Awareness and knowledge of risk factors associated with oral cancer among military personnel in Nigeria.

Background: The military lifestyle has been reported to increase the risk of this population group to the development of oral cancer. Aim: This study aimed to determine the awareness and knowledge of oral cancer in a population of soldiers to acquire data for establishing an educational program for units of the Nigerian Army in oral cancer prevention and monitoring. The study was conducted in the dental center of 82 Division Military Hospital, Nigerian Army, Enugu, Nigeria. A cross-sectional survey was performed using a pre-tested self-administered questionnaire. Materials and Methods: Questions relating to oral cancer awareness, knowledge of causes, and relationship to certain habits, treatment options, and desirability of screening opportunities for oral cancer were asked. Soldiers attending the military hospital, dental center, were chosen randomly for the study. Results: Three hundred soldiers were surveyed. The mean age of those surveyed was 37.5 and had spent an average of 11-15 years in the Army. The majority of the soldiers (80.7%) have heard of cancer; the types most known were breast (75%), skin (30%), and lung cancer (28.3%). Of the 300 soldiers surveyed, 15.3% knew about oral cancer, with 41.3% of these able to identify cigarette smoking and (26%) alcohol consumption as possible risk factors associated with oral cancer. The majority believed that cancer was caused by some form of supernatural phenomenon. Conclusion: Oral cancer awareness is low among soldiers in the Nigerian Armed Forces, and strategies to increase awareness should be developed.

Fluoride content of commercial drinking water and carbonated soft drinks available in Southeastern Nigeria: dental and public health implications.

OBJECTIVE AND AIM: The importance of fluoride in preventing dental diseases cannot be overemphasized. The aim of this study was to determine the fluoride content of commercial bottled water, sachet water and carbonated soft drinks available in Southeastern-Nigeria at the same time, eliciting their dental and public health implications. METHOD: Determination of fluoride level in water and carbonated drinks was carried out using Colorimetric-SPADNS (Trisodium 2-(4-sulfophenylazo)-1, 8-dihydroxynaphthalene-3, 6-disulfonate) method. This is a simple and rapid technique with high accuracy. 10 brands of bottled water, 10 brands of carbonated soft drinks and 20 brands of sachet water were studied. The experiment for each brand was carried out in duplicates and mean fluoride concentrations generated. Data analysis was done using SPSS version 17. RESULTS: Fluoride contents in mg/L of bottled water brands ranged from 0.0173 ± 0.0019 mg/L to 0.1607 ± 0.0630 mg/L [mean: 0.0442 ± 0.0184 mg/L] and that of sachet water brands was from 0.0131 ± 0.0019 mg/L to 0.1754 ± 0.1344 mg/L. Mean fluoride content of carbonated soft drinks was 0.0228 ± 0.0064 mg/L with one of the brands having as low as 0.0066 ± 0.0028 mg/L fluoride. CONCLUSION: None of the drinks investigated contained level of fluoride up to standard admissible values suggesting sub-optimal intake. As the suitability of advice on fluoride use in preventing dental abnormalities depends on the individual's total fluoride intake from drinks and other sources, a further study is warranted to relate this total with the baseline decayed missing and filled teeth of the population.

Assessing health workers knowledge on the determinants of health: a study in Enugu Nigeria.

BACKGROUND: Different social economic and personal factors have been touted as determining a person's health. This encompasses a person's living environment, economic status, genetic makeup, physical attributes and not just access to health services. It is important that health workers recognize that a person's socio-economic environment can have an adverse effect on the health status ofthe individual so as to capture this aspect in their choice of intervention. METHODS: The study was carried out in two tertiary institutions in Enugu state selected purposively because they housed a dental clinic. It was a descriptive cross sectional study consisting of 87 participants which represented all the dental taff available during the study period. The participants were interviewed with a structured questionnaire used to elicit the knowledge of health workers on health determinants. RESULTS: When individual factors were considered, a greater percentage of health workers, believed that safe drinking water (98.9%), where a person lives (96.6%) and a balanced diet, affect health more than availability of health services (59.8%) or the ability of the health care system to meet the needs of the people (55.2%). However when ranking the magnitude of the contribution of the various determinants of health the majority (37.9%) considered a good health care system the most important contributory factor to determining health of a community while social environment (14.9%) was the least. CONCLUSION: The ranking of good healthcare system over social environment points to the emphasis being laid on curative instead of preventive management of diseases, which have been entrenched in our health workers. Considerations should therefore be made for public health institutions to dwell more on health promotion and education activites on the importance of the social determinatants on health.

The delusion of halitosis: experience at an eastern Nigerian tertiary hospital.

BACKGROUND: Halitosis is a recognized problem in dental practice. Some individuals have the belief that they have offensive mouth odour which neither the dental clinician nor any other person can perceive. This condition is known as delusional halitosis. Delusional halitosis can be classified as either Pseudo halitosis or Halitophobia depending on the response to initial treatment. Halitophobia is an olfactory reference syndrome and is a psychological condition that the dental surgeon is ill equipped to treat alone. This study aimed to analyse patients diagnosed with delusional halitosis, highlight our experiences and make suggestions for improved management of such patients. METHODOLOGY: All patients who presented at the dental clinics of University of Nigeria Teaching Hospital between January 2005 and December 2009 with a primary complaint of oral malodour were examined organoleptically. Those with obvious halitosis and known psychological conditions were excluded from the study Once a diagnosis of delusional halitosis was made, each patient was educated on the nature of halitosis, its causes and prevention. They then received oral prophylaxis and oral hygiene instructions. They were then recalled at one week, four week and six week intervals to establish a definitive classification. RESULT: 18 out of the 25 patients who presented were diagnosed with delusional halitosis. 61% of them male and 39% of them female with an average age of 30yrs. Pseudo halitosis comprised a majority of the cases seen (13). Halitophobia was seen in the minority (5). Reasons sited for believing that they had mouth odour by the patients studied included, peoples reaction when they were in close proximity and how people tended to avoid them (94.4%), ability to self perceive the foul odour from their mouths (55%) and 27.8 % said they had been told by another person that they had bad breath. All the patients had very good oral hygiene, with a tendency to over indulge on oral care products and tended to use mouthwash, breath mints and sweets in an attempt to mask the perceived odour with a few having excessive tooth brushing habits. Most had visited 2 or more other physicians within the year of presentation at the clinic with the same complaint. The patients were embarrassed (55.6%) frustrated (27.6%), self conscious (11.1%) or felt helpless (5.6%) by their perceived foul mouth odour, but none claimed to have suicidal thoughts. CONCLUSION: In all cases of delusional halitosis, there is usually an underlying psychosomatic problem, which can range from an over valued belief to a frank delusional disorder where the individual can hardly be dissuaded from their belief of mouth odour. A multidisciplinary approach to treatment between the dental surgeons and the psychological specialists may present the best approach for the patients.

Determinants of non-adherence to subsidized anti-retroviral treatment in southeast Nigeria.

The anti-retroviral (ARV) treatment programme in Nigeria is delivered through selected teaching and mission hospitals at a free/subsidized rate. The government aims to scale up ARV treatment in the country. However, non-adherence to ARV medication can lead to viral resistance, treatment failure, toxicities and waste of financial resources. This study examined the factors responsible for non-adherence to free/subsidized ARV treatment in south-east Nigeria. The study was cross-sectional and descriptive. Information was collected from 174 patients selected by simple random sampling from the register of all patients who had been on anti-retroviral therapy (ART) for at least 12 months at the beginning of the study period. Patients were identified during their clinic visits. Information on their socio-demographic profile, ARV treatment and determinants of non-adherence to ARV treatment was obtained from those who gave consent, using pre-tested interviewer-administered questionnaires. All patients clearly understood the need to take ARV drugs throughout their lives, and what the costs entailed. They understood the need for periodic testing, the probability that complications would develop, cost of transportation to treatment site and the daily treatment regimen. Seventy-five per cent of respondents were not adhering fully to their drug regimen; the mean number of days that respondents had been off drugs was 3.57 days the preceding month. Reasons for non-adherence included: physical discomfort (side effects); non-availability of drugs at treatment site; forgetting to carry drugs during the day; fear of social rejection; treatment being a reminder of HIV status; and selling of own drugs to those unable to enrol in the projects. Being female, under 35 years, single, and having higher educational status were significantly associated with non-adherence. It is important that policy makers and programme managers address the factors responsible for non-adherence when scaling up subsidized ARV treatment in Nigeria and other parts of sub-Saharan Africa.