The Effects of an Educational Intervention on the Early Management of Oral Lesions in the Umgungundlovu District in Kwazulu-Natal

Oral lesions that are associated with human immunodeficiency virus (HIV) infection are often the first clinical signs of an underlying infection. This study aimed to test primary healthcare (PHC) nurses' knowledge and practices before and after an educational intervention on the detection and management of oral diseases; and in particular; those associated with HIV infection. A cross-sectional study was conducted among PHC nurses who were employed in a range of clinical settings within the public sector (hospitals; clinics and nurse training colleges) in urban and rural areas in the uMgungundlovu Health District of KwaZulu-Natal. The convenience sample comprised 121 nurses who completed a self-administered questionnaire; undertook pre-education testing; were provided with educational material and underwent post-education testing. The obtained results showed that most nurses (90) had received little or no undergraduate or postgraduate training in the examination; diagnosis or treatment of oral lesions. Analysis of the pre-education test results that pertained to the identification of a number of oral lesions revealed a mean correct response rate of 38.5. Post-education results revealed a statistically significant (p-value .0001) (24) improvement to 62.4. The provision of a basic education intervention can have significant effects on knowledge; treatment and referral patterns; and can lead to early diagnosis; treatment and improved quality of life for persons who are infected with HIV

Oral Lesions in HIV-Infected Patients; Before and After Antiretroviral Treatment

Oral lesions cause considerable morbidity in HIV-infected patients. Antiretroviral therapy (ART) reconstitutes the immune system and reduces the incidence of opportunistic infections and malignan-cies. The aim of the present study was to determine the prevalence and range of oral lesions in patients before and after starting ART in Harare; Zimbabwe. A longitudinal; prospective study of oral lesions presenting in HIV-infected patients at baseline and three and six months after the initiation of ART was conducted. The study was undertaken at three hospitals in Harare. Two hundred and ten patients were enrolled; 96 (46) and 49 (23) patients presented for follow-up at three and six months; respectively. Two-thirds of the patients who completed follow-up were female; median age was 36 years. At six months of ART; the overall prevalence of oral lesions declined significantly (p 0.05). Oral candidiasis was the most common finding and showed the most significant reduction on ART. In contrast; the incidence of facial warts increased from baseline to three and six months. ART was effective in reducing the overall prevalence of oral lesions in HIV-infected patients; although incidence was variable depending on the type of lesion. Unmasking immune reconstitution inflammatory syndrome to human papillomavirus (HPV) is the likely cause for the increase in facial warts

Dog Bites to the Head; Neck and Face in Children

Dog bites are a poorly understood and complex public health problem. Children are most frequently the victims of dog bites and the face is often the favoured target. A review of dog bite wounds in small children presenting to the Red Cross War Memorial Children's Hospital was carried out over a period of 13.5 years (1991-2004). One thousand eight hundred and seventy-one dog bite wounds were admitted from a total of 125;677 patients treated. From 1;871 patients presenting with dog bite injuries; we identified 596 children who sustained injuries to the head; face or neck. Dog bites to the head; face or neck were responsible for 0.5 of all trauma unit presentations and 32 of all dog bite injuries. The mean age of the children was 5.1 years. Male children accounted for 68 of the patients. The peak incidence was noted in children aged 2 to 4 years old. One hundred and seventy-two (29) bites occurred between the summer months of December and February. Two hundred and forty-nine (42) patients presented to hospital between the hours of 12:00 and 18:00 hours and 275 (46) children presented between 18:00 and 0:00 hours. A large proportion of all attacks occurred either inside or outside the victim's own home and at the home of friends or family. Superficial injuries were treated with wound cleaning; suturing and dressing. There were no fatalities. Dog bites are relatively common in small children; but do not represent a major cause of morbidity and mortality