Dental Caries Pattern Amongst Tanzanian Children: National Oral Health Survey.

BACKGROUND: Dental caries in young children and adolescents is a public oral health challenge in countries with developing economies and economic transition. This study presents a demographic pattern of dental caries in primary and permanent dentition of 5-, 12-, and 15-year-old Tanzanians based on the 2020 National Oral Health Survey findings. METHODS: This is a cross-section study based on data from Tanzania's 5th National Oral Health Survey. Data on dental caries and basic demographics were collected employing World Health Organization Oral Health Survey protocols. Analysis was done using the SPSS computer programme version 23, and proportions and mean dental caries experiences in Decayed extracted filled teeth in primary dentition/Decayed Missing Filled Teeth in permanent dentition were summarised and chi-square statistics and binary logistic regression assessed the differences and determined the association between dental caries and the selected demographic characteristics. RESULTS: The survey included 2187 participants; 42.4% were from rural areas and 50.7% were female. Overall caries prevalence was 17%, specifically 43.2%, 20.5%, and 25.5% amongst 5-, 12- and 15-year-olds, respectively. Decayed teeth components were 98.4%, 89.8%, and 91.4% amongst 5-, 12-, and 15-year-olds, respectively. Overall mean (SD) DMFT amongst 12- and 15-year-olds were 0.40 (0.27) and 0.59 (1.35), respectively. Urban participants had significantly lower odds of dental caries experience (odds ratio, 0.62, 95% confidence interval 0.45-0.84) compared with rural participants, whilst the 15-year-olds had higher odds of dental caries experience than the 12-year-olds. CONCLUSION: Dental caries prevalence in primary dentition was high. The proportion of decayed teeth components of def/DMFT was the highest compared with that of missing and filled teeth components. Older adolescents and those from rural areas had higher odds of dental caries experience.

Dental Caries and Associated Factors in Children Aged 2-4 Years Old in Mbeya City, Tanzania.

STATEMENT OF THE PROBLEM: Dental caries in infants and young children is prevalent worldwide; its magnitude and associated factors vary between communities because of cultural and social economic differences. No such information was available for pre-school children in Mbeya city. PURPOSE: To determine dental caries status and associated factors in 2 to 4-year-old children in Mbeya city. MATERIALS AND METHOD: A cross sectional study was conducted among 525 children aged 2-4 years and their parents/caregivers. Caries was assessed using caries assessment spectrum and treatment index, oral hygiene by visual inspection for visible plaque on index teeth, and dietary and oral hygiene habits by a questionnaire. Kappa statistics was used to test reliability of study instruments, χ2-test and logistic regression was employed for studying associations. RESULTS: Caries free children for dmft1, dmft2 and dmft3 were 79.8%, 83.8% and 94.7% and caries experience was 0.49 (1.23), 0.4 (1.14) and 0.10 (0.53) respectively. Older age [(OR =2.722 (1.617-4.582) p=< 0.001)]; and frequent consumption of factory made sugary foods/snacks at age 1-2 years [(OR=3.061 (1.188-7.887) p=0.021] were associated with caries. Prolonged breastfeeding for more than 1 year and breastfeeding at night had no association with dental caries. CONCLUSION: The prevalence of dental caries was very low. Older age and frequent consumption of factory made sugary foods at age 1-2 years were associated with higher odds of developing dental caries. Prolonged breasfeeding and breastfeeding at night had no association with dental caries. Prevention of dental caries should be instituted as soon as primary teeth start erupting, especially through discouraging consumption of factory made sugary foods/snacks.

Changes in adolescents' oral health status following oral health promotion activities in Tanzania.

OBJECTIVE: To assess the impact of oral health promotion integrated with a health promoting school (HPS) initiative on the oral health outcomes of secondary school students. MATERIALS AND METHOD: Using an urban-rural stratified cluster randomized approach, the intervention was applied to secondary school students in Arusha, Tanzania. In the urban, three control (n = 315) and two intervention (n = 214) schools performed oral clinical examination and questionnaires at baseline. In rural the corresponding figures at baseline were two (n = 188) and three (n = 360) schools. After 2 years, 374 and 358 students remained in the intervention and control arms. RESULTS: Mean number of decayed teeth (DT) increased in the intervention (mean score 1.0 vs 1.7, p < 0.001) and control schools (mean score 1.2 vs 1.7, p < 0.001). Mean number of teeth with plaque decreased significantly in intervention and control schools. No significant difference in caries increment and plaque decline scores was observed between groups. Mean number of teeth with bleeding decreased (0.5 vs 0.3, p < 0.05) in intervention schools, whereas no change was observed in the control schools (0.4 vs 0.5, p = 0.051). Increment in mean number of DT between baseline and follow-up was largest and smallest in students who, respectively, deteriorated and improved their plaque and bleeding scores. CONCLUSION: The intervention activities did not show any effect with respect to dental caries, calculus and plaque status among the students investigated. Compared with the control group, more favorable changes in the intervention group occurred with respect to bleeding on probing, suggesting a weak but positive effect on students' oral hygiene status.

Prevalence of oral pain and barriers to use of emergency oral care facilities among adult Tanzanians.

BACKGROUND: Oral pain has been the major cause of the attendances in the dental clinics in Tanzania. Some patients postpone seeing the dentist for as long as two to five days. This study determines the prevalence of oral pain and barriers to use of emergency oral care in Tanzania. METHODS: Questionnaire data were collected from 1,759 adult respondents aged 18 years and above. The study area covered six urban and eight rural study clusters, which had been selected using the WHO Pathfinder methodology. Chi-square tests and logistic regression analyses were performed to identify associations. RESULTS: Forty two percent of the respondents had utilized the oral health care facilities sometimes in their lifetime. About 59% of the respondents revealed that they had suffered from oral pain and/or discomfort within the twelve months that preceded the study, but only 26.5% of these had sought treatment from oral health care facilities. The reasons for not seeking emergency care were: lack of money to pay for treatment (27.9%); self medication (17.6%); respondents thinking that pain would disappear with time (15.7%); and lack of money to pay for transport to the dental clinic (15.0%). Older adults were more likely to report that they had experienced oral pain during the last 12 months than the younger adults (OR = 1.57, CI 1.07-1.57, P < 0.001). Respondents from rural areas were more likely report dental clinics far from home (OR = 5.31, CI = 2.09-13.54, P < 0.001); self medication at home (OR = 3.65, CI = 2.25-5.94, P < 0.001); and being treated by traditional healer (OR = 5.31, CI = 2.25-12.49, P < 0.001) as reasons for not seeking emergency care from the oral health care facilities than their counterparts from urban areas. CONCLUSION: Oral pain and discomfort were prevalent among adult Tanzanians. Only a quarter of those who experienced oral pain or discomfort sought emergency oral care from oral health care facilities. Self medication was used as an alternative to using oral care facilities mainly by rural residents. Establishing oral care facilities in rural areas is recommended.

Staphylococcus aureus HrtA is an ATPase required for protection against heme toxicity and prevention of a transcriptional heme stress response.

During systemic infection, Staphylococcus aureus acquires nutrient iron from heme, the cofactor of vertebrate myoglobin and hemoglobin. Upon exposure to heme, S. aureus up-regulates the expression of the heme-regulated transporter, HrtAB. Strains lacking hrtAB exhibit increased sensitivity to heme toxicity, and upon heme exposure they elaborate a secreted protein response that interferes with the recruitment of neutrophils to the site of infection. Taken together, these results have led to the suggestion that hrtAB encodes an efflux system responsible for relieving the toxic effects of accumulated heme. Here we extend these observations by demonstrating that HrtA is the ATPase component of the HrtAB transport system. We show that HrtA is an Mn(2+)/Mg(2+)-dependent ATPase that functions at an optimal pH of 7.5 and exhibits in vitro temperature dependence uncommon to ABC transporter ATPases. Furthermore, we identify conserved residues within HrtA that are required for in vitro ATPase activity and are essential for the functionality of HrtA in vivo. Finally, we show that heme induces an alteration in the gene expression pattern of S. aureus Delta hrtA, implying the presence of a novel transcriptional regulatory mechanism responsible for the previously described immunomodulatory characteristics of hrtA mutants exposed to heme.

The use of the theory of planned behavior to explore beliefs about sugar restriction.

OBJECTIVES: To identify beliefs underlying attitudes, subjective norms and perceived behavioral control regarding sugar restriction using the theory of planned behavior, TPB. METHODS: A survey of 981 students was conducted in Dar es Salaam, Tanzania. RESULTS: The TPB predicted behavioral intention, with R2 = 0.25. Analysis of variance showed consistent differences between intenders (strong intentions) and nonintenders (weak intentions) with regard to beliefs of immediate sensory concerns and psychological control factors. CONCLUSIONS: Support was provided for the TPB constructs to predict intended sugar restriction. Beliefs distinguishing intenders from nonintenders represent targets for interventions aimed at maintaining a low-level sugar intake among students in Tanzania.

A longitudinal study of occlusal caries among schoolchildren in Dar es Salaam, Tanzania.

OBJECTIVES: To describe the clinical caries status and the radiographic progression of occlusal caries lesions in permanent first and second molars among primary schoolchildren in Dar es Salaam over a 3-year period. METHODS: Clinical and radiographic diagnosis of caries in first and second permanent molars in 223 children aged 8-16 years were carried out annually from 1994 to 1997. The drop-out rates from the baseline in 1994 to the follow-up examinations in 1995, 1996 and 1997 were 16.6%, 22.0% and 35.4%, respectively. Twenty-one percent of the dropouts were picked up during the study. RESULTS: Less that 5% of all occlusal surfaces that were sound at the beginning of the study developed new clinical caries lesions over the 3-year study period. The highest rate of new lesions was found in second molars. The mandibular second molars were most frequently affected by new caries lesions followed by the mandibular first molars. Progression of lesions was generally slow. After 1, 2 and 3 years, 30.0%, 47.9% and 52.8% of lesions in occlusal surfaces of first molars had progressed, compared to 47.9%, 71.3% and 100.0% of lesions in second molars. CONCLUSIONS: Dental caries prevalence was low. New occlusal lesions were more likely to appear in mandibular second molars. Carious lesions were progressing slowly, especially in the first molars. Fissure abrasion may play a role in minimizing the risk of developing new occlusal lesions as well as progression of existing lesions.

Social and behavioral correlates of oral quality of life studied among university students in Tanzania.

This study applies an abbreviated version of the Oral Impacts on Daily Performances (OIDP) and the Life Satisfaction scale to oral-health-related quality of life (OHRQOL) and quality of life (QOL) among Tanzanian university students. The following questions were addressed: Are social and behavioral status associated with overall OIDP frequency scores? Do social and behavioral variables contribute to the explainable variance of the OIDP frequency scores beyond the effect of clinical indicators of oral disorders? Do OIDP frequency scores influence general QOL as measured by the Life Satisfaction scale? A two-wave cross-sectional study was conducted during the summer of 1999, involving 19-45-year-old students at the University of Dar es Salaam. One-thousand-one-hundred-and-twenty-three students completed self-administered questionnaires and 228 respondents were re-examined clinically after 4 weeks. The rates of tooth decay and tooth loss were 34% and 37%, respectively. Medical-non-medical status (OR = 2.7) self-perceived health status (OR = 2.7), and sugar avoidance (OR = 2.2) varied systematically with OIDP scores in multivariate analyses. Tooth decay and tooth loss alone contributed 10% to the explainable variance in the OIDP scores. Entering social and behavioral variables increased the explainable variance to 19%. Finally, life-satisfaction scores varied systematically and positively with the OIDP frequency scores in bi- and multivariate analyses. This study gives some indications that the social and behavioral contexts of Tanzanian university students are important in shaping their responses to oral disorders.

Oral health behavior patterns among Tanzanian university students: a repeat cross-sectional survey.

PURPOSE: This study examines oral health behavioral trends and the development of sociodemographic differences in oral health behaviors among Tanzanian students between 1999 and 2000. METHODS: The population targeted was students attending the Muhimbili University College of Health Sciences (MUCHS) at the University of Dar es Salaam (UDSM), Dar es Salaam, Tanzania. Cross-sectional surveys were conducted and a total of 635 and 981 students, respectively, completed questionnaires in 1999 and 2001. RESULTS: Cross-tabulation analyses revealed that in 1999, the rates of abstinence from tobacco use, and of soft drink consumption, regular dental checkups, and intake of chocolate/candy were 84%, 51%, 48%, and 12%, respectively, among students of urban origin and 83%, 29%, 37%, and 5% among their rural counterparts. The corresponding rates in 2001 were 87%, 56%, 50%, and 9% among urban students and 84%, 44%, 38%, and 4% among rural ones. Multiple logistic regression analyses controlling for sex, age, place of origin, educational level, year of survey, and their interaction terms revealed a significant increase in the rate of soft drink consumption, implementation of oral hygiene measures, and abstinence from tobacco use between 1999 and 2001. Social inequalities observed in 1999, with urban students being more likely than their rural counterparts to take soft drinks and go for regular dental checkups, had leveled off by 2001. CONCLUSION: This study provides initial evidence of oral health behavioral trends, that may be utilized in the planning of preventive programs among university students in Tanzania.