Spatial clusters of HIV-negative and HIV-positive populations in a highly endemic area of Western Kenya

Hoshi, Tomonori

Spatial clusters of HIV-negative and HIV-positive populations in a highly endemic area of Western Kenya

Sunday, 17 August 2014

Exhibit hall (Dena'ina Center)

Tomonori Hoshi, MPH , Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan

Chihiro Tanigawa, MS , Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan

Masashi Miura, PhD , Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan

Samson M Nzou, MS , Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan

Kiche O Ibrahim, BS , Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan

Matilu Mwau, PhD , Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan

Yoshito Fujii, PhD , Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan

Kensuke Goto, PhD , Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan

Satoshi Kaneko, PhD , Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan

INTRODUCTION: Human immunodeficiency virus (HIV) is a major health problem in developing countries, and two-thirds of HIV patients live in sub-Saharan Africa. To prevent the spread of HIV and improve patient quality of life, health education and antiretroviral therapies have been implemented. However, the limited resources for HIV control have been allocated without enough bases. Hence, we aimed to locate HIV clusters that will serve as guiding information in the appropriation of resources within an HIV endemic area.

METHODS: From among our cohort of 42,617 individuals, we randomly sampled 2000 individuals and stratified them according to sex and age. Each stratum had 100 participants. Blood sampling was conducted between July and August 2010. HIV diagnoses were performed as part of our Neglected Tropical Diseases project. SaTScan was used for the detection of HIV clusters, and a p-value less than or equal to 0.01 was considered as statistically significant.

RESULTS: A total of 1975 samples were eligible for the analyses. The crude HIV prevalence was 25.3%, and the women tended to have higher HIV prevalence. In Eastern Mbita, 60% of the female participants aged 30–34 years were HIV-positive. We detected an HIV-positive cluster (P = 0.055) in Eastern Mbita and the largest HIV-negative cluster in a northwestern island of Mbita (P = 0.047). One HIV-negative cluster in Western Mbita had a p-value slightly below the statistical significance (P = 0.112).

CONCLUSIONS: We revealed in detail the HIV prevalence in Western Kenya. The area has a high HIV prevalence owing to their cultural practices; however, few studies have shown in detail the age- and sex-related prevalence of HIV in the area. Furthermore, we suggest locating more drug resources and encouraging people around the positive clusters to have themselves tested for HIV infection. Moreover, we recommend strengthening protective measurements against HIV infection around the negative clusters.