Clients' satisfaction with HIV treatment and care services in Nigeria.

OBJECTIVE: Many Sub-Saharan Africa countries have witnessed rapid scale-up of HIV treatment and care services in recent years. However, there is increasing evidence suggestive of poor quality of services. In this study, we examined clients' satisfaction with quality of HIV treatment and care services in Nigeria. STUDY DESIGN: This was a cross-sectional survey of people living with HIV (PLHIV) receiving HIV treatment and care services. METHODS: The study included 1212 PLHIV receiving HIV treatment and care in 96 health facilities across 12 states. We collected data on clients' satisfaction with four quality domains (confidentiality, staff attitude, physical structure, and perceived improved health) and the overall quality of care, sociodemographic characteristics, type of facility, distance to facility, and time spent at facility. A logistic regression analysis was conducted with clients' satisfaction with the overall quality of care as the dependent variable. RESULTS: About 90% of the respondents were satisfied with the overall quality of care. Women, rural dwellers, and Muslims, public (government-owned) healthcare facility users, those unsatisfied with confidentiality, and those unsatisfied with staff attitude had statistically significant lower odds of being satisfied with the overall quality of care. After adjusting for sociodemographic characteristics and the type of facility, confidentiality (adjusted odds ratio [AOR] = 0.1, 95% confidence interval [CI] = 0.01-0.81, P = 0.031) and staff attitude (AOR = 0.24, 95% CI = 0.09-0.67, P = 0.006) remained statistically significant. CONCLUSIONS: Clients' satisfaction with the quality of HIV treatment and care services at health facilities in Nigeria appears high. HIV service provision should be in line with standard ethical principles and more patient centered and responsive to sociodemographic characteristics of PLHIV.

Malocclusion and its impact on quality of life of school children in Nigeria.

BACKGROUND: Malocclusion, though not life-threatening, is an important public health issue, which has a large impact on the individual, causing discomfort, social and functional limitations. OBJECTIVE: To evaluate objectively orthodontic treatment needs in Nigerian schoolchildren and the impact of malocclusion on their quality of life. METHODS: This cross-sectional study involved schoolchildren aged 12 to 16 years from four randomly selected secondary schools in Lagos, Nigeria. A prestructured questionnaire was administered and a clinical examination was conducted. Occlusal status was assessed for each subject using the Dental Aesthetic Index (DAI). Oral Health Impact Profile-14 (OHIP- 14) was also evaluated. RESULTS: There were 410 (50.9%) females and 395 (49.1%) males aged 12 to 16 years. Mean age was 14.5±1.3 years. Irregularity of teeth was the most prevalent malocclusion. Generalised spacing and midline diastema were seen in 59% and 31% respectively; crowding in 43% of the schoolchildren. Other occlusal anomalies were recorded. There was no statistically significant difference between the sexes. Over one third of the study population did not need treatment, treatment was mandatory in 24.3%, elective in 21% and highly desirable in 17%. More females than males did not need orthodontic treatment. Oral conditions had no effect on the quality of life of 85.3% of the study sample. CONCLUSION: Most Nigerian schoolchildren were found to have a dental appearance that needed orthodontic treatment. However, components of the oral conditions impacted on the quality of life of a few subjects. Psycho-social need is very important in orthodontic diagnosis.

Malocclusion and its impact on quality of life of school children in Nigeria

BACKGROUND: Malocclusion, though not life-threatening,is an important public health issue, which has a large impacton the individual, causing discomfort, social and functionallimitations.OBJECTIVE: To evaluate objectively orthodontic treatment needsin Nigerian schoolchildren and the impact of malocclusion ontheir quality of life.METHODS: This cross-sectional study involved schoolchildrenaged 12 to 16 years from four randomly selected secondaryschools in Lagos, Nigeria. A prestructured questionnaire wasadministered and a clinical examination was conducted.Occlusal status was assessed for each subject using the DentalAesthetic Index (DAI). Oral Health Impact Profile-14 (OHIP-14) was also evaluated.RESULTS: There were 410 (50.9%) females and 395 (49.1%)males aged 12 to 16 years. Mean age was 14.5 ± 1.3 years.Irregularity of teeth was the most prevalent malocclusion.Generalised spacing and midline diastema were seen in 59%and 31% respectively; crowding in 43% of the schoolchildren.Other occlusal anomalies were recorded. There was nostatistically significant difference between the sexes. Over onethird of the study population did not need treatment, treatmentwas mandatory in 24.3%, elective in 21% and highly desirablein 17%. More females than males did not need orthodontictreatment. Oral conditions had no effect on the quality of life of85.3% of the study sample.CONCLUSION: Most Nigerian schoolchildren were found tohave a dental appearance that needed orthodontic treatment.However, components of the oral conditions impacted on thequality of life of a few subjects. Psycho-social need is veryimportant in orthodontic diagnosis. WAJM 2010; 29(6): 417­424