Walter Jaoko - Academia.edu (original) (raw)

Papers by Walter Jaoko

Europe PMC (PubMed Central), Apr 1, 2013

Journal of Acquired Immune Deficiency Syndromes, Apr 1, 2016

BMC Public Health, May 8, 2023

AIDS and Behavior

For women living with HIV (WLH) in serodiscordant partnerships, decisions about childbearing can ... more For women living with HIV (WLH) in serodiscordant partnerships, decisions about childbearing can challenge condom use and antiretroviral adherence. In a prospective cohort of 148 WLH in serodiscordant partnerships, 58 (39%) wanted more children in the future but were not currently trying to conceive (fertility desire), and 32 (22%) were currently trying to become pregnant (fertility intent). Detection of prostate specific antigen (PSA) in vaginal secretions, a marker for recent condomless sex, was lowest in women with fertility desire and highest in women with fertility intent. Detectable viral load followed a similar pattern. Risk of HIV transmission, when condomless sex and PSA detection occurred concurrently, was three to fourfold higher at visits with fertility intent compared to visits with fertility desire. Qualitative interviews underscored the importance women place on childbearing and suggested that they had limited information about the role of antiretroviral therapy in re...

Background: There is need to focus on HIV prevention as the global number of people acquiring HIV... more Background: There is need to focus on HIV prevention as the global number of people acquiring HIV has not declined enough to meet set targets. Painful sexual intercourse may be indicative of minor epithelial injury. Epithelial trauma signs are potential risk factors of HIV infection in men who have sex with men (MSM) and female sex workers (FSWs). The objective of the study was to establish whether there is a relationship between HIV serostatus and signs of epithelial disruption in two HIV key population samples. Methods: Participants were randomly selected from registers of two health facilities in Nairobi, namely Bar Hostess and Hoymas, which serve FSWs and MSM respectively. A questionnaire was administered to 322 FSWs and 231 MSM, who provided data on HIV infection status, sexual dysfunction, intercourse frequency and previous abstinence behaviour. Sexual dysfunction scores were created from items of the Female Sexual Function Index (FSFI-19). Additional questions addressed visua...

Central nervous system (CNS) infection is a common and serious disease that needs rapid and appro... more Central nervous system (CNS) infection is a common and serious disease that needs rapid and appropriate diagnosis for an appropriate treatment. However, in most recourse limited setting including Rwanda, conventional microbiological method is the only way to establish a confirmed infectious etiology. This was a 4 years retrospective review of registers and electronic laboratory records aimed to determine the causative agents in hospitalized patient’s suspected to be suffering from CNS infection at four referral hospitals in Rwanda. In this review, the majority of participants (48%) were in the age group between 25 and 44 years (median = 34), with 53 and 47% being males and female, respectively. Cerebrospinal fluid (CSF) was clear in 67% (112/168), turbid in 30% (50/168) and bloody in 3% (6/168) patients. Only 1% (2/168) of the samples had WBC count >1,000 cells/mm3 and 13% (21/168) had WBC count between 101 and 1,000 cells/mm3, WBC count between 10 and 100 cells/mm3 was present...

African Health Sciences, 2020

Background: Although antiretroviral therapy (ART) has resulted in significant decrease in opportu... more Background: Although antiretroviral therapy (ART) has resulted in significant decrease in opportunistic infections (OIs), OIs continue to cause significant morbidity and mortality among HIV patients. Objective: To determine the prevalence and types of HIV/AIDS-related OIs among patients attending Kenyatta National Hospital (KNH) in Nairobi, Kenya. Methods: A cross-sectional study was conducted from May to August 2010 among patients ≥19 years. An interviewer-ad- ministered questionnaire was used to collect data on socio-demographic factors, HIV and OIs. CD4 data were extracted from clinical records. Results: Most patients (72%) had lived with HIV for ≤ 5 years and 78.8% had an OI. The 3 most common OIs were TB (35%), Herpes Zoster (HZ; 15.4%) and oral thrush (OT; 8%). Years of HIV infection significantly predicted TB (p=0.01). Patients with CD4 ≤ 349 were almost twice as likely to have TB, than those with CD4 ≥500. Type of occupation predicted OT (p=0.04) with skilled workers less li...

BMJ Open, 2020

IntroductionBacterial vaginosis (BV) and vaginal microbiota disruption during pregnancy are assoc... more IntroductionBacterial vaginosis (BV) and vaginal microbiota disruption during pregnancy are associated with increased risk of spontaneous preterm birth (SPTB), but clinical trials of BV treatment during pregnancy have shown little or no benefit. An alternative hypothesis is that vaginal bacteria present around conception may lead to SPTB by compromising the protective effects of cervical mucus, colonising the endometrial surface before fetal membrane development, and causing low-level inflammation in the decidua, placenta and fetal membranes. This protocol describes a prospective case-cohort study addressing this hypothesis.Methods and analysisHIV-seronegative Kenyan women with fertility intent are followed from preconception through pregnancy, delivery and early postpartum. Participants provide monthly vaginal specimens during the preconception period for vaginal microbiota assessment. Estimated date of delivery is determined by last menstrual period and first trimester obstetrical...

International Journal of Cardiovascular Research, 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes, 2017

Background: Kenyan female sex workers (FSWs) have a high HIV prevalence, increasing their tubercu... more Background: Kenyan female sex workers (FSWs) have a high HIV prevalence, increasing their tuberculosis (TB) risk. Despite recommendations that HIV-positive individuals be offered isoniazid preventive therapy (IPT), uptake has been limited. Methods: In this longitudinal cohort of HIV-positive FSWs, we retrospectively characterized the IPT care cascade between March 2000 and January 2010, including reasons for cascade loss or appropriate exit. Cascade success required completion of 6 months of IPT. Baseline characteristics were assessed as potential correlates of cascade loss using multivariable logistic regression. Results: Among 642 HIV-positive FSWs eligible for IPT evaluation, median age was 31 years (IQR 26–35) with median CD4 lymphocyte count of 409 (IQR 292–604) cells per cubic millimeter. There were 249 (39%) women who successfully completed 6 months of IPT, 157 (24%) appropriately exited the cascade, and 236 (37%) were cascade losses. Most cascade losses occurred at symptom s...

Sexually Transmitted Diseases, 2016

AIDS Research and Human Retroviruses, 2015

AIDS Research and Human Retroviruses, 2014

Sexually Transmitted Infections, 2013

JAIDS Journal of Acquired Immune Deficiency Syndromes, 2013

East African Medical Journal, 2010

JAIDS Journal of Acquired Immune Deficiency Syndromes, 2017

Background: Three randomized controlled trials showed that voluntary medical male circumcision (V... more Background: Three randomized controlled trials showed that voluntary medical male circumcision (VMMC) reduces the risk of female-to-male HIV transmission by approximately 60%. However, data from communities where VMMC programs have been implemented are needed to assess changes in circumcision prevalence and whether men and women compensate for perceived reductions in risk by increasing their HIV risk behaviors. Methods: Scale-up of free VMMC began in Kisumu, Kenya in 2008. Between 2009 and 2013, a sequence of 3 unlinked cross-sectional surveys were conducted. All individuals 15–49 years of age residing in randomly selected households were interviewed and offered HIV testing. Male circumcision status was confirmed by examination. Design-adjusted bivariate comparisons and multivariable analyses were used for statistical inference. Results: The prevalence of male circumcision increased from 32% (95% CI: 26% to 38%) in 2009 to 60% (95% CI: 56% to 63%) in 2013. The adjusted prevalence ra...

BMC Infectious Diseases, 2013

Europe PMC (PubMed Central), Apr 1, 2013

Journal of Acquired Immune Deficiency Syndromes, Apr 1, 2016

BMC Public Health, May 8, 2023

AIDS and Behavior

For women living with HIV (WLH) in serodiscordant partnerships, decisions about childbearing can ... more For women living with HIV (WLH) in serodiscordant partnerships, decisions about childbearing can challenge condom use and antiretroviral adherence. In a prospective cohort of 148 WLH in serodiscordant partnerships, 58 (39%) wanted more children in the future but were not currently trying to conceive (fertility desire), and 32 (22%) were currently trying to become pregnant (fertility intent). Detection of prostate specific antigen (PSA) in vaginal secretions, a marker for recent condomless sex, was lowest in women with fertility desire and highest in women with fertility intent. Detectable viral load followed a similar pattern. Risk of HIV transmission, when condomless sex and PSA detection occurred concurrently, was three to fourfold higher at visits with fertility intent compared to visits with fertility desire. Qualitative interviews underscored the importance women place on childbearing and suggested that they had limited information about the role of antiretroviral therapy in re...

Background: There is need to focus on HIV prevention as the global number of people acquiring HIV... more Background: There is need to focus on HIV prevention as the global number of people acquiring HIV has not declined enough to meet set targets. Painful sexual intercourse may be indicative of minor epithelial injury. Epithelial trauma signs are potential risk factors of HIV infection in men who have sex with men (MSM) and female sex workers (FSWs). The objective of the study was to establish whether there is a relationship between HIV serostatus and signs of epithelial disruption in two HIV key population samples. Methods: Participants were randomly selected from registers of two health facilities in Nairobi, namely Bar Hostess and Hoymas, which serve FSWs and MSM respectively. A questionnaire was administered to 322 FSWs and 231 MSM, who provided data on HIV infection status, sexual dysfunction, intercourse frequency and previous abstinence behaviour. Sexual dysfunction scores were created from items of the Female Sexual Function Index (FSFI-19). Additional questions addressed visua...

Central nervous system (CNS) infection is a common and serious disease that needs rapid and appro... more Central nervous system (CNS) infection is a common and serious disease that needs rapid and appropriate diagnosis for an appropriate treatment. However, in most recourse limited setting including Rwanda, conventional microbiological method is the only way to establish a confirmed infectious etiology. This was a 4 years retrospective review of registers and electronic laboratory records aimed to determine the causative agents in hospitalized patient’s suspected to be suffering from CNS infection at four referral hospitals in Rwanda. In this review, the majority of participants (48%) were in the age group between 25 and 44 years (median = 34), with 53 and 47% being males and female, respectively. Cerebrospinal fluid (CSF) was clear in 67% (112/168), turbid in 30% (50/168) and bloody in 3% (6/168) patients. Only 1% (2/168) of the samples had WBC count >1,000 cells/mm3 and 13% (21/168) had WBC count between 101 and 1,000 cells/mm3, WBC count between 10 and 100 cells/mm3 was present...

African Health Sciences, 2020

Background: Although antiretroviral therapy (ART) has resulted in significant decrease in opportu... more Background: Although antiretroviral therapy (ART) has resulted in significant decrease in opportunistic infections (OIs), OIs continue to cause significant morbidity and mortality among HIV patients. Objective: To determine the prevalence and types of HIV/AIDS-related OIs among patients attending Kenyatta National Hospital (KNH) in Nairobi, Kenya. Methods: A cross-sectional study was conducted from May to August 2010 among patients ≥19 years. An interviewer-ad- ministered questionnaire was used to collect data on socio-demographic factors, HIV and OIs. CD4 data were extracted from clinical records. Results: Most patients (72%) had lived with HIV for ≤ 5 years and 78.8% had an OI. The 3 most common OIs were TB (35%), Herpes Zoster (HZ; 15.4%) and oral thrush (OT; 8%). Years of HIV infection significantly predicted TB (p=0.01). Patients with CD4 ≤ 349 were almost twice as likely to have TB, than those with CD4 ≥500. Type of occupation predicted OT (p=0.04) with skilled workers less li...

BMJ Open, 2020

IntroductionBacterial vaginosis (BV) and vaginal microbiota disruption during pregnancy are assoc... more IntroductionBacterial vaginosis (BV) and vaginal microbiota disruption during pregnancy are associated with increased risk of spontaneous preterm birth (SPTB), but clinical trials of BV treatment during pregnancy have shown little or no benefit. An alternative hypothesis is that vaginal bacteria present around conception may lead to SPTB by compromising the protective effects of cervical mucus, colonising the endometrial surface before fetal membrane development, and causing low-level inflammation in the decidua, placenta and fetal membranes. This protocol describes a prospective case-cohort study addressing this hypothesis.Methods and analysisHIV-seronegative Kenyan women with fertility intent are followed from preconception through pregnancy, delivery and early postpartum. Participants provide monthly vaginal specimens during the preconception period for vaginal microbiota assessment. Estimated date of delivery is determined by last menstrual period and first trimester obstetrical...

International Journal of Cardiovascular Research, 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes, 2017

Background: Kenyan female sex workers (FSWs) have a high HIV prevalence, increasing their tubercu... more Background: Kenyan female sex workers (FSWs) have a high HIV prevalence, increasing their tuberculosis (TB) risk. Despite recommendations that HIV-positive individuals be offered isoniazid preventive therapy (IPT), uptake has been limited. Methods: In this longitudinal cohort of HIV-positive FSWs, we retrospectively characterized the IPT care cascade between March 2000 and January 2010, including reasons for cascade loss or appropriate exit. Cascade success required completion of 6 months of IPT. Baseline characteristics were assessed as potential correlates of cascade loss using multivariable logistic regression. Results: Among 642 HIV-positive FSWs eligible for IPT evaluation, median age was 31 years (IQR 26–35) with median CD4 lymphocyte count of 409 (IQR 292–604) cells per cubic millimeter. There were 249 (39%) women who successfully completed 6 months of IPT, 157 (24%) appropriately exited the cascade, and 236 (37%) were cascade losses. Most cascade losses occurred at symptom s...

Sexually Transmitted Diseases, 2016

AIDS Research and Human Retroviruses, 2015

AIDS Research and Human Retroviruses, 2014

Sexually Transmitted Infections, 2013

JAIDS Journal of Acquired Immune Deficiency Syndromes, 2013

East African Medical Journal, 2010

JAIDS Journal of Acquired Immune Deficiency Syndromes, 2017

Background: Three randomized controlled trials showed that voluntary medical male circumcision (V... more Background: Three randomized controlled trials showed that voluntary medical male circumcision (VMMC) reduces the risk of female-to-male HIV transmission by approximately 60%. However, data from communities where VMMC programs have been implemented are needed to assess changes in circumcision prevalence and whether men and women compensate for perceived reductions in risk by increasing their HIV risk behaviors. Methods: Scale-up of free VMMC began in Kisumu, Kenya in 2008. Between 2009 and 2013, a sequence of 3 unlinked cross-sectional surveys were conducted. All individuals 15–49 years of age residing in randomly selected households were interviewed and offered HIV testing. Male circumcision status was confirmed by examination. Design-adjusted bivariate comparisons and multivariable analyses were used for statistical inference. Results: The prevalence of male circumcision increased from 32% (95% CI: 26% to 38%) in 2009 to 60% (95% CI: 56% to 63%) in 2013. The adjusted prevalence ra...

BMC Infectious Diseases, 2013