Environmental Characteristics of HIV/AIDS Affected Households in a Nigerian Rural Community.

A study of environmental attributes of HIV/AIDS affected households in Ijesa region, Nigeria (N = 297). Data from both primary and secondary sources were used to establish the relationship between socio-economic and environmental characteristics at different rural community zones; namely traditional core, post traditional and contemporary. There were more female HIV/AIDS patients, located in traditional core zones (78.1%) with high house density, living in shared apartments where residents shared sleeping and bath/toilet rooms. Thus, rape was significantly associated with the design and habitation density of households. In addition, widowhood, young age, informal education, menial jobs and unemployment of patients did not correlate with most environmental variables related to HIV/AIDS in contemporary zone compared with traditional zone. However, wealth status and quality education in relation to good housing environment and decent house density were significant in contemporary zone respectively. The study concluded that policies on HIV/AIDS prevalence at rural community level should focus more on high density areas having poor socio-economic and environmental characteristics.

Use of teachers as agents of oral health education: Intervention study among public secondary school pupils in Lagos.

BACKGROUND: Common oral diseases are preventable and if detected early are reversible and schools provide a setting in which the oral health behavior of pupils can be influenced. We aimed to assess the effectiveness of using teachers in place of oral health professionals to deliver oral health education (OHE) in public secondary schools in Lagos State. METHODS: This quasi-experimental study was conducted in four phases from September 2016-April 2017. A multistage sampling method was adopted to enlist the research participants from four enlisted schools, which were randomly assigned into two groups. Trained dentists delivered OHE in the first group of schools while trained teachers did in the second group and the impact of the intervention was assessed over six months. P values for significant differences were set at 0.05. RESULTS: At the 3 months evaluation, the mean oral health knowledge (OHK) scores were higher among pupils in the Teachers Intervention Schools (TIS) (71.3 ± 19.3) than that in the Dentist Intervention Schools (DIS) (61.3 ± 17.7) (P = 0.023). Subsequent evaluation sessions from baseline revealed a gradual increase in the proportion of pupils with positive oral health attitude scores; with a higher proportion of pupils in the DIS (34.5%) compared to the TIS (34.0%) at 6 months assessment time. At 6 months evaluation, the proportion of pupils with poor oral health practices decreased in both groups of schools (P = 0.104). CONCLUSION: The proportion of pupils with good OHK was higher in the TIS at post-intervention periods; this difference was statistically significant at 3 months. This result suggests that teachers are as effective as dentists in delivering OHE.

Pattern of Utilisation of Dental Health Care Among HIV-positive Adult Nigerians.

PURPOSE: To determine the pattern of dental care utilisation of people living with HIV (PLHIV). MATERIALS AND METHODS: A cross-sectional questionnaire survey of 239 PLHIV patients in three care centres was done. Information on sociodemographics, dental visit, risk groups, living arrangement, medical insurance and need of dental care was recorded. The EC Clearinghouse and WHO clinical staging was used to determine the stage of HIV/AIDS infection following routine oral examinations under natural daylight. Multivariate logistic regression models were created after adjusting for all the covariates that were statistically significant at univariate/bivariate levels. RESULTS: The majority of subjects were younger than 50 years, about 93% had not seen a dentist before being diagnosed HIV positive and 92% reported no dental visit after contracting HIV. Among nonusers of dental care, 14.3% reported that they wanted care but were afraid to seek it. Other reasons included poor awareness, lack of money and stigmatisation. Multivariate analysis showed that lack of dental care was associated with employment status, living arrangements, educational status, income per annum and presenting with oral symptoms. The area under the receiver operating curve was 84% for multivariate logistic regression model 1, 70% for model 2, 67% for model 3 and 71% for model 4, which means that the predictive power of the models were good. CONCLUSION: Contrary to our expectations, dental utilisation among PLHIV was generally poor among this group of patients. There is serious and immediate need to improve the awareness of PLHIVs in African settings and barriers to dental care utilisation should also be removed or reduced.

Perception of patients with amalgam fillings about toxicity of mercury in dental amalgam.

OBJECTIVE: The objective of this study is to evaluate the awareness of patients with dental fillings about the toxicity of mercury in dental amalgam. MATERIALS AND METHODS: Adult patients having at least one amalgam filling in their mouth were recruited in the Oral Diagnosis Department of OAUTHC, Ile-Ife Dental Hospital. Participants were recruited consecutively as they report in the clinic. Data were collected using a structured questionnaire developed based on standard questions from relevant publications. They were asked to indicate the type of filling material in their mouth, ingredients of the material, previous knowledge of mercury in dental amalgam and ailments due to mercury. They were to indicate their level of agreement with filling their cavities with dental amalgam despite prior information about its mercury content. RESULTS: There were about 446 respondents analyzed; male, 194 (43.5%); female 252 (56.5%). Six (1.4%) and 21 (4.7%) respondents were primary and secondary schools students respectively; 15(3.4%) had no formal education while about 410 (91.9%) were either undergraduate or graduate. All of them had at least one amalgam filling. 249 (55%) participants know the type of filling on their teeth; 156 (34.5%) had the knowledge of the presence of mercury in dental amalgam while 26.1% believed mercury can cause problems in human beings. About 90 (19.9%) participants claimed to have heard about adverse reactions to dental amalgams and 34 (7.5%) of them have heard about people recovering from an illness after removal of their filling. The level of agreement with filling their cavities with amalgam despite prior knowledge of its mercury content was 74% while 60% was observed for allowing just any material to be placed on their teeth. CONCLUSION: Awareness of toxicity of mercury in dental amalgam was slightly low among the respondents studied. This may be suggested to be a reflection of nonexistent of global amalgam controversy in Nigeria.

Assessment of dental waste management in a Nigerian tertiary hospital.

This study assessed the practice of disposing of waste from the eight dental clinics of Obafemi Awolowo University Teaching Complex, Ile-Ife, Nigeria. All the cleaners (14) in the hospitals were surveyed through questionnaire. Information obtained from the cleaners included socio-economic characteristics (biodata), personal protection, facilities available for them to work with and job satisfaction. Two soil samples were obtained from the open dump site (0.15 and 0.30 m depth) and two water samples were also collected (at 0.00 and 50.00 m) within the vicinity of the dump site. Both the soil and water samples were taken to the central science laboratory for chemical analyses. Ten (71.4%) of the 14 cleaners were not satisfied with their job. The laboratory findings suggested a very high content of lead, chromium, mercury, cadmium and manganese in both soil and water samples in comparison with the Nigerian Federal Environmental Protection Agency standards. The study concludes that the use of tooth-coloured restorative materials and digital X-ray facility to serve as alternatives to the generation of these wastes is recommended and that farming activities should not be allowed in the area until an audit of the soil and water have been performed.

The economic burden of HIV and AIDS on households in Nigeria.

The study estimates the economic burden of HIV and AIDS on households in a Nigerian population. The data derive from a cross-sectional survey of households affected by HIV or AIDS in Ife-Ijesa Zone, Osun State, Nigeria. The sample consisted of 117 purposively selected, consenting adult HIV patients attending a general and teaching hospital. Participants were asked to self-report monetary expenses for HIV-related care, loss of savings, and funeral costs. The data show a significantly sharp drop in the participants' household income as a result of care for HIV-related illnesses, from the time of knowing one's HIV status to the time of illness, among three occupational categories (artisans, civil servants and unemployed; p = 0.02). Mean income among those in the unemployed category fell by 84.1%, income among artisans dropped by 72.6%, and income among civil servants decreased by 44.4%. The monetary loss during the course of HIV-related illnesses was heaviest for the artisan group, followed by the unemployed and the civil servants. Those who had lost a substantial part of their savings to HIV-related care were most numerous among the unemployed, followed by artisans and civil servants. Out of 16 households, 11 (42.3%) had received support from relatives during a funeral ceremony. There was a significant association between the occupational group and working for more hours after illness (χ(2) = 9.28, df = 4; p = 0.05). Nearly all orphaned children were distributed to the extended family following the AIDS death of a parent. Among all the occupational groups, borrowing from a cooperative society during the course of HIV-related sickness was the commonest form. The findings add to data showing that despite the extended family support system, adult deaths due to AIDS continue to undermine the viability of sub-Saharan African households.

Oral health and the elderly in Nigeria: a case for oral health promotion.

OBJECTIVES: To determine the prevalence of problems associated with chewing and the relationship with body mass index, the self-reported rating of oral health and normative oral hygiene assessment among the elderly. MATERIALS AND METHODS: This was a descriptive community based study carried out in three locations in Ife-Ijesa zone (south western Nigeria). Elderly persons of 55 years and above were recruited through the religious organisations. All elderly who volunteered were assisted in completing a questionnaire on their socio-demographic status, chewing ability, any quadrant associated with problems and self-rating of oral health. An oral examination under a natural daylight using sterile wooden spatulae and an upright chair was carried out. The Oral Hygiene Index of Greene and Vermillion [Journal of the American Dental Association (1964) 61, p. 172] was used to determine the oral hygiene status. RESULTS: The lower right quadrant had the highest frequency of complaint on difficulty with chewing (15.6%), and 44.1% of the subjects had problems with chewing. Twenty-nine per cent rated their oral health as poor or very poor. There was a statistically significant association between the rating of oral health and the presence of calculus (p = 0.022). This was also true for oral hygiene and having any problem with chewing (p = 0.001). The self-rating of oral health was not in agreement with that of the normative finding. CONCLUSION: Health promotion focusing on the oral health of the elderly is a significant requirement for the study population. Proper evaluation of the effectiveness of traditional dentifrices must be carried out and interventions designed to address the possibility of improper usage.

Pattern of dental extraction in children in a Nigerian tertiary hospital.

Changes that occurred in the pattern of tooth extraction in the last 13 years among a population of children in Nigerian were studied. The result of this study was then compared to that of a past study done in the same institution 13 years earlier. Information on age, gender, and indication of tooth extraction was collected prospectively from 379 consecutive patients who visited the outpatient Pediatric Dental Clinic for the first time during the year 2002. Results showed tooth extraction due to caries decreased, while there was an increase in tooth extraction from an apparent increase in orthodontic treatment needs. Acute necrotizing ulcerative gingivitis (ANUG), a significant cause of tooth loss in the last decade, decreased significantly. The pattern of deciduous tooth loss also changed as more anterior teeth were lost for orthodontic reasons in this present study. The pattern of tooth loss in the permanent dentition remains very similar to that of the past study, though more premolars were lost in the present study. There appears to be an increasing need for tooth extractions in orthodontic treatment for this population of children. The focus of planned dental health care provisions, treatment policies, and training emphasis in child dental care may need to shift to addressing orthodontic needs.