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Late diagnosis triggering more deaths in HIV-positive children – Study

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Latest study: Late diagnosis triggering more deaths in HIV-positive children

By ALLAN TAWAI

Latest study shows that more children infected with HIV are dying early in hospitals in spite of anti-retroviral therapy (ART) being available, blaming delayed diagnosis among this pool of patients for the problem.

The study which was conducted in four hospitals in Kenya – Kenyatta National Hospital and Mbagathi District Hospital in Nairobi and Jaramogi Oginga Odinga Teaching and Referral Hospital and Kisumu County Hospital in Nyanza between April 2013 and November 2015 indicates that HIV infection in most is only known when they are admitted to hospitals, an indication that there has been little or no focus for routine checks for status among children.

The findings published in the Lancet Health Journal last week reveal that ART has not helped increase chances of survival for hospitalized children.

“Many HIV-infected children in sub-Saharan Africa are frequently diagnosed during hospitalisation for an acute co-infection and experience high early mortality,” it stated.

It also stated that anti-retroviral therapy among hospitalised HIV-infected children might not speed up recovery and may in fact inhibit immune regeneration.

The research was done on 191 (76 percent) out of the 250 hospitalised HIV-infected children in the hospitals. They were aged between 0-12 years.

Of these, 181 children were randomly enrolled, 90 to urgent anti-retroviral therapy (done within 48 hours of enrolment) and 91 to post-stabilization ART (done 7-14 days after enrolment).

Overall, almost a quarter (21 percent) of children died in the first 3 months.

Eighteen (10 percent) of 181 children died in the first week. 12 (13 percent) of 90 children died in the urgent ART group and six (7 percent) of 91 children died in the post-stabilisation group.

Most of the deaths of the children occurred in the first month and dropped strikingly between one month and three months.

No deaths occurred between three months and six months after ART initiation.

“Overall it was observed that there was a high mortality rate in the first few weeks after ART initiation, with more than 80 percent of deaths occurring in the first month and all deaths occurring within three months,” said the study.

Results show that speeding up anti-retroviral therapy during hospitalisation does not have any survival benefit.

“Though rapid HIV diagnosis within one day of enrolment was practised at the four hospital sites, ART initiated within 48 hours did not reduce mortality when compared with ART initiated between 7 days and 14 days,” the research revealed.

A previous study in Kenya showed that 41 percent of hospitalised infants died before ART initiation at the average of 11 days after diagnosis, suggesting a narrow window for intervention in children.

Researchers in that study also found no survival benefit of initiating ART within seven days compared with 21 days in a hospitalised pediatric unit.

“Together, these studies suggest that waiting for more than 21 days might be too late while expediting to less than seven days might not provide survival benefit,” said the study.

The research also found out that delays by caregivers in providing ART treatment to the children were common and may have increased the risk of death.

More than a third of the children who had previously been hospitalised had not started ART either because of not having been tested for HIV, having been diagnosed but not referred for ART, or failing to link to ART services.

Pre-ART loss to follow-up rates of 15·2 per 100 people were also reported from a large treatment programme in western Kenya and 16 percent of children who did not follow-up died.

“Once children are discharged from the hospital, they often fail to return to clinic to start ART,” it read.

“This missed opportunity for earlier HIV diagnosis and treatment too often resulted in mortality,” added the report.

According to the World Health Organisation (WHO), about 1.6 million persons in Kenya are infected with HIV and only about one million are on ART.

Kenya has an estimated 71,034 new HIV infections among adults and about 6,613 new infections among children annually.

Approximately 120, 000 children in Kenya are living with HIV while only 78, 700 children (65 percent) are accessing anti-retroviral treatment.

In 2016, about 4, 800 children died due to HIV/AIDS.

The study proposes that the high mortality risk observed despite accelerated ART emphasizes the need for alternative strategies to improve survival in HIV-infected children who are presented late to care as well as interventions to test and treat children.

 

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Africa

US warns Kenyans over fake marriages, says they won’t be allowed to fly out

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The US embassy in Nairobi on Monday issued a warning to Kenyans getting duped into fake marriages to acquire a visa.

Through their official social media pages, the embassy advised caution in the event somebody offers to get you a green card using dubious means.

“Has anyone ever told you they can get a green card for you? Don’t believe them! They are lying and just trying to steal your money. Don’t believe them when they say you can have a fake marriage and still get your green card.

“If you apply with a fake marriage, you will get caught and you will not get your green card. You will become permanently ineligible to ever go to the United States, and you will never be able to get a U.S. visa or a green card,” the embassy warned.

Visa denied FILE/PHOTO

Kenyans were further urged to apply for a visa or the green card lottery by themselves.

The statement conveyed: “You don’t need to use a fixer to apply for the diversity visa or green card lottery. You can do it yourself and pay the required fee.”

The embassy stated that one should only apply through the Embassy’s official website.

“If you know about anyone promising they can get a green card for you if you enter into a fake marriage, go to the police and report them. You should also report them to the U.S. Embassy,” the statement concluded.

Earlier last week, US Ambassador to Kenya Robert Godec announced that the United States government was gearing up to fight fake news in Kenya adding that it had eroded confidence in Kenya’s real news media.

Speaking during an interview, Godec stated: “Fake news is being weaponized. It’s undermining democracy in Kenya.”

President Uhuru Kenyatta with US Secretary of Transport Anthony Foxx (C) and Ambassador Robert Godec when he led a US business delegation to State House, Nairobi on June 25, 2015. PHOTO | PSCU

He further remarked: “We’re not asking them to believe any particular thing. We’re just urging people not to take everything they see on their phone via WhatsApp as the truth because it may not be.”

Source -Kenyans.co.ke

 

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VIDEO: Former Kenya’s head of Civil Service Francis Kimemia speaks to VOA

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BY BMJ MURIITHI

Former Kenya’s head of Civil Service and Secretary to the Cabinet who is the current governor of Nyandarua County, Francis Kimemia, has told the Voice of America (VOA) that contrary to a position taken by some naysayers, the devolved system of government is fast transforming Kenya in a myriad ways.

During an interview at VOA’s headquarters in Washington DC Thursday, Kimemia hailed the “good relations between Kenya and the US,” as well as the assistance extended by the latter over the years to the East African nation in support of good governance.

“I am very proud of the role I played in ensuring that the constitution was changed to pave way for the county system of governance,” he said. Kimemia also spoke on several topical issues, including Corruption, national reconciliation and eviction of Kenyans from Mau Forest, Kibera and other areas.

Earlier in the day, he was a guest at an online live-streaming event organised by Voice of America’s Student Union, an online community and news site for international students who study or wish to study in the United States.

Kimemia was among Kenyan Governors, their deputies and Senators who attended this year’s annual United States National Governors Association (NGA) Summer session in Santa Fe, New Mexico.

Watch the Full interview here:

23  Kenyan governors, several senators and other government officials joined the general secretary of German Chancellor Angela Merkel’s ruling party, the Chinese and Japanese ambassadors to the United States, and Japanese Prime Minister Shinzo Abe’s national security adviser, who also attended the event.

International leaders talked about the relationship between sub-national governments and the federal government. Speakers included the governor of Kenya’s Turkana County, Josphat Nanok – who is also the Chairman og Council of Governors in Kenya, as well  the general secretary of Germany’s Christian Democratic Party.

NGA is an organization consisting of the Governors of the states, territories and commonwealths of the United States which acts as a collective voice for Governors on matters of national policy, as well as allowing governors to share best practices and coordinate inter-state initiatives.

 

Former head of Kenyan Civil Service and Secretary to the Cabinet, who is the current Governor, Nyandarua County, Francis Kimemia during the interview at VOA Studios in Washington DC. PHOTO/VOA

This year’s attendees held discussions on international development and diplomacy.

Later, the Council of Governors Peace Committee held  a meeting with the National Democratic Institute in Washington DC, where they discussed possible areas of partnerships and support for peace and reconciliation efforts.

The Kenyan delegation also visited several US Cities, including Dallas, Texas, where a number of governors attended a Diaspora Conference organized by Kenya Diaspora Advisory Council.

 Voice of America is the U.S.’s largest international broadcaster, reaching 236.8 million people weekly in more than 40 languages. For more information, you can visit our website.

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Kenyan scientist George Njoroge receives another prestigious award in US

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A US-based Kenyan research scientist has been honoured at a banquet in New York for his discoveries of drugs used to treat cancer and other life-threatening diseases.

Dr George Njoroge was presented with a “pioneer award” from Face2Face Africa, a pan-Africa media company, for his sustained impact on science and medicine.

The 64-year-old Kiambu native holds more than 100 patents for his work on cancer and immunology.

Currently a senior research fellow at the global pharmaceutical company Eli Lilly, Mr Njoroge plans to move next year to Naivasha, where he is establishing a biotechnology institute.

He said he hopes to attract 100 doctoral degree-holders from around the world to take part in the institute’s work on malaria, Aids, diabetes and cancer.

“Africa has to step up the plate and get involved by participating in the global scientific platform,” Mr Njoroge said in accepting the Face2Face Africa award on Saturday.

“We cannot afford to be left behind. In Africa, we have great brains and abundance of resources — we just need to embrace the power of biotechnology.”

He added in an interview that the latest of his numerous awards is particularly meaningful because it specifically honours persons of African origin.

Dr Njoroge credits his now-deceased mother, Alice Nyaucha, for having inspired his interest in science through her work as a practitioner of herbal medicine.

Dr Njoroge received his undergraduate degree from the University of Nairobi and earned a PhD in organic chemistry at Case Western Reserve University in Cleveland, Ohio.

He is married to Esther Nyambura, who works at Eli Lilly as an accountant. The couple have two adult children, both of whom are studying for medical degrees.

-Nation.co.ke

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