KAIS 2007 1 - Kenya National AIDS & STI Control Programme ...

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Regular, voluntary, non‐remunerated blood donors are preferred over family/replacement donors ordonors who are paid because the latter groups have been shown to have higher HIV prevalenceworldwide. 1 All donated blood units are screened for HIV, hepatitis B and C, and syphilis. Blood unitsfound to be positive for any of these infectious agents are discarded.In this chapter, we report on the proportion and demographics of adults aged 15‐64 years in the 2007KAIS who reported donating blood in the past year, the source of their blood donation request andexplore blood safety issues. We also report on the frequency of injections by medical personnel andtraditional healers, and the use of safe injection equipment in clinical settings.Appendix B.9 provides sample sizes and 95% confidence intervals for estimates presented in thischapter. Throughout the chapter, the term significant indicates a chi‐square p‐value less than 0.05;marginally significant indicates a p‐value between 0.05 and 0.10, inclusive; and not significantindicates a p‐value greater than 0.10.Population estimates reported in this chapter were calculated based 2007 projected population byprovince, age and sex reported in Revised Population Projections for Kenya 2000‐2020. Kenya NationalBureau of Statistics (August 2006). Weighted national estimates for selected indicators from the 2007KAIS were used in these calculations. Methods used for calculating population estimates are describedin Appendix A.It is important to remind readers that as with other chapters in this report, the findings presented inthis chapter are based on univariate and bivariate analyses only. Findings should be interpretedcautiously as potential confounders which may have biased associations were not controlled for in theanalysis. In addition, the 2007 KAIS was based on cross‐sectional data and therefore causality cannotbe inferred.1WHO Global Database on Blood Safety: Report 2001 – 2002. Accessible at :http:\\www.who.int/bloodsafety\GDBS_Report_2001‐2002.pdf.KAIS 2007 164
D ATA IN C ONTEXT: N ATIONAL B LOOD T RANSFUSION S ERVICESThe Kenya National Blood Transfusion Service (KNBTS), established in 2001, ensures safe andadequate blood supplies for the country. It collects, tests, processes, and distributes blood andpromotes its appropriate use. Previously, blood was collected from family and replacementdonors at hospital‐based transfusion units that lacked standard procedures. The 2001 policyguidelines on blood transfusion recommended a centralized system which would later beindependent. In January 2007, Kenya established National Standards for Blood Banks andTransfusion Services. This system ensures standardization of procedures, improved quality ofblood supplies and thus, reduced transmission of HIV and other infections. The KNBTS hasraised the total number of blood units collected per year from 41,869 in the 2003 to 123,787 in2007. 222NBTS/MOH. Unpublished service statistics. Kenya: NBTS/MOH, 2007.KAIS 2007 165
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KAIS 2007 1
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P.O. Box: 9361 Code: 00202 Nairobi,
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KEMRIKNASPKNBSKshLLITNMCHmlμLMOMSM
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KEY FINDINGS: HIV PREVENTION• Amo
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Among HIV‐uninfected women, 71.2%
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Men 5.4 26.3 1.9Total 7.1 35.1 1.8O
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Kenya is also committed to the “T
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Table 1.4 Distribution of sampled c
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1.7 SURVEY IMPLEMENTATIONTrainingIn
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Data processing included a number o
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Characteristic 2003 KDHS 2007 KAISQ
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Figure 1.11 Sampled clusters and el
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Table 1.11c Survey response rates b
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Population estimates reported in th
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2.4 HIV PREVALENCE AMONG YOUTHFigur
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Figure 2.6b HIV prevalence among ru
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2.7 HIV PREVALENCE BY PROVINCEFigur
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Figure 2.7c Estimated number of HIV
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2.9 HIV PREVALENCE BY EDUCATION LEV
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Figure 2.10b HIV prevalence among r
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2.11 HIV PREVALENCE BY TIME AWAY FR
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2.13 MALE CIRCUMCISION AND ASSOCIAT
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Figure 2.13c HIV prevalence among c
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Comparison of HIV Prevalence in the
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3.3 SEXFigure 3.3a HIV prevalence a
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Figure 3.4b. HIV prevalence among m
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3.7 PROVINCEFigure 3.7a HIV prevale
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2003 KDHS 1 2007 KAIS 2Marital stat
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3.10 WEALTH INDEXFigure 3.10a HIV p
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DATA IN CONTEXT: APPROACHES TO HIV
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Figure 4.3c Ever been tested for HI
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Figure 4.3e Ever been tested for HI
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Figure 4.3g Women aged 15-49 years
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Figure 4.4a Time since last HIV tes
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Figure 4.5a Reasons for not testing
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Increasing access to HIV testing wi
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4.7. Gaps and unmet needs• Two‐
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Figure 5.3b Self-reported HIV statu
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This section examines participants
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Figure 5.5a Knowledge of HIV status
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Figure 5.5c Percent of partnerships
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uninfected. A couple was considered
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Figure 5.6c Women and men aged 15-6
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Sexual Partners, Sexual DebutCircum
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Figure 6.3b. HIV prevalence among w
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Figure 6.3d. HIV prevalence among w
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Figure 6.3f. Men aged 15-64 years r
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In this section, “consistent cond
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Figure 6.4c. Marital or cohabiting
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Figure 6.5b. Young women and men ag
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Figure 6.5d. Young women and men ag
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Figure 6.6a. Male circumcision amon
Page 114 and 115: Figure 6.6d. HIV prevalence among m
Page 116 and 117: Knowledge, Attitudes and Beliefs ch
Page 118 and 119: Figure 7.3b. Most common source of
Page 120 and 121: Figure 7.3c Women and men aged 15-6
Page 122 and 123: Figure 7.3e Overall scores for 12 q
Page 124 and 125: Figure 7.3g Women and men aged 15-6
Page 126 and 127: Figure 7.3i Correct responses to se
Page 128 and 129: • If a female teacher has the AID
Page 130 and 131: 7.5. Perceived risk of HIV infectio
Page 132 and 133: Figure 7.5c Reasons given for havin
Page 134 and 135: 7.6. Attitudes toward women’s rol
Page 136 and 137: who had never been tested for HIV o
Page 138 and 139: 8.2 INTRODUCTIONIn the absence of i
Page 140 and 141: 8.3 ANTENATAL CLINIC ATTENDANCE, 20
Page 142 and 143: 8.4 KNOWLEDGE OF MOTHER-TO-CHILD TR
Page 144 and 145: The analysis in this section consid
Page 146 and 147: Figure 8.5b Women aged 15-49 years
Page 148: • Incorrect communication or unde
Page 151 and 152: 8.8 CURRENTLY PREGNANT WOMEN: HIV T
Page 153 and 154: Among currently pregnant women, 7.1
Page 155 and 156: Among pregnant, HIV‐uninfected wo
Page 157 and 158: Figure 8.11b Desire for a child in
Page 159 and 160: 8.12 CONTRACEPTIVE USEThe next figu
Page 161 and 162: Figure 8.12c Contraceptive use* amo
Page 163: Blood and Injection Safety chapter
Page 167 and 168: Figure 9.3a Source of blood donatio
Page 169 and 170: Figure 9.3b Source of blood donatio
Page 171 and 172: Figure 9.3d Source of blood donatio
Page 173 and 174: 9.4 Blood transfusionsAlthough the
Page 175 and 176: 10080Injec tionsPillsNo preferenceW
Page 177 and 178: HIV prevalence among adults who rep
Page 179 and 180: 9.6 Gaps and unmet needs• HIV pre
Page 181 and 182: The Ministry of Medical Services re
Page 183 and 184: 10.3 COTRIMOXAZOLE PROPHYLAXIS FOR
Page 185 and 186: Coverage also varied significantly
Page 187 and 188: 10.4 ARV ELIGIBILITY, COVERAGE AND
Page 189 and 190: ARV coverage was estimated by takin
Page 191 and 192: Figure 10.4b ARV coverage among HIV
Page 193 and 194: DATA IN CONTEXTEstimates of HIV-inf
Page 195 and 196: 10.5 GAPS AND UNMET NEEDS• The es
Page 197 and 198: debilitating illness leading to hos
Page 199 and 200: Among HIV‐infected adults (83.6%
Page 201 and 202: Figure 11.3d HIV-infected adults ag
Page 203 and 204: Figure 11.4b HIV-infected adults ag
Page 205 and 206: Figure 11.4d HIV-infected adults ag
Page 207 and 208: DATA IN CONTEXTHIV Basic Care Packa
Page 209 and 210: Figure 11.5b HIV-infected adults ag
Page 211 and 212: Figure 11.6b Percent of HIV-infecte
Page 213 and 214: 11.8 GAPS AND UNMET NEEDS• Counse
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12.3 HSV-2 prevalenceHSV‐2 preval
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807071.0WomenMen64.3HSV-2 Prevalenc
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Figure 12.3d HSV-2 prevalence among
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Figure 12.4b HSV-2 prevalence among
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Figure 12.5a HIV prevalence by HSV-
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Figure 12.6b Condom use during last
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12.7 Gaps and unmet needs• Increa
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also at substantially elevated risk
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Figure 13.3b Prevalence of syphilis
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Figure 13.3d Prevalence of syphilis
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Figure 13.3f Prevalence of syphilis
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Figure 13.4b Prevalence of syphilis
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13.6 GAPS AND UNMET NEEDS• Patien
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Household Characteristics andImpact
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Figure 14.3a Sex of head of househo
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Figure 14.3d Household population,
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14.5 PREVALENCE OF HIV-AFFECTED HOU
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Figure 14.5c HIV-affected household
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social and economic conditions of h
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households used chemical disinfecta
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14.7 HOUSEHOLD OWNERSHIP OF MOSQUIT
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Figure 14.7b HIV-affected and HIV-u
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Table 14.7b Source of bednets among
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Overall, 52.3% percent of children
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14.9 CARE AND SUPPORT FOR ORPHANS A
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For consistency with other populati
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Returning Test Results15.1 KEY FIND
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Figure 15.3b. Participants aged 15-
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Figure 15.3d. Participants aged 15-
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Figure 15.3f. Participants aged 15-
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15.4 RETURNING TO RECEIVE TEST RESU
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Figure 15.5 Women aged 15-64 years
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Methods of the 2007 KAISThis Append
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ClustersHouseholdsProvince Rural Ur
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and treatment services and other he
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The KEMRI Ethical Review Committee
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Red top (5 ml)Whole blood collected
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algorithm using two HIV EIAs (Viron
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Figure A5.a. Structure and flow of
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Recruitment and training of results
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observe confidentiality of particip
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Documentation. Results counsellors
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Normalisation of weightsNormalised
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This report presents the results of
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