| dc.description.abstract | Introduction: HIV/AIDS is a major global health problem affecting both low and high- income countries. Oral manifestations of HIV infection further threaten the usually poor health of HIV- positive children and lower their quality of life. HIV- oral lesions are frequently the first clinical sign of HIV infection and may interfere with oral functions. Dental caries may give rise to pain which affects feeding and general health among infected children. The Mildmay dental needs assessment (Kawuma et al 2006) reported that 94% of the children accessing care at the facility had dental problems and 80% of the patients had not visited a dentist in the previous three months. With that back- ground a dental clinic was commissioned on site in October 2006. Currently it is the only dental clinic in Uganda offering dental treatment to HIV positive children. However the magnitude of HIV-oral manifestations among children accessing care at the facility is yet to be documented. Yet it is important so that oral health care is well planned to improve the quality of life in this group of children.
Methodology: The cross-sectional study was conducted at Mildmay Uganda, between November 2007 and February 2008. The study population was children attending the Mildmay dental and pediatric clinics. A sample of 368 children between 0 to17years was systematically selected. Examinations of the mouth, followed by a short interview were conducted in the dental clinic and medical records were reviewed for CD4 cell count. Data was collected using the WHO data form for oral lesions, the Mildmay dental record card and a pre-tested semi structured questionnaire. Analysis was done using the stata computer soft ware version 11.0. The results are presented in text, tables and figures.
Results: Female participants were 194 (52.7%), the mean age was 8.8 years (SD 4.180), 67% were on ART, and 66.6% had fair oral hygiene. 77.4% had some form of HIV associated oral lesion, oral candidiasis was the most prevalent, it was seen in 50% of the children, 54% had experienced dental caries, the mean DMFT was 2.7 while mean deft was 11.8. A total of 62% reported interference of oral functions due to presence of oral lesions and swallowing of drugs was the most affected oral function. At bivariate analysis having poor oral hygiene (COR 2.8, CI 1.0-7.7, p= 0.004), not taking ARVs (COR 1.8, CI;1.0-3.4, p= 1.0) and low CD4+ cell counts (COR 1.9, CI;0.8 - 4.3, p= 0.3) were associated with presence of oral lesions. On multivariate analysis, among all other factors the association of poor oral hygiene and presence of oral lesions was found to be statistically significant. (AOR 2.8, CI 1.0 - 7.7, p=0.014).
Conclusions and Recommendations: HIV oral manifestations are common among children receiving care at Mildmay Uganda. Presence of HIV-oral lesions interferes with oral functions and the lower the CD4+cell-count the more likely the occurrence of oral lesions. The recommendations include training of health care providers in diagnosis and management of HIV-oral manifestations, regular dental check ups and regular CD4+ cell count for all children | en_US |
