Publications by authors named "Waruiru Wanjiru"

Introduction: Effective coverage of Human Immunodeficiency Virus prevention services for Key Populations (KPs) including female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and transgender (TG) people necessitates periodic validation of physical venues and size estimates. Kenya conducted a robust size estimation of KPs in 2012 and a repeat mapping and size estimation exercise was conducted in 2018 to update KP Size Estimates and sub-typologies within each County for calculation of realistic program indicators.

Methods: A prospective mixed methods programmatic mapping approach adopted comprised two steps.

View Article and Find Full Text PDF

Background: Understanding the magnitude and causes of mortality at national and sub-national levels for countries is critical in facilitating evidence-based prioritization of public health response. We provide comparable cause of death data from Kisumu County, a high HIV and malaria-endemic county in Kenya, and compared them with Kenya and low-and-middle income countries (LMICs).

Methods: We analyzed data from a mortuary-based study at two of the largest hospital mortuaries in Kisumu.

View Article and Find Full Text PDF
Article Synopsis
  • PWID in Kenya face high rates of HIV (14-26%) and hepatitis C (11-36%), prompting an evaluation of the effectiveness of current and enhanced treatment strategies.
  • A model was used to analyze the potential benefits of existing therapies like antiretroviral therapy (ART), opioid agonist therapy (OAT), and needle syringe programs (NSP) as well as proposed strategies for harm reduction and increased treatment over the next decade.
  • Results showed that while existing interventions significantly reduced HIV and HCV infections, achieving substantial reductions by 2030 will require scaling up these interventions along with measures to decrease sexual risk and an increased focus on HCV treatment.
View Article and Find Full Text PDF

Background: Lack of dependable morbidity and mortality data complicates efforts to measure the demographic or population-level impact of the global HIV/AIDS epidemic. Mortuary-based mortality surveillance can address gaps in vital statistics in low-resource settings by improving accuracy of measuring HIV-associated mortality and indicators of access to treatment services among decedents. This paper describes the process and considerations taken in conducting mortuary and hospital-based HIV mortality surveillance among decedents in Kenya.

View Article and Find Full Text PDF
Article Synopsis
  • Reviewed medical charts from two mortuaries in Kisumu County, Kenya, to determine the underlying causes of death (UCOD) for 456 decedents; found that HIV/AIDS was the leading cause.
  • The study revealed an all-cause mortality rate of 1,086 deaths per 100,000 population, with significant differences in mortality rates for noncommunicable diseases between genders.
  • There was a high rate of incorrect UCOD recorded, with only 29.2% agreement between the notified and ascertained causes, indicating a need for better documentation practices to improve mortality statistics.
View Article and Find Full Text PDF

Background: Estimating cause-related mortality among the dead is not common, yet for clinical and public health purposes, a lot can be learnt from the dead. HIV/AIDS accounted for the third most frequent cause of deaths in Kenya; 39.7 deaths per 100,000 population in 2019.

View Article and Find Full Text PDF

Background: Accurate data on HIV-related mortality are necessary to evaluate the impact of HIV interventions. In low- and middle-income countries (LMIC), mortality data obtained through civil registration are often of poor quality. Though not commonly conducted, mortuary surveillance is a potential complementary source of data on HIV-associated mortality.

View Article and Find Full Text PDF

Background And Aims: Hepatitis C virus (HCV) treatment is essential for eliminating HCV in people who inject drugs (PWID), but has limited coverage in resource-limited settings. We measured the cost-effectiveness of a pilot HCV screening and treatment intervention using directly observed therapy among PWID attending harm reduction services in Nairobi, Kenya.

Design: We utilized an existing model of HIV and HCV transmission among current and former PWID in Nairobi to estimate the cost-effectiveness of screening and treatment for HCV, including prevention benefits versus no screening and treatment.

View Article and Find Full Text PDF
Article Synopsis
  • Recent infection testing for HIV can help differentiate between newly acquired and long-standing infections, addressing the growing need for these methods in various healthcare settings.
  • Pilot studies in Kenya and Zimbabwe demonstrated varying rates of recent HIV infections, highlighting different challenges such as sample acceptance, transportation, and testing complexities that impact the implementation of testing algorithms.
  • Despite establishing a cooperative laboratory network, issues like delivering timely test results to clients remained unsolved, underscoring the need for improved processes in recency testing.
View Article and Find Full Text PDF
Article Synopsis
  • The study looked at how to find out if someone has recently caught HIV to help prevent more infections.
  • Researchers tested people in different places, like pregnant women in Kenya and female sex workers in Zimbabwe, using a special method to see if the infections were new.
  • Results showed that a small percentage of people tested had recent infections, with some findings suggesting that pregnant women in early stages were more likely to test positive for recent infections compared to those further along.
View Article and Find Full Text PDF

Background: Serological tests can distinguish recent (in the prior 12 months) from long-term HIV infection. Integrating recency testing into routine HIV testing services (HTS) can provide important information on transmission clusters and prioritize clients for partner testing. This study assessed the feasibility and use of integrating HIV recency into routine testing.

View Article and Find Full Text PDF

Understanding the characteristics of individuals who are newly diagnosed with HIV is critical to controlling the HIV epidemic. Characterizing this population can improve strategies to identify undiagnosed positives and assist in targeting the provision of HIV services to improve health outcomes. We describe the characteristics of newly diagnosed HIV cases in western Kenya from 124 health facilities.

View Article and Find Full Text PDF

Background: Death is an important but often unmeasured endpoint in public health HIV surveillance. We sought to describe HIV among deaths using a novel mortuary-based approach in Nairobi, Kenya.

Methods: Cadavers aged 15 years and older at death at Kenyatta National Hospital (KNH) and City Mortuaries were screened consecutively from January 29 to March 3, 2015.

View Article and Find Full Text PDF
Article Synopsis
  • The study highlights the implementation of a pilot HIV-related mortuary surveillance system in two large mortuaries in Nairobi, Kenya, to assess HIV mortality rates, given the lack of comprehensive vital statistics in low to medium-income countries.
  • The system focused on determining HIV positivity and cause-specific mortality rates among cadavers aged 15 and over, revealing an overall HIV positivity rate of 19.5%, with a notable difference between genders (14.6% for men vs. 29.5% for women).
  • The evaluation followed CDC guidelines to assess the system’s performance attributes, including its simplicity, flexibility, and data quality, to identify strengths and weaknesses for future improvements.
View Article and Find Full Text PDF

Background: A universal health care identifier (UHID) facilitates the development of longitudinal medical records in health care settings where follow up and tracking of persons across health care sectors are needed. HIV case-based surveillance (CBS) entails longitudinal follow up of HIV cases from diagnosis, linkage to care and treatment, and is recommended for second generation HIV surveillance. In the absence of a UHID, records matching, linking, and deduplication may be done using score-based persons matching algorithms.

View Article and Find Full Text PDF

Background: Understanding sexual risk among youth can inform the design of effective HIV prevention interventions.

Methods: The 2012 Kenya AIDS Indicator Survey was a nationally representative population-based survey. We administered a questionnaire and collected blood samples for HIV testing.

View Article and Find Full Text PDF

Background: Cross-sectional population-based surveys are essential surveillance tools for tracking changes in HIV epidemics. In 2007, Kenya implemented the first AIDS Indicator Survey [Kenya AIDS Indicator Survey (KAIS) 2007)], a nationally representative, population-based survey that collected demographic and behavioral data and blood specimens from individuals aged 15-64 years. Kenya's second AIDS Indicator Survey (KAIS 2012) was conducted to monitor changes in the epidemic, evaluate HIV prevention, care, and treatment initiatives, and plan for an efficient and effective response to the HIV epidemic.

View Article and Find Full Text PDF

Background: HIV testing and counseling (HTC) is essential for successful HIV prevention and treatment programs. The national target for HTC is 80% of the adult population in Kenya. Population-based data to measure progress towards this HTC target are needed to assess the country's changing needs for HIV prevention and treatment.

View Article and Find Full Text PDF

Background: Enhanced HIV surveillance using demographic, behavioral, and biologic data from national surveys can provide information to evaluate and respond to HIV epidemics efficiently.

Methods: From October 2012 to February 2013, we conducted a 2-stage cluster sampling survey of persons aged 18 months to 64 years in 9 geographic regions in Kenya. Participants answered questionnaires and provided blood for HIV testing.

View Article and Find Full Text PDF

The President's Emergency Plan for AIDS Relief (PEPFAR) programme for the Caribbean Region was established in 2008 to address health system challenges, including fragile laboratory services and systems. The laboratory component of this programme consisted of several phases: assessment of laboratory needs of all 12 countries engaged in the programme; addressing gaps identified during the assessment; and monitoring and evaluation of the progress achieved. After one year of PEPFAR collaboration with national governments and other partners, laboratory services and systems greatly improved.

View Article and Find Full Text PDF