title: Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention.
abstract: HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to collect 1,957 blood samples from 42,617 individuals registered in the Health and Demographic Surveillance System in Mbita, which is located on the shore of Lake Victoria in western Kenya. We used these samples to evaluate existing antibody detection assays for several infectious diseases, including HIV antibody titers. Based on the results of the assays, we evaluated the prevalence of HIV infection according to sex, age, and altitude of participating households. We also used Kulldorff's spatial scan statistic to test for HIV clustering in the study area. The prevalence of HIV at our study site was 25.3%. Compared with the younger age group (15-19 years), adults aged 30-34 years were 6.71 times more likely to be HIV-positive, and the estimated HIV-positive population among women was 1.43 times larger than among men. Kulldorff's spatial scan statistic detected one marginally significant (P = 0.055) HIV-positive and one significant HIV-negative cluster (P = 0.047) in the study area. These results suggest a homogeneous HIV distribution in the communities surrounding fishing villages. In addition to individual behavior, more complex and diverse factors related to the social and cultural environment can contribute to a homogeneous distribution pattern of HIV infection outside of African fishing villages. To reduce rates of transmission in HIV-endemic areas, HIV prevention and control programs optimized for the local environment need to be developed.
authors: Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.|Department of Ecoepidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.|Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
authors: Tomonori
authors: T
authors: Hoshi
authors: Department of Ecoepidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
authors: Yoshito
authors: Y
authors: Fuji
authors: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUTIM-KEMRI) Project, Nairobi, Kenya.|Centre for Infections and Parasitic Disease Control Research, Kenya Medical Research Institute (KEMRI), Busia, Kenya.
authors: Samson Muuo
authors: SM
authors: Nzou
authors: Department of Ecoepidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
authors: Chihiro
authors: C
authors: Tanigawa
authors: Thomas Odhiambo Campus, International Centre of Insect Physiology and Ecology (ICIPE), Mbita, Kenya.
authors: Ibrahim
authors: I
authors: Kiche
authors: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUTIM-KEMRI) Project, Nairobi, Kenya.|Centre for Infections and Parasitic Disease Control Research, Kenya Medical Research Institute (KEMRI), Busia, Kenya.
authors: Matilu
authors: M
authors: Mwau
authors: Production Department, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
authors: Anne Wanjiru
authors: AW
authors: Mwangi
authors: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUTIM-KEMRI) Project, Nairobi, Kenya.|Centre for Public Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
authors: Mohamed
authors: M
authors: Karama
authors: Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.|Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
authors: Kenji
authors: K
authors: Hirayama
authors: National Mental Support Center for School Children Crisis, Osaka Kyoiku University, Osaka, Japan.
authors: Kensuke
authors: K
authors: Goto
authors: Department of Ecoepidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.|Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan.
authors: Satoshi
authors: S
authors: Kaneko
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods; D000293:Adolescent; D000328:Adult; D000368:Aged; D000531:Altitude; D016000:Cluster Analysis; D019353:Endemic Diseases; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D055815:Young Adult
chemical_list: D015483:HIV Antibodies