Prevalence, correlates and treatment needs of dental caries among people on antiretroviral therapy in Uganda: a cross sectional study.


Journal

BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684

Informations de publication

Date de publication:
10 06 2022
Historique:
received: 07 03 2022
accepted: 30 05 2022
entrez: 10 6 2022
pubmed: 11 6 2022
medline: 15 6 2022
Statut: epublish

Résumé

Oral diseases are estimated to affect half of people living with HIV in the western world, and are often marked by pain, discomfort, disfigurement and reduced quality of life. Both HIV-specific and antiretroviral therapy-associated oral diseases have been found in this population. However, the prevalence, correlates and treatment needs of dental caries among people on antiretroviral therapy has not been well studied in rural Africa where majority of people living with HIV reside. Moreover, health behaviors and access to dental care vary significantly from high-income countries in the global north. A cross-sectional study was conducted among people living with HIV attending a high-volume HIV clinic with an enrollment of 10,000 patients in a regional referral hospital in Southwestern Uganda. The clinic is located in an urban setting with a large rural catchment area. Oral health data was collected using the modified World Health Organization oral health questionnaire for adults. Dental examinations were conducted to identify and classify dental caries using the decayed, missing, filled, teeth (DMFT) index and compute the treatment need. Logistic regression models were employed to identify correlate of dental caries. A total of 194 participants were included in the study. The majority were female (124/194, 63.9%) with a median age of 42 years (IQR 36-49). The prevalence of dental caries experience among study participants was 67%, (130/194, 95% CI 60-75%). The mean DMFT index score was 4 (IQR 2-6) and treatment need was 96% (192/200). A higher CD4 count was associated with the presence of dental caries (OR 0.403, 95% CI 0.175-0.932) although it was not significant in multivariate analysis. There is a high prevalence of dental caries among people living with HIV on ART in Uganda. Our data demonstrate a high oral treatment need among this population. We recommend inclusion of preventive and therapeutic oral care into HIV care in this region.

Sections du résumé

BACKGROUND
Oral diseases are estimated to affect half of people living with HIV in the western world, and are often marked by pain, discomfort, disfigurement and reduced quality of life. Both HIV-specific and antiretroviral therapy-associated oral diseases have been found in this population. However, the prevalence, correlates and treatment needs of dental caries among people on antiretroviral therapy has not been well studied in rural Africa where majority of people living with HIV reside. Moreover, health behaviors and access to dental care vary significantly from high-income countries in the global north.
METHODS
A cross-sectional study was conducted among people living with HIV attending a high-volume HIV clinic with an enrollment of 10,000 patients in a regional referral hospital in Southwestern Uganda. The clinic is located in an urban setting with a large rural catchment area. Oral health data was collected using the modified World Health Organization oral health questionnaire for adults. Dental examinations were conducted to identify and classify dental caries using the decayed, missing, filled, teeth (DMFT) index and compute the treatment need. Logistic regression models were employed to identify correlate of dental caries.
RESULTS
A total of 194 participants were included in the study. The majority were female (124/194, 63.9%) with a median age of 42 years (IQR 36-49). The prevalence of dental caries experience among study participants was 67%, (130/194, 95% CI 60-75%). The mean DMFT index score was 4 (IQR 2-6) and treatment need was 96% (192/200). A higher CD4 count was associated with the presence of dental caries (OR 0.403, 95% CI 0.175-0.932) although it was not significant in multivariate analysis.
CONCLUSION
There is a high prevalence of dental caries among people living with HIV on ART in Uganda. Our data demonstrate a high oral treatment need among this population. We recommend inclusion of preventive and therapeutic oral care into HIV care in this region.

Identifiants

pubmed: 35689234
doi: 10.1186/s12903-022-02256-5
pii: 10.1186/s12903-022-02256-5
pmc: PMC9188082
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

231

Informations de copyright

© 2022. The Author(s).

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Auteurs

Wilfred Arubaku (W)

Department of Dental Surgery, Mbarara University of Science and Technology, Mbarara, Uganda.

Godfrey Kwizera (G)

Department of Dental Surgery, Mbarara University of Science and Technology, Mbarara, Uganda.

Deusdedit Tusubira (D)

Department of Biochemistry, Mbarara University of Science and Technology, Mbarara, Uganda.

Michael Kanyesigye (M)

Mbarara Regional Referral Hospital, Mbarara, Uganda.

Steffany Chamut (S)

Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, USA.

Brittany Anne Seymour (BA)

Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, USA.

Mark J Siedner (MJ)

Department of Medicine, Massachusetts General Hospital, Boston, USA.
Department of Medicine, Harvard Medical School, Boston, USA.
Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.

Vallence Niyonzima (V)

Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda.

Josephine N Najjuma (JN)

Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda.

Samuel Maling (S)

Department of Psychiatry, Mbarara University of Science and Technology, P O Box 1410, Mbarara, Uganda. sammaling@must.ac.ug.

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