Publications

2017

Some F, Koech M, Chesire E, Kigen G. Reversal of tenofovir induced nephrotoxicity: case reports of two patients. Pan African Medical Journal 2017;27

2016

Kigen G, Maritim A, Some F, Kibosia J, Rono H, Chepkwony S, Kipkore W, Wanjoh B. Ethnopharmacological survey of the medicinal plants used in Tindiret, Nandi County, Kenya. African Journal of Traditional, Complementary and Alternative Medicines 2016;13:156–168.

Kigen G, Edwards G. Intracellular accumulation of Praziquantel in T lymphoblastoid cell lines, CEM (parental) and CEMVBL (P-gp-overexpressing). BMC Pharmacology and Toxicology 2016;17:37.

Busakhala NW, Chite FA, Wachira J, Naanyu V, Kisuya JW, Keter A, ann Mwangi, Njiru E, Chumba D, Lumarai L, others. Screening by clinical breast examination in Western Kenya: Who comes?. Journal of global oncology 2016;2:114–122.

2015

Kigen G, Busakhala N, Njiru E, Chite F, Loehrer P. Palmar-plantar erythrodysesthesia associated with capecitabine chemotherapy: a case report. Pan African Medical Journal 2015;21

Kigen G, Busakhala N, Ogaro F, Chesire E, Saat N, Too R, Nyandiko W. A Review of the Ingredients Contained in Over the Counter (OTC) Cough Syrup Formulations in Kenya. Are They Harmful to Infants?. PloS one 2015;10:e0142092.

2014

Kigen G, Rotich J, Jefitha Karimurio HR. Collateral benefits arising from mass administration of azithromycin in the control of active trachoma in resource limited settings. The Pan African medical journal 2014;19

Kipkore W, Wanjohi B, Rono H, Kigen G. A study of the medicinal plants used by the Marakwet Community in Kenya. Journal of ethnobiology and ethnomedicine 2014;10:24.

2013

Kigen GK, Ronoh HK, Kipkore WK, Rotich JK. Current trends of traditional herbal medicine practice in Kenya: a review. African Journal of Pharmacology and Therapeutics 2013;2

2011

Kigen G, Kimaiyo S, Nyandiko W, Faragher B, Sang E, others. Prevalence of Potential Drug-Drug Interactions Involving Antiretroviral Drugs in a. 2011;

Kigen G, Kimaiyo S, Nyandiko W, Faragher B, Sang E, Jakait B, Owen A, Back D, Gibbons S, Seden K, others. Prevalence of potential drug-drug interactions involving antiretroviral drugs in a large Kenyan cohort. PloS one 2011;6:e16800.

2009

Kigen GK. Assessment of Drug Interactions Between Antiretroviral and the Anthelminthic drugs. Department of Molecular and Clinical Pharmacology, University of Liverpool (UK) 2009;

2008

Kigen GK, Kimaiyo S, Back DJ, Gibbons SE, Sang E, Edwards IG, Owen A, Khoo SH. O122 Prevalence of drug interactions between antiretroviral and co-administered drugs at the Moi teaching and referral hospital (Ampath), Eldoret, Kenya. Journal of the International AIDS Society 2008;11:O7.

Kigen G, Kimaiyo S, Owen A, Edwards G, Back D, Gibbons S, Sang E, Khoo S. Prevalence of drug interactions between antiretroviral and co-administered drugs in Kenya. In: 9th International Congress on Drug Therapy in HIV Infection. 2008 p. 9–13.

Recent Publications

Tita ATN, Carlo WA, McClure EM, Mwenechanya M, Chomba E, Hemingway-Foday JJ, Kavi A, Metgud MC, Goudar SS, Derman R, Lokangaka A, Tshefu A, Bauserman M, Bose C, Shivkumar P, Waikar M, Patel A, Hibberd PL, Nyongesa P, Esamai F, Ekhaguere OA, Bucher S, Jessani S, Tikmani SS, Saleem S, Goldenberg RL, Billah SM, Lennox R, Haque R, Petri W, Figueroa L, Mazariegos M, Krebs NF, Moore JL, Nolen TL, Koso-Thomas M, Group} {A-PLUST. Azithromycin to Prevent Sepsis or Death in Women Planning a Vaginal Birth. N Engl J Med 2023;388:1161–1170.Abstract

BACKGROUND: The use of azithromycin reduces maternal infection in women during unplanned cesarean delivery, but its effect on those with planned vaginal delivery is unknown. Data are needed on whether an intrapartum oral dose of azithromycin would reduce maternal and offspring sepsis or death. METHODS: In this multicountry, placebo-controlled, randomized trial, we assigned women who were in labor at 28 weeks' gestation or more and who were planning a vaginal delivery to receive a single 2-g oral dose of azithromycin or placebo. The two primary outcomes were a composite of maternal sepsis or death and a composite of stillbirth or neonatal death or sepsis. During an interim analysis, the data and safety monitoring committee recommended stopping the trial for maternal benefit. RESULTS: A total of 29,278 women underwent randomization. The incidence of maternal sepsis or death was lower in the azithromycin group than in the placebo group (1.6% vs. 2.4%), with a relative risk of 0.67 (95% confidence interval [CI], 0.56 to 0.79; P<0.001), but the incidence of stillbirth or neonatal death or sepsis was similar (10.5% vs. 10.3%), with a relative risk of 1.02 (95% CI, 0.95 to 1.09; P = 0.56). The difference in the maternal primary outcome appeared to be driven mainly by the incidence of sepsis (1.5% in the azithromycin group and 2.3% in the placebo group), with a relative risk of 0.65 (95% CI, 0.55 to 0.77); the incidence of death from any cause was 0.1% in the two groups (relative risk, 1.23; 95% CI, 0.51 to 2.97). Neonatal sepsis occurred in 9.8% and 9.6% of the infants, respectively (relative risk, 1.03; 95% CI, 0.96 to 1.10). The incidence of stillbirth was 0.4% in the two groups (relative risk, 1.06; 95% CI, 0.74 to 1.53); neonatal death within 4 weeks after birth occurred in 1.5% in both groups (relative risk, 1.03; 95% CI, 0.86 to 1.24). Azithromycin was not associated with a higher incidence in adverse events. CONCLUSIONS: Among women planning a vaginal delivery, a single oral dose of azithromycin resulted in a significantly lower risk of maternal sepsis or death than placebo but had little effect on newborn sepsis or death. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and others; A-PLUS ClinicalTrials.gov number, NCT03871491.).

Koech MK, Ali SM, Karoney MJ, Kigen G. Severe abacavir hypersensitivity reaction in a patient with human immunodeficiency virus infection: a case report. J Med Case RepJ Med Case RepJ Med Case Rep 2022;16:407.Abstract

BACKGROUND: Abacavir is a nucleoside reverse transcriptase inhibitor that is used as a component of the antiretroviral treatment regimen in the management of the human immunodeficiency virus for both adults and children. It is efficacious, but its use may be limited by a hypersensitivity reaction linked with the HLA-B*57:01 genotype. HLA-B*57:01 has been reported to be rare in African populations. Because of the nature of its presentation, abacavir hypersensitivity is prone to late diagnosis and treatment, especially in settings where HLA-B*57:01 genotyping is not routinely done. CASE REPORT: We report a case of a severe hypersensitivity reaction in a 44-year-old Kenyan female living with the human immunodeficiency virus and on abacavir-containing antiretroviral therapy. The patient presented to the hospital after recurrent treatment for a throat infection with complaints of fever, headache, throat ache, vomiting, and a generalized rash. Laboratory results evidenced raised aminotransferases, for which she was advised to stop the antiretrovirals that she had recently been started on. The regimen consisted of abacavir, lamivudine, and dolutegravir. She responded well to treatment but was readmitted a day after discharge with vomiting, severe abdominal pains, diarrhea, and hypotension. Her symptoms disappeared upon admission, but she was readmitted again a few hours after discharge in a hysterical state with burning chest pain and chills. Suspecting abacavir hypersensitivity, upon interrogation she reported that she had taken the abacavir-containing antiretrovirals shortly before she was taken ill. A sample for HLA-B*57:01 was taken and tested positive. Her antiretroviral regimen was substituted to tenofovir, lamivudine, and dolutegravir, and on subsequent follow-up she has been well. CONCLUSIONS: Clinicians should always be cognizant of this adverse reaction whenever they initiate an abacavir-containing therapy. We would recommend that studies be done in our setting to verify the prevalence of HLA-B*57:01.

Atkinson EG, Dalvie S, Pichkar Y, Kalungi A, Majara L, Stevenson A, Abebe T, Akena D, Alemayehu M, Ashaba FK, Atwoli L, Baker M, Chibnik LB, Creanza N, Daly MJ, Fekadu A, Gelaye B, Gichuru S, Injera WE, James R, Kariuki SM, Kigen G, Koen N, Koenen KC, Koenig Z, Kwobah E, Kyebuzibwa J, Musinguzi H, Mwema RM, Neale BM, Newman CP, Newton CRJC, Ongeri L, Ramachandran S, Ramesar R, Shiferaw W, Stein DJ, Stroud RE, Teferra S, Yohannes MT, Zingela Z, Martin AR. Genetic structure correlates with ethnolinguistic diversity in eastern and southern Africa [Internet]. The American Journal of Human Genetics 2022;109:1667-1679. Website Abstract

Summary African populations are the most diverse in the world yet are sorely underrepresented in medical genetics research. Here, we examine the structure of African populations using genetic and comprehensive multi-generational ethnolinguistic data from the Neuropsychiatric Genetics of African Populations-Psychosis study (NeuroGAP-Psychosis) consisting of 900 individuals from Ethiopia, Kenya, South Africa, and Uganda. We find that self-reported language classifications meaningfully tag underlying genetic variation that would be missed with consideration of geography alone, highlighting the importance of culture in shaping genetic diversity. Leveraging our uniquely rich multi-generational ethnolinguistic metadata, we track language transmission through the pedigree, observing the disappearance of several languages in our cohort as well as notable shifts in frequency over three generations. We find suggestive evidence for the rate of language transmission in matrilineal groups having been higher than that for patrilineal ones. We highlight both the diversity of variation within Africa as well as how within-Africa variation can be informative for broader variant interpretation; many variants that are rare elsewhere are common in parts of Africa. The work presented here improves the understanding of the spectrum of genetic variation in African populations and highlights the enormous and complex genetic and ethnolinguistic diversity across Africa.

Gabriel Kigen

Associate Professor of Pharmacology & Therapeutics

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