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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Increased Rates of Respiratory and Diarrheal Illnesses in HIV-Negative Persons Living With HIV-Infected Individuals in a Densely Populated Urban Slum in Kenya</title>
<author><name sortKey="Wong, Joshua M" sort="Wong, Joshua M" uniqKey="Wong J" first="Joshua M." last="Wong">Joshua M. Wong</name>
<affiliation><nlm:aff id="A1">Centers for Disease Control and Prevention, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cosmas, Leonard" sort="Cosmas, Leonard" uniqKey="Cosmas L" first="Leonard" last="Cosmas">Leonard Cosmas</name>
<affiliation><nlm:aff id="A1">Centers for Disease Control and Prevention, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nyachieo, Dhillon" sort="Nyachieo, Dhillon" uniqKey="Nyachieo D" first="Dhillon" last="Nyachieo">Dhillon Nyachieo</name>
<affiliation><nlm:aff id="A2">Kenya Medical Research Institute, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Williamson, John M" sort="Williamson, John M" uniqKey="Williamson J" first="John M." last="Williamson">John M. Williamson</name>
<affiliation><nlm:aff id="A3">Centers for Disease Control and Prevention, Emory University, Atlanta, Georgia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Olack, Beatrice" sort="Olack, Beatrice" uniqKey="Olack B" first="Beatrice" last="Olack">Beatrice Olack</name>
<affiliation><nlm:aff id="A2">Kenya Medical Research Institute, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Okoth, George" sort="Okoth, George" uniqKey="Okoth G" first="George" last="Okoth">George Okoth</name>
<affiliation><nlm:aff id="A2">Kenya Medical Research Institute, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Njuguna, Henry" sort="Njuguna, Henry" uniqKey="Njuguna H" first="Henry" last="Njuguna">Henry Njuguna</name>
<affiliation><nlm:aff id="A1">Centers for Disease Control and Prevention, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Feikin, Daniel R" sort="Feikin, Daniel R" uniqKey="Feikin D" first="Daniel R." last="Feikin">Daniel R. Feikin</name>
<affiliation><nlm:aff id="A3">Centers for Disease Control and Prevention, Emory University, Atlanta, Georgia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Burke, Heather" sort="Burke, Heather" uniqKey="Burke H" first="Heather" last="Burke">Heather Burke</name>
<affiliation><nlm:aff id="A3">Centers for Disease Control and Prevention, Emory University, Atlanta, Georgia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Montgomery, Joel M" sort="Montgomery, Joel M" uniqKey="Montgomery J" first="Joel M." last="Montgomery">Joel M. Montgomery</name>
<affiliation><nlm:aff id="A1">Centers for Disease Control and Prevention, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Breiman, Robert F" sort="Breiman, Robert F" uniqKey="Breiman R" first="Robert F." last="Breiman">Robert F. Breiman</name>
<affiliation><nlm:aff id="A4">Emory Global Health Institute, Emory University, Atlanta, Georgia</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25722292</idno>
<idno type="pmc">4664072</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4664072</idno>
<idno type="RBID">PMC:4664072</idno>
<idno type="doi">10.1093/infdis/jiv107</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">001865</idno>
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</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Increased Rates of Respiratory and Diarrheal Illnesses in HIV-Negative Persons Living With HIV-Infected Individuals in a Densely Populated Urban Slum in Kenya</title>
<author><name sortKey="Wong, Joshua M" sort="Wong, Joshua M" uniqKey="Wong J" first="Joshua M." last="Wong">Joshua M. Wong</name>
<affiliation><nlm:aff id="A1">Centers for Disease Control and Prevention, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cosmas, Leonard" sort="Cosmas, Leonard" uniqKey="Cosmas L" first="Leonard" last="Cosmas">Leonard Cosmas</name>
<affiliation><nlm:aff id="A1">Centers for Disease Control and Prevention, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nyachieo, Dhillon" sort="Nyachieo, Dhillon" uniqKey="Nyachieo D" first="Dhillon" last="Nyachieo">Dhillon Nyachieo</name>
<affiliation><nlm:aff id="A2">Kenya Medical Research Institute, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Williamson, John M" sort="Williamson, John M" uniqKey="Williamson J" first="John M." last="Williamson">John M. Williamson</name>
<affiliation><nlm:aff id="A3">Centers for Disease Control and Prevention, Emory University, Atlanta, Georgia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Olack, Beatrice" sort="Olack, Beatrice" uniqKey="Olack B" first="Beatrice" last="Olack">Beatrice Olack</name>
<affiliation><nlm:aff id="A2">Kenya Medical Research Institute, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Okoth, George" sort="Okoth, George" uniqKey="Okoth G" first="George" last="Okoth">George Okoth</name>
<affiliation><nlm:aff id="A2">Kenya Medical Research Institute, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Njuguna, Henry" sort="Njuguna, Henry" uniqKey="Njuguna H" first="Henry" last="Njuguna">Henry Njuguna</name>
<affiliation><nlm:aff id="A1">Centers for Disease Control and Prevention, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Feikin, Daniel R" sort="Feikin, Daniel R" uniqKey="Feikin D" first="Daniel R." last="Feikin">Daniel R. Feikin</name>
<affiliation><nlm:aff id="A3">Centers for Disease Control and Prevention, Emory University, Atlanta, Georgia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Burke, Heather" sort="Burke, Heather" uniqKey="Burke H" first="Heather" last="Burke">Heather Burke</name>
<affiliation><nlm:aff id="A3">Centers for Disease Control and Prevention, Emory University, Atlanta, Georgia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Montgomery, Joel M" sort="Montgomery, Joel M" uniqKey="Montgomery J" first="Joel M." last="Montgomery">Joel M. Montgomery</name>
<affiliation><nlm:aff id="A1">Centers for Disease Control and Prevention, Nairobi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Breiman, Robert F" sort="Breiman, Robert F" uniqKey="Breiman R" first="Robert F." last="Breiman">Robert F. Breiman</name>
<affiliation><nlm:aff id="A4">Emory Global Health Institute, Emory University, Atlanta, Georgia</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">The Journal of infectious diseases</title>
<idno type="ISSN">0022-1899</idno>
<idno type="eISSN">1537-6613</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Prolonged pathogen shedding and increased duration of illness associated with infections in immunosuppressed individuals put close human immunodeficiency virus (HIV)–negative contacts of HIV-infected persons at increased risk of exposure to infectious pathogens.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We calculated incidence and longitudinal prevalence (number of days per year) of influenzalike illness (ILI), diarrhea, and nonspecific febrile illness during 2008 from a population-based surveillance program in the urban slum of Kibera (Kenya) that included 1830 HIV-negative household contacts of HIV-infected individuals and 13 677 individuals living in exclusively HIV-negative households.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">For individuals ≥5 years old, incidence was significantly increased for ILI (risk ratio [RR], 1.47; <italic>P</italic>
< .05) and diarrhea (RR, 1.41; <italic>P</italic>
< .05) in HIV-negative household contacts of HIV-infected individuals compared with exclusively HIV-negative households. The risk of illness among HIV-negative persons was directly proportional to the number of HIV-infected persons living in the home for ILI (RR, 1.39; <italic>P</italic>
< .05) and diarrhea (RR, 1.36; <italic>P</italic>
< .01). We found no increased rates of illness in children <5 years old who lived with HIV-infected individuals.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Living with HIV-infected individuals is associated with modestly increased rates of respiratory and diarrheal infections in HIV-negative individuals >5 years old. Targeted interventions are needed, including ensuring that HIV-infected persons are receiving appropriate care and treatment.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0413675</journal-id>
<journal-id journal-id-type="pubmed-jr-id">4830</journal-id>
<journal-id journal-id-type="nlm-ta">J Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Infect. Dis.</journal-id>
<journal-title-group><journal-title>The Journal of infectious diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">0022-1899</issn>
<issn pub-type="epub">1537-6613</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25722292</article-id>
<article-id pub-id-type="pmc">4664072</article-id>
<article-id pub-id-type="doi">10.1093/infdis/jiv107</article-id>
<article-id pub-id-type="manuscript">HHSPA740087</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Increased Rates of Respiratory and Diarrheal Illnesses in HIV-Negative Persons Living With HIV-Infected Individuals in a Densely Populated Urban Slum in Kenya</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Wong</surname>
<given-names>Joshua M.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cosmas</surname>
<given-names>Leonard</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nyachieo</surname>
<given-names>Dhillon</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Williamson</surname>
<given-names>John M.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Olack</surname>
<given-names>Beatrice</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Okoth</surname>
<given-names>George</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Njuguna</surname>
<given-names>Henry</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Feikin</surname>
<given-names>Daniel R.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Burke</surname>
<given-names>Heather</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Montgomery</surname>
<given-names>Joel M.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Breiman</surname>
<given-names>Robert F.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Centers for Disease Control and Prevention, Nairobi</aff>
<aff id="A2"><label>2</label>
Kenya Medical Research Institute, Nairobi</aff>
<aff id="A3"><label>3</label>
Centers for Disease Control and Prevention, Emory University, Atlanta, Georgia</aff>
<aff id="A4"><label>4</label>
Emory Global Health Institute, Emory University, Atlanta, Georgia</aff>
<author-notes><corresp id="CR1">Correspondence: Robert F. Breiman, MD, Emory Global Health Institute, Emory University, 1599 Clifton Rd, Atlanta, GA 30322 (<email>rfbreiman@emory.edu</email>
).</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>24</day>
<month>11</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>25</day>
<month>2</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><day>1</day>
<month>9</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>9</month>
<year>2016</year>
</pub-date>
<volume>212</volume>
<issue>5</issue>
<fpage>745</fpage>
<lpage>753</lpage>
<pmc-comment>elocation-id from pubmed: 10.1093/infdis/jiv107</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Prolonged pathogen shedding and increased duration of illness associated with infections in immunosuppressed individuals put close human immunodeficiency virus (HIV)–negative contacts of HIV-infected persons at increased risk of exposure to infectious pathogens.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We calculated incidence and longitudinal prevalence (number of days per year) of influenzalike illness (ILI), diarrhea, and nonspecific febrile illness during 2008 from a population-based surveillance program in the urban slum of Kibera (Kenya) that included 1830 HIV-negative household contacts of HIV-infected individuals and 13 677 individuals living in exclusively HIV-negative households.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">For individuals ≥5 years old, incidence was significantly increased for ILI (risk ratio [RR], 1.47; <italic>P</italic>
< .05) and diarrhea (RR, 1.41; <italic>P</italic>
< .05) in HIV-negative household contacts of HIV-infected individuals compared with exclusively HIV-negative households. The risk of illness among HIV-negative persons was directly proportional to the number of HIV-infected persons living in the home for ILI (RR, 1.39; <italic>P</italic>
< .05) and diarrhea (RR, 1.36; <italic>P</italic>
< .01). We found no increased rates of illness in children <5 years old who lived with HIV-infected individuals.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Living with HIV-infected individuals is associated with modestly increased rates of respiratory and diarrheal infections in HIV-negative individuals >5 years old. Targeted interventions are needed, including ensuring that HIV-infected persons are receiving appropriate care and treatment.</p>
</sec>
</abstract>
<kwd-group><kwd>HIV</kwd>
<kwd>surveillance</kwd>
<kwd>home-based counseling and testing</kwd>
<kwd>household transmission</kwd>
<kwd>Africa</kwd>
<kwd>Kibera</kwd>
<kwd>nonspecific febrile illness</kwd>
<kwd>respiratory infection</kwd>
<kwd>pneumonia</kwd>
<kwd>influenzalike illness</kwd>
<kwd>ILI</kwd>
<kwd>acute lower respiratory infection</kwd>
<kwd>ALRI</kwd>
<kwd>diarrhea</kwd>
<kwd>nonspecific febrile illness</kwd>
<kwd>incidence rates</kwd>
<kwd>urban slum</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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