long-acting agents for HIV prevention are needed for women. We aimed to evaluate the safety and efficacy of injectable cabotegravir compared with daily oral tenofovir diphosphate plus emtricitabine (TDF-FTC) for HIV prevention in HIV-uninfected women.

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Objectives: HPTN 075 enrolled men who have sex with men (MSM) and transgender women (TGW) in sub-Saharan Africa. Persons in HIV care or on antiretroviral treatment (ART) were not eligible to enroll. We evaluated antiretroviral (ARV) drug use, viral suppression, and drug resistance in this cohort over a 12-month follow-up period.

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Background: The HIV Prevention Trials Network (HPTN) 075 study evaluated the feasibility of enrolling and retaining men who have sex with men (MSM) and transgender women (TGW) from Kenya, Malawi, and South Africa. During the study follow-up, 21 participants acquired human immunodeficiency virus (HIV) (seroconverters). We analyzed HIV subtype diversity, drug resistance, transmission dynamics, and HIV superinfection data among MSM and TGW enrolled in HPTN 075.

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Article Synopsis
  • - The study focuses on using neurovascular ultrasound as a cost-effective alternative to traditional imaging techniques for assessing cerebral atherosclerosis in Malawian adults experiencing stroke-like symptoms, addressing a lack of epidemiological data in sub-Saharan Africa.
  • - Out of 66 enrolled patients, the study found a 39.4% occurrence of extracranial atherosclerosis, along with notable rates of abnormal carotid intima media thickness and carotid plaques, indicating a significant burden of vascular disease.
  • - The findings suggest that while neurovascular ultrasound is feasible for evaluating cervical arteries in this population, challenges like high failure rates in transcranial imaging highlight the need for improved techniques or agents to enhance imaging success.
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Throughout the world, men who have sex with men (MSM) are at increased risk for HIV infection compared to heterosexual men. Little is known about awareness of HIV infection and other gaps in the HIV care continuum for MSM, especially in sub-Saharan Africa (SSA). This information is urgently needed to address the HIV epidemic in this population.

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Some HIV-infected individuals in research studies may choose not to disclose knowledge of their HIV status to study staff. We evaluated the accuracy of self-reported HIV status among African men and transgender women who have sex with men and who were screened for a research study. Sixty-seven of 183 HIV-infected participants reported a prior HIV diagnosis.

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Article Synopsis
  • The study focused on analyzing antiretroviral drug use and HIV drug resistance among HIV-infected men who have sex with men (MSM) and transgender women participating in the HIV Prevention Trials Network 075 study.
  • Out of 183 participants with confirmed HIV infection, 34.4% had detectable antiretroviral drugs, but only 17.5% of those were virally suppressed, indicating issues with treatment effectiveness and drug resistance.
  • The findings suggest a significant prevalence of drug-resistant HIV among participants and emphasize the urgent need for better HIV care strategies for MSM and transgender women in Africa.
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Background: Control of hypertension in low- and middle-income countries (LMICs) is poor, often less than 10%. A strong body of evidence demonstrates that home blood pressure management lowers blood pressure, and recent guidelines from the National Institute for Clinical Health and Excellence recommends home blood pressure monitoring. However, the preponderance of data on the benefits of home blood pressure management comes from studies in high-income countries.

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Background: Hypertension and diabetes prevalence is high in Africans. Data from HIV infected populations are limited, especially from Malawi. Integrating care for chronic non-communicable co-morbidities in well-established HIV services may provide benefit for patients by preventing multiple hospital visits but will increase the burden of care for busy HIV clinics.

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Background: Ultrasound utilization studies in the developing world are important to support appropriate use.

Methods: A prospective, cross-sectional study in the medical wards at Queen Elizabeth Central Hospital, Blantyre, Malawi, was performed which aimed to assess referrals, reports and usefulness of scans to develop local recommendations. The primary outcome of a 'useful scan' was based on scan results and utilization of the report.

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Background: Sulphadoxine-pyrimethamine (SP) is the only single dose therapy for uncomplicated malaria, but there is widespread resistance. At the time of this study, artemether-lumefantrine (AL) and chlorproguanil-dapsone (CPD), both multi-dose regimes, were considered possible alternatives to SP in Malawi. The aim of this study was to investigate the impact of poor adherence on the effectiveness of AL and CPD.

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