Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.7.10.2 (focal adhesion kinase)
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We examined partner notification among syphilitic pregnant women in Nairobi. At delivery, 377 women were found to be rapid plasma reagin (RPR) reactive. Data were available for 94% of the partners of women who were tested during pregnancy; over 67% of the partners had received syphilis treatment while 23% had not sought treatment mainly because they felt healthy. Six per cent of the women had not informed their partners as they feared blame and/or violence. Adverse pregnancy outcome was related to lack of partner treatment during pregnancy (7% versus 19%, odds ratio (OR) 3.0, 95% confidence interval (CI) 0.9-10.0). Our data suggest that messages focusing on the health of the unborn child have a positive effect on partner notification and innovative and locally adapted strategies for partner notification need more attention.
Int J STD AIDS 2000 Apr
PMID:Partner notification of pregnant women infected with syphilis in Nairobi, Kenya. 1077 91

Our objectives were to describe the baseline findings of a trial of antibiotic prophylaxis to prevent sexually transmitted infections (STIs) and HIV-1 in a cohort of Nairobi female sex workers (FSWs). A questionnaire was administered and a medical examination was performed. HIV-negative women were randomly assigned to either one gram azithromycin or placebo monthly. Mean age of the 318 women was 32 years, mean duration of sex work 7 years and mean number of clients was 4 per day. High-risk behaviour was frequent: 14% practised anal intercourse, 23% sex during menses, and 3% used intravenous drugs. While 20% reported condom use with all clients, 37% never use condoms. However, STI prevalence was relatively low: HIV-1 27%, bacterial vaginosis 46%, Trichomonas vaginalis 13%, Neisseria gonorrhoeae 8%, Chlamydia trachomatis 7%, syphilis 6% and cervical intraepithelial neoplasia (CIN) 3%. It appears feasible to access a population of high-risk FSWs in Nairobi with prevention programmes, including a proposed trial of HIV prevention through STI chemoprophylaxis.
Int J STD AIDS 2000 Dec
PMID:A randomized, placebo-controlled trial of monthly azithromycin prophylaxis to prevent sexually transmitted infections and HIV-1 in Kenyan sex workers: study design and baseline findings. 1113 16

Quality of health education during STD case management in Nairobi was assessed in 142 healthcare facilities, through interviews of 165 providers, observation of 441 STD patients managed by these providers, and 165 visits of simulated patients. For observations, scores were high for education on contact treatment (74-80%) and compliance (83%), but unsatisfactory for counselling (52%) and condom promotion (20-41%). The World Health Organization (WHO) indicator for STD case management Prevention Indicator 7 (PI7) (condom promotion plus contact treatment) was poor (38%). Public clinics strengthened for STD care generally performed best, whereas pharmacies and mission clinics performed worst. Compared with observations, scores were higher during interviews and lower during simulated patient visits, indicating that knowledge was not fully translated into practice. Interventions to improve the presently unsatisfactory service quality would be wide distribution of health education materials, ongoing training and supervision of providers, implementation of STD management checklists, and the introduction of pre-packaged kits for STD management.
Int J STD AIDS 2001 May
PMID:Quality of health education during STD case management in Nairobi, Kenya. 1136 6

Annually, between 158 million and 328 million cases of curable STDs occur in the world. According to a French study an incredible 90%-99% of HIV infections could be attributable to STDs, suggesting that if other STDs were wiped out, the HIV epidemic could be brought under control. The INSERM U88 study focussed on a group of 10,000 people in south-west Uganda tracing the progress of HIV through the community from its introduction in 1980 to 1990. Then it estimated the fraction of HIV infections that were attributable to STDs using local statistics and simulated modelling. In the low scenario, the likelihood of transmission was increased 10-fold for ulcerative STDs, and two-fold for nonulcerative STDs in women. In the high scenario, the likelihood was increased 100-fold and 10-fold, respectively. In the low scenario between 90%-95% of cumulative HIV infections could be attributed to other STDs, which rose to 99% in the high scenario. According to the simulation models the HIV infections from 1990-2000 were reduced by 40% using the low scenario and by 80% using the high scenario. In the long term, HIV infection could not maintained at all if STDs were completely wiped out. STD control programs are needed in all communities, but more work is needed before the relationship between STDs and HIV can be clearly defined. In Thailand STD rates have been falling since 1986-87, while HIV rates have continued to rise. On the other hand, rates of bacterial STDs in Europe have been falling since the mid-seventies perhaps accounting for low heterosexual transmission. At an STD clinic in Nairobi the percentage of men who stopped transmitting HIV fell by half after being treated for gonorrhea. These studies lend support for better STD care integrated into general care, as more people would be at less risk of contracting HIV for medical reasons.
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PMID:Quantifying the STD-HIV connection. 1228 6

This article presents a trial study of an HIV vaccine in Kenya. A joint Kenyan-Canadian-British HIV vaccine trial was launched in March of 1999. It is supported by the US-based International AIDS Vaccine Initiative (IAVI). STD clinics will be used as the basis of trials, and volunteers will be injected with genetic material developed from local HIV strains (most vaccine research up to this point has involved strains found in Europe or North America). Concerns have been raised that the vaccine could actually cause AIDS. Professor Ndinya Achola of the University of Nairobi denied that there was such a possibility, as the portions used in the vaccine were not infectious and could not revert to a live virus.
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PMID:HIV vaccine trial in Kenya. 1229 Mar 61

In 1991, the University of Nairobi launched an HIV/STD project to strengthen community-based control activities and improve health facility-based STD management. With an eye toward ensuring sustainability, all activities were integrated into the existing infrastructure and implemented through local personnel. Serving a population of approximately 400,000, the project initially operated in Nairobi in 5 city health centers and their catchment areas, and in all 5 municipal health centers, the provincial hospital, and their catchment areas in Nakuru. Within a few years, 10 model clinics had been strengthened in the 2 cities and 497 health workers had been trained and organized into multidisciplinary teams of health professionals. High quality and accessible HIV/STD-related health services are now available at the clinics. In Nairobi and Nakuru, 2500-3000 clients are treated monthly for STD syndromes, over 1000 women are screened for syphilis, almost all syphilis-seropositive women and 60-70% of partners are appropriately treated, and more than 20,000 condoms are distributed. An evaluation of project impact in Nairobi found an impact upon risk perceptions, sex behavior, and the prevalence of STDs over the course of the project. Lessons learned are described.
AIDS STD Health Promot Exch 1997
PMID:Country watch: Kenya. 1229 20

The African Union Against Venereal Diseases and Treponematoses (AUVDT), inaugurated in 1979, held its 3rd biannual conference in Nairobi in March 1983 with local participants and participants from 15 English and French speaking countries as well as from Europe, USA and Canada. The conference was devoted to high level training and discussion, workshops on genital ulcer diseases (GUD) and scientific sessions during which many papers were read and discussed. Resolutions and recommendations were made concerning STD in Africa and later passed on to relevant health authorities for necessary action. It was agreed that all African governments who have not already done so should set their own STD control committees as soon as possible. The establishment of microbiological laboratories was strongly urged as well as specific training of health workers. It was felt that gonorrhea and genital ulcer disease were the most frequent sexually transmitted diseases and so management recommendations were made. The efficacy of current regimens using penicillin is increasingly dropping and trimethoprim sulfametrole should be substituted. Failure rates of over 10% would indicate the need to review the accepted regimen. The ideal drug should be effective, orally administered as a single dose, whithout harmful side-effects and preferably not masking syphilis. National programs can purchase drugs through WHO's and UNICEF's purchasing channels at very low prices and governments should utilize these channels. Monitoring of antimicrobial sensitivities should be encouraged and assistance should be sought from university departments of microbiology whenever possible. Genital Ulcer Disease (GUD) is an important public health problem in Africa. Chancroid is the most frequently diagnosed and etiologically proven GUD in eastern, central and southern Africa, accounting for 3-60% of GUD cases. Syphilis, herpetic ulceration, lymphogranuloma venereum and donovanosis are other GUDs found in Africa. Consideration of efficacy, availability, and compliance should be given to treatment. Recent studies have shown that single doses or short-term therapy regimens are as efficient for both ulcers and bubos. Syphilis may be treated with benzathine penicillin im or aqueous procaine penicillin G. No current curative therapy is available for herpes. Local management includes keeping lesions clean and dry; symptomatic treatment involves giving analgesics.
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PMID:AUVDT recommendations for management of gonorrhoea and genital ulcers in Africa. 1234 Jan 86

In eastern Africa within the past 10 years, anthropologists, clinicians, and public health specialists have developed a condensed form of anthropology known as Rapid Assessment Procedures (RAP) which uses interviews, conversation, questionnaires, participant observation, and focus group discussions. The RAP techniques are used with triangulation, which involves the use of 2 or more methods to address a single research issue. RAP was established in East Africa in 1989 during a workshop for researchers and health workers involved in AIDS prevention. A group of 5 social and health scientists based at the African Medical and Research Foundation (AMREF) participated in the training. RAP has proven an effective tool for addressing STD/AIDS prevention among long distance truck drivers operating on the Mombasa-Nairobi-Uganda highway. RAP was used to identify the social and cultural characteristics of the truck drivers. AMREF discovered that the truck drivers, petrol station attendants, commercial sex workers, and restaurant workers along the highway comprised a closely knit sub-culture. Informal interviews were used to discuss individual perceptions, fears, and concerns. A number of factors, such as having multiple sex partners, non-use of condoms, and self-treatment for STDs, facilitated STD/HIV transmission. HIV/AIDS was regarded as an invisible disease, affecting foreigners, and plump women were believe to be free of the disease. Positive AIDS prevention messages were developed by using RAP techniques and focus group discussions. Condom use has increased, and truck drivers seek early treatment for STDs. Communities within the various truck stop points have started planning STD/AIDS prevention programs. Originally funded by FHI/AIDSTECH, the program is now spreading along the major truck routes in Kenya. In neighboring Tanzania, a more extensive program is well underway.
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PMID:Anthropology and HIV /AIDS prevention in Kenya. New ways of cooperation. 1234 95

In its fight against the spread of AIDS, which is inextricably linked to the issues of international development, the Canadian International Development Agency (CIDA) has focused support on strengthening existing health care systems, helping vulnerable groups gain control over their lives and health, promoting AIDS prevention measures, and building links to other related health services. Funding includes 1) a grant to Hope House in Zambia (counseling and support for persons with AIDS); 2) a contribution to the Canadian Public Health Association's $11 million Southern Africa AIDS Training Programme (helps regional organizations working in AIDS prevention and support through education, training, hospital outreach, peer education for vulnerable groups, assistance to women's shelters, and networking); 3) support for Laval University's Laval Centre for International Cooperation in Health and Development (runs a $22 million program in French-speaking West Africa that operates in over 10 countries and focuses on epidemiological surveillance, information, education, and communication, control of sexually transmitted diseases [STDs], and management of national AIDS programs); 4) support for the University of Manitoba's $3 million program with the University of Nairobi to slow the spread of HIV (strengthens local health care capabilities for STD/HIV diagnosis, treatment, and counseling, with special emphasis on training and education); 5) support in the past for a study of proposed AIDS legislation and its potential impact on the human rights of PLWHIV/AIDS in Thailand; 6) a contribution to help equip the office of the National Movement for Street Children, Rio de Janeiro (focuses on preventing the spread of AIDS among child prostitutes); and 7) long-term financial support to the Interagency Coalition on AIDS and Development, a coalition of Canadian development nongovernmental organizations responding to AIDS in developing countries. An address to obtain a pamphlet giving more information on Canada's contributions to the worldwide fight against AIDS is given.
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PMID:CIDA funds AIDS counselling and care centre in Zambia. 1234 81

To describe the role of traditional healers in STD case management, in-depth interviews were held with 16 healers (seven witchdoctors, five herbalists and four spiritual healers) in four slum areas in Nairobi, Kenya. All healers believed that STDs are sexually transmitted and recognized the main symptoms. The STD-caseload varied largely, with a median of one patient per week. Witchdoctors and herbalists dispensed herbal medication for an average of seven days, whereas spiritual healers prayed. Thirteen healers gave advice on sexual abstinence during treatment, 11 on contact treatment, four on faithfulness and three on condom use. All healers asked patients to return for review and 13 reported referring patients whose conditions persist to public or private health care facilities. Thus, traditional healers in Nairobi play a modest but significant role in STD management. Their contribution to STD health education could be strengthened, especially regarding the promotion of condoms and faithfulness.
Int J STD AIDS 2003 Mar
PMID:Traditional healers and the management of sexually transmitted diseases in Nairobi, Kenya. 1266 44


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