I've wanted to be able to use Esent as a simple, fast, reliable and persistent key/value store. The Python standard libraries contain that kind of functionality in the *dbm modules. I've been working on providing identical functionality layered on top of Esent. I've uploaded the esedb module to the release page for ManagedEsent on Codeplex. To use it you need Esent.Interop.dll and esedb.py. The module exports an open function which returns a dictionary object that is backed by an Esent database. The dictionary keys and values are restricted to strings.
>>> db = open('test.db')
>>> db['a'] = 'somedata'
The module is still under development, but the current functionality should be quite stable.