Oral Impacts on Daily Performances among People Living with Human Immunodeficiency Virus on HAART Era Attending Care and Treatment Clinics in Dar es Salaam, Tanzania

Oral disease/conditions are reported to have negative effects on the quality of life of People Living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (PLWHIV/AIDS). This study aimed to assess the prevalence and causes of oral impacts on daily performances (OIDP) and its associated factors among PLWHIV/AIDS. A cross-sectional study was conducted among 218 PLWHIV/AIDS attending two HIV Care and Treatment Centres (CTCs) in Dar es Salaam. The study utilized a structured interview schedule containing questions on socio-demography and a single item of global oral health measure on the perception of current oral health status (OHS). A Swahili version of an OIDP inventory was used to assess the impacts of oral conditions on participants’ daily performances. Frequency distribution, chi-square, and logistic regression analyses were conducted (p < 0.05). Participants’ age ranged from 20 to 70 years, mean of 41.15 SD 10.7. About 70% (n = 154) of the participants perceived their oral health status (OHS) as good. The prevalence of OIDP (³ 1) was 26.1% (n = 57). The most affected performances reported were eating and chewing food followed by maintaining the usual emotional state without being irritable. Toothache was the main cause of impacts on all daily performances except ‘speaking and pronouncing clearly’ which was caused by oral ulcer. Age (p = 0.025) and perceived oral health status (p = 0.000) were significantly associated with OIDP. More studies on biological and behavioural factors are recommended to support inclusion of oral health in CTCs. Keywords: Care and Treatment Centres; HAART; HIV; Oral health; Quality of lif

Dental Anxiety and Its Consequences to Oral Health Care Attendance and Delivery

Dental anxiety has been reported to be a common problem affecting widespread societies, hence a global public health concern. This chapter provides an updated information to dental practitioners, about dental anxiety and its implication to oral health-care attendance and service delivery. It is introduced by defining dental anxiety, providing a summary of prevalence of the problem among children and adults; and its relationship with sociodemography, oral health status, and cultural issues. Causes of dental anxiety and simple ways to diagnose it and management options of dental anxiety for different age groups of populations are summarized to assist dental practitioners during patient management. How dental anxiety influences dental attendance and ultimately impact oral health status of populations; and its relationship with oral health-care delivery are also discussed. Finally, preventive measures both in community and clinical settings are provided and recommendation for dental professionals and other stake holders is outlined

Perceived dental treatment need among older Tanzanian adults – a cross-sectional study

Need perceptions for dental care play a key role as to whether people in general will seek dental care. The aim was to assess the prevalence of perceived need of problem based dental care, dental check-ups and any type of dental care. Guided by the conceptual model of Wilson and Cleary, the relationship of perceived need for dental care with socio-demographic characteristics, clinically defined dental problems and self-reported oral health outcomes was investigated. Partial prosthetic treatment need was estimated using a socio-dental approach. A cross-sectional survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. Information from interviews and clinical examination became available for 511 urban and 520 rural adults (mean age 62.9 yr). 51.7% (95% CI 46.2, 57.0) urban and 62.5 % (95% CI 53.1, 70.9) rural inhabitants confirmed need for dental check-up, 42.9% (95% CI 36.9, 48.9) urban and 52.7% (95% CI 44.5, 60.6) rural subjects confirmed need for problem oriented care and 38.4% (95% CI 32.4, 44.6) urban versus 49.6% (95% CI 41.8, 57.4) rural residents reported need for any type of dental care. Binary and ordinal multiple logistic regression analyses revealed that adults who reported bad oral health and broken teeth were more likely to perceive need for dental care across the three outcome measures than their counterparts. Socio-demographic factors and clinically defined problems had less impact. Based on a normative and an integrated socio-dental approach respectively 39.5% and 4.7% were in need for partial dentures. About half of the participants confirmed need for problem oriented care, dental check-ups and any type of dental care. Need perceptions were influenced by perceived oral health, clinically assessed oral problems and socio-demographic characteristics. Need estimates for partial denture was higher when based on clinical examination alone compared to an integrative socio-dental approach

Clinical and socio-behavioral correlates of tooth loss: a study of older adults in Tanzania

BACKGROUND: Focusing 50 year olds and above, this study assessed the frequency, extent and correlates of tooth loss due to various reasons. Frequency and correlates of posterior occluding support was also investigated. METHOD: A cross-sectional household survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. One thousand and thirty-one subjects, mean age 62.9 years participated in a clinical examination and completed interviews. RESULTS: The prevalence of tooth loss due to any reason was 83.5 %, due to caries 63.4% and due to other reasons than caries, 32.5%. A total of 74.9% had reduced number of posterior occluding units. Compared to subjects having less than 5 teeth lost due to caries, those with 5 or more lost teeth were more likely to be females, having decayed teeth, confirming dental attendance and to be among the least poor residents. Compared to subjects who had lost less than 5 teeth due to reasons other than caries, those who had lost 5 or more teeth were more likely to be of higher age, having mobile teeth, being males, being very poor and to disconfirm dental attendance when having problems. Predictors of prevalence of tooth loss (1 or more lost tooth) due to various reasons and reduced number of occluding units followed similar patterns of relationships. CONCLUSION: The results are consistent with prevalence and extent of tooth loss due to caries and due to reasons other than caries being differently related to disease- and socio- behavioral risk indicators. Caries was the principle cause of tooth loss and molar teeth were the teeth most commonly lost

Oral health related behaviors among adult Tanzanians: a national pathfinder survey

<p>Abstract</p> <p>Background</p> <p>The oral health education programs which have been organised and delivered in Tanzania were not based on a thorough understanding of behaviours which influence oral health. Therefore, evaluation of these programs became difficult. This study aimed at investigating the oral health related behaviours and their determinants among Tanzanian adults.</p> <p>Methods</p> <p>A national pathfinder cross sectional survey was conducted in 2006 involving 1759 respondents from the six geographic zones of mainland Tanzania. Frequency distributions, Chi square and multiple logistic regression analyses were performed using SPSS version 13.0.</p> <p>Results</p> <p>The rates of abstinence from alcohol for the past 30 days and life time smoking were 61.6% and 16.7% respectively, with males being more likely to smoke (OR 9.2, CI 6.3 -12.9, p < 0.001) and drink alcohol (OR 1.5, CI 1.2 -1.8, p < 0.001). Multiple regression analysis revealed that; having dental pain (OR 0.7, CI 0.5-0.8; p < 0.001) and being minimally educated (OR 0.48, CI 0.4-0.6; p < 0.001) reduced the likelihood of having a high sugar score. Whereas being male (OR 1.5, CI 1.2- 1.8; p < 0.001), urban (OR 1.9, CI 1.5 -2.3; p < 0.001), and young (OR 1.5, CI 1.2 -1.8; p < 0.001) increased the likelihood of having a high sugar score. Urban residents were less likely to take alcohol (OR 0.7, CI 0.6-0.9; p < 0.01), or smoke cigarette (OR = 0.7, CI = 0.6-0.9); less likely to be those who do not use fruits (OR 0.3, CI 0.2-0.4; p < 0.001); dental clinic (OR 0.5, CI 0.4-0.7; p < 0.001); factory made tooth brushes (OR 0.1, CI 0.08-0.17; p < 0.001) and toothpaste (OR 0.1, CI 0.1-0.2; p < 0.001) than their rural counterparts. More rural (13.2%) than urban (4.6%) residents used charcoal.</p> <p>Conclusion</p> <p>The findings of this study demonstrated social demographic disparities in relation to oral health related behaviors, while dental pain was associated with low consumption of sugar and high likelihood to take alcohol.</p

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Root canal morphology of native Tanzanian permanent mandibular molar teeth

Introduction:&nbsp;research has shown variations in morphology of root canals to differ amongst ethnic groups. We aimed to investigate the root morphology and canal configuration of permanent mandibular molars in a native Tanzanian population. Methods:&nbsp;146 first and 85 second mandibular molars were collected from Tanzanian patients. After removal of the pulp tissues and staining using Methylene blue ink from the canal system, the teeth were decalcified and rendered clear using 98% methyl salicylate. The teeth were then examined under magnification of 10X for: number of roots, tooth length, number of canals, location of apical foramen, presence of an apical delta and canal configuration using Vertucci's classification. Results:&nbsp;all mandibular molars had two separate roots. The mean tooth length for mandibular 1st&nbsp;and 2nd&nbsp;molars were 21.7 mm and 20.5mm, respectively, with no statistically significant difference in mean tooth length between males and females. All the mesial roots 1st and 2nd&nbsp;mandibular molars possessed two root canals, while 40.4% and 54.1% of the distal roots of 1st&nbsp;and 2nd&nbsp;molars, respectively, had two canals. The majority of the examined teeth had their apical foramen located centrally, with an apical delta present in the distal root of one-second molar. Root canal configuration types commonly reported were Type II in the mesial and Type I in the distal roots of the mandibular 1st&nbsp;molar; while the 2nd&nbsp;molar had, respectively, root types II / IV and type I. Conclusion:&nbsp;there were observed variations in the morphology of root canals in a Tanzanian population. Caution is advised to clinicians when performing root canal treatment

Evidence Based Dentistry among Dentists in Low and Middle Income Countries: A Systematic Review

Purpose of this systematic review was to bring together studies of evidence-based practice among dentists in low- and middle-income countries, where its use has been reported to be limited. The protocol was registered in PROSPERO. Methodology: We searched the evidence (in English only) from medical databases including PubMed, EBSCO, The Cochrane Library, CINAHL, ScienceDirect, HINARI summon, and SCOPUS and Web of Science via Research4Life, grey literature, hand search from relevant articles, and augmented results on Google scholar.Published reports were retrieved from relevant websites and organizations. Studies included those that looked at key factors that facilitate or hinder Evidence Based Dentistry (EBD), as well as outcomes in terms of: knowledge, attitudes and skills of EB practice among dentists; and the methodology used and their relevance in future EBD strategies.Main focus was on dentists, as practitioners and faculty members. Studies on students and non-dental personnel were excluded.Findings:A total of 4568 records were retrieved and five potentially relevant articles were selected after title/abstract screening. Two articles were excluded after full text screening, and therefore Three papers were included in this review. The studies report limited knowledge,unsatisfactory attitude towards EBD and lowpractice of EBD and use of scientific evidence databases. None of the studies reported implementation of EBD nor evaluation thereof. The main barriers that constrained application of EBD ranged from lack of interest to infrastructural limitations. Originality: The current review showed that there is a need to strategised implementation of EBD in this region