Dental caries and extractions of permanent teeth in Jos, Nigeria

Objective: To determine the effect of tooth morphology and positioning on the occurrence of dental caries in permanent teeth. Design: Retrospective study. Method: Data was extracted from the case notes of patients that underwent extraction at the Plateau State Dental Centre, Jos, Nigeria from January 2000 to December 2001, as a result of dental caries and its sequalae. Result: 12696 patients attended the clinic, with a total of 11546-teeth extracted. 6145 (53.2%) permanent teeth were extracted due to caries and it's sequalae within the period under review. The upper anteriors accounted for 3.2%, pre-molars 7.7% and molars 29.8% while lower anteriors accounted for 0.4%, pre-molars 3.3% and molars 55.6%. The upper anteriors were eight times more vulnerable to caries attack compared to their corresponding lower anteriors. The upper right (43.3%) and left (36.9%) first premolars were four times prone to losses due to caries compared to their corresponding lower right (11.5%) and left (8.3%) first premolars. Similar pattern was observed for the upper and lower second premolar (P = 0.001). The lower right (31.3%) and left (31.3%) first molar were about two times more susceptible to caries than their corresponding upper right (18.2%) and left (19.2%) first molar. The same trend holds for the second and third molars (P = 0.000). Conclusion: The result of this study revealed that the upper premolars were more susceptible to dental caries than the corresponding lower teeth. The study also revealed that the molars were most susceptible to dental caries and would benefit from the use of prophylactic pits and fissure sealants. Key Words: Tooth morphology; extraction; fissure sealant; caries African Journal of Oral Health Vol.1(1) 2004: 31-3

Exclusive breastfeeding and its relevance to infant teething

Objective: To determine the relevance of exclusive breast-feeding practice, in the development of healthy oral tissue among teething infants. Method: A cross sectional study design of children aged 6-36 months was carried out in 14 wards of Jos North Local Government Area. A multistage sampling technique was adopted in selecting 1081 mothers who qualified and were interviewed using structured interviewer questionnaire on their knowledge and perception on common complaints during teething in children. The index children were examined for number and type of teeth erupted using mouth mirror under natural light. Result: One thousand and eighty-one mothers and their babies were interviewed and examined; out these 16.5%, 38.7% and 44.8% babies were of age groups 6-12, 13-24 and 25-36 months respectively; 50.2% were female and 49.8% were male. Of the babies examined 62.4% were exclusively breast-fed. There was a significant association between maternal educational status and knowledge of teething complaints. Three hundred and twenty-six (30.1%) babies had cough during their teething period, 349 (32.3%) experienced drooling of saliva, and 352 (32.6%) were observed to bite objects during teething. The high percentage of babies that were exclusively breast-fed but did not experience these symptoms were found to be statistically significant (p = 0.00). Seven hundred and forty-two (68.6%) babies had diarrhoea during teething; out of these 459(42.5%) were exclusively breast-fed and it was however not found to be statistically significant (p = 0.55). Conclusion: This study draws attention to the relatively poor anecdotal evidence related to symptoms associated with the teething process. The result has also demonstrated that exclusive breast-feeding is not only able to reduce the symptoms ascribed to teething, but also promote the development of a healthy oral tissue. Key words: Breastfeeding, teething, development, oral tissue

Ranking of diagnostic features of childhood pulmonary tuberculosis by medical doctors in southeastern Nigeria

Objective: To rank diagnostic features of childhood pulmonary tuberculosis; and to determine the effect of working in tuberculosis Directly Observed Treatment Short Course (DOTS) facilities on the ranking of these features by medical doctors. Methods: A cross sectional descriptive study, using structured questionnaires to collect data from medical doctors whose daily routine included attending to sick children in 34 selected children outpatient clinics and TB DOTS centers in southeastern Nigeria. Results: Approximately, one quarter (25.3% or 56 of 221) of respondents worked in Directly Observed Treatment Short course (DOTS) clinics, while three quarters (74.7% or 165 of 221) worked in nonDOTSclinics. Majority of the respondents (69.7%) ranked chronic persistent cough (1), 42.5 % ranked weight loss and failure to thrive (2), another 27.7% ranked weight loss and failure to thrive (3), while 17.6% and 21.7% ranked History of contact with adult index case and radiographic abnormalities, (4) and (5), respectively. The study found that the percentage of doctors working in DOTS clinics who ranked weight loss and failure to thrive (2) was statistically and significantly higher than those of non-DOTS respondents. Conclusions: The most important symptoms/signs on which medical doctors based their diagnosis of childhood pulmonary tuberculosis include cough, weight loss and failure to thrive, history of contact with adult with smear positive pulmonary tuberculosis, and radiographic abnormalities consistent with active tuberculosis. There was statistically significant difference between the ranking of weight loss and failure to thrive by doctors working in DOTS clinics and their counterparts in non DOTS clinics. This study showed a decline in the percentage of ranking in both DOTS and Non DOTS respondents as they moved from the first to the fifth.KEY WORDS: Childhood pulmonary tuberculosis, Doctors, Ranking, Diagnostic features, Directly observed treatment short course (DOTS)

Global burden of peripheral artery disease and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Peripheral artery disease is a growing public health problem. We aimed to estimate the global disease burden of peripheral artery disease, its risk factors, and temporospatial trends to inform policy and public measures. Methods Data on peripheral artery disease were modelled using the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 database. Prevalence, disability-adjusted life years (DALYs), and mortality estimates of peripheral artery disease were extracted from GBD 2019. Total DALYs and age-standardised DALY rate of peripheral artery disease attributed to modifiable risk factors were also assessed. Findings In 2019, the number of people aged 40 years and older with peripheral artery disease was 113 million (95% uncertainty interval [UI] 99·2–128·4), with a global prevalence of 1·52% (95% UI 1·33–1·72), of which 42·6% was in countries with low to middle Socio-demographic Index (SDI). The global prevalence of peripheral artery disease was higher in older people, (14·91% [12·41–17·87] in those aged 80–84 years), and was generally higher in females than in males. Globally, the total number of DALYs attributable to modifiable risk factors in 2019 accounted for 69·4% (64·2–74·3) of total peripheral artery disease DALYs. The prevalence of peripheral artery disease was highest in countries with high SDI and lowest in countries with low SDI, whereas DALY and mortality rates showed U-shaped curves, with the highest burden in the high and low SDI quintiles. Interpretation The total number of people with peripheral artery disease has increased globally from 1990 to 2019. Despite the lower prevalence of peripheral artery disease in males and low-income countries, these groups showed similar DALY rates to females and higher-income countries, highlighting disproportionate burden in these groups. Modifiable risk factors were responsible for around 70% of the global peripheral artery disease burden. Public measures could mitigate the burden of peripheral artery disease by modifying risk factors. Funding Bill & Melinda Gates Foundation

Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021

Background Anaemia is a major health problem worldwide. Global estimates of anaemia burden are crucial for developing appropriate interventions to meet current international targets for disease mitigation. We describe the prevalence, years lived with disability, and trends of anaemia and its underlying causes in 204 countries and territories. Methods We estimated population-level distributions of haemoglobin concentration by age and sex for each location from 1990 to 2021. We then calculated anaemia burden by severity and associated years lived with disability (YLDs). With data on prevalence of the causes of anaemia and associated cause-specific shifts in haemoglobin concentrations, we modelled the proportion of anaemia attributed to 37 underlying causes for all locations, years, and demographics in the Global Burden of Disease Study 2021. Findings In 2021, the global prevalence of anaemia across all ages was 24·3% (95% uncertainty interval [UI] 23·9–24·7), corresponding to 1·92 billion (1·89–1·95) prevalent cases, compared with a prevalence of 28·2% (27·8–28·5) and 1·50 billion (1·48–1·52) prevalent cases in 1990. Large variations were observed in anaemia burden by age, sex, and geography, with children younger than 5 years, women, and countries in sub-Saharan Africa and south Asia being particularly affected. Anaemia caused 52·0 million (35·1–75·1) YLDs in 2021, and the YLD rate due to anaemia declined with increasing Socio-demographic Index. The most common causes of anaemia YLDs in 2021 were dietary iron deficiency (cause-specific anaemia YLD rate per 100 000 population: 422·4 [95% UI 286·1–612·9]), haemoglobinopathies and haemolytic anaemias (89·0 [58·2–123·7]), and other neglected tropical diseases (36·3 [24·4–52·8]), collectively accounting for 84·7% (84·1–85·2) of anaemia YLDs. Interpretation Anaemia remains a substantial global health challenge, with persistent disparities according to age, sex, and geography. Estimates of cause-specific anaemia burden can be used to design locally relevant health interventions aimed at improving anaemia management and prevention. Funding Bill & Melinda Gates Foundation

Use of recommended score chart and ranking of clinical features in diagnosis of childhood pulmonary tuberculosis by doctors

Background: The diagnosis of childhood pulmonary tuberculosis among medical doctors has presented serious challenge in tuberculosis case finding in resource poor settings.Aim of the study: To determine the use of recommended score chart among medical doctors; and to compare the ranking of diagnostic clinical features of childhood pulmonary tuberculosis between users and non users of tuberculosis score chart (TSC) among medical doctors.Methodology: A cross sectional study, using structured questionnaires to collect data from medical doctors who provided care to children in some selected health facilities in southeastern Nigeria.Results: Majority (82.8% or 183 of 221) of the subjects did not use tuberculosis score chart. The ranking of symptoms by all respondents were persistent non remitting cough (1), weight loss or failure to thrive (2&3), history of contact with adult with smear positive tuberculosis (4), radiographic abnormalities (5). Weight loss and failure to thrive was scored highest in ranks (2) and (3). There was a difference in the ranking of TSC users, where fever was ranked (3), followed by history of contact, whereas the non TSC users ranked history of contact, twice (3& 4). There was a falling trend in the percentage scores in the ranking by both TSC and non TSC users.Conclusions: Most medical doctors who provided care to children did not use National Tuberculosis and Leprosy Control Programme’s Tuberculosis Score Chart in the diagnosis of childhood pulmonary tuberculosis

Diagnostic Approach of Childhood Pulmonary Tuberculosis in Endemic Areas of Southeast Nigeria

No Abstrac

An assessment of cross infection control practice in Nigerian oral health care workers

Objective: This study was aimed at assessing the cross infection control practices among dental health care practitioners in Nigeria.Method: Questionnaires were administered to 137 Dentists, 56 Dental Therapists and 62 Dental Surgery Assistants (DSAs) practicing in both government and private practices across the six geopolitical areas of the country. Each questionnaire comprised of questions on basic infection control procedures.Result: Results indicate that all the participants use gloves during treatment, 93.8% wear face mask, 48.5% wear eye protection, 95.5% clinical gown/coat. Furthermore 27.3% have had a puncture or laceration from a dental needle or instrument while only 41.4% have had Hepatitis B vaccination.Conclusion: Infection control practice by dental personnel in Nigeria has improved compared to previous studies, particularly in the use of gloves. However in the areas of sterilization, vaccination, there are needs for improvement.Key words: Infection Control, Dental Health Care Workers, Sterilization, Immunizatio

A four year review of external quality assessment of sputum AFB smear microscopy centres in Southeast Nigeria.

Objective: To identify the types, pattern and trend of errors in sputum smear microscopy in peripheral primary health laboratories in the Southeast States of Nigeria.Design: Retrospective studyMethods: A retrospective study of laboratory reports of randomly selected and blinded re-checked sputum smear microscopic slides at the peripheral laboratory centres (using Lots Quality Assurance Sampling Method) in the Southeast States of Nigeria between 2003 and 2006.Result: A total of 862 errors were found between 2003 and 2006 (862/873 or 98.7%), and consisted of HFN 155 (18%), HFP 138 (16%), LFN 161 (18.7%), LFP 186 (21.3%), and QE 222 (25.7%). There was a statistically significant association (P value < .05) between the following types of errors (LFN, QE, total minor errors and total errors) and the period 2003 to 2006. However, there was no statistically significant association between these types of errors and slide volume (microscopic workload). The means of total error, and total minor errors declined as the sampling quarter moved from 1st to the 3rd quarter, while total errors declined as the year moved from 2003 to 2006.Conclusion: There was a statistically significant relationship between types of errors, pattern of minor errors and period of the study. The study showed a trend between the errors (LFN, QE, and TE) and the period of review (2003 to 2006), while the total minor errors and total errors declined as the sampling quarter moved from 1st to the 4th quarter of the years.Key Words: External Quality Assessment, Lots Quality Assurance Sampling Method, Nigeria, and sputum smear microscopy