Oral lesions associated with HIV/AIDS in HIV-seropositive patients attending a counselling and treatment centre in Dar es Salaam

Schoolteachers for Action Against HIV/AIDS-related Oral Disease of Children in Africa

PURPOSE

The intention of the study was to evaluate whether Sub-Saharan schoolteachers may play a key role in oral health promotion of primary schoolchildren, particularly in terms of prevention of HIV/AIDS-related oral health problems.

MATERIALS AND METHODS

The study examined the level of knowledge about oral disease and the prevention of HIV/AIDS oral lesions amongst schoolteachers of Tanzania and Burkina Faso, identified their sources of information, and evaluated their ability for HIV/AIDS intervention. A multi-centre cross-sectional study was implemented in the two Sub-Saharan African countries. Participants comprised primary school teachers selected by stratified cluster sampling: 261 teachers from Tanzania and 313 teachers from Burkina Faso. All participants completed a structured questionnaire prepared for self-administration. The questions were designed from a standardised questionnaire developed by the World Health Organization.

RESULTS

Most teachers knew about the principal causes of the major oral diseases and the means of disease prevention. Nearly all teachers (95.6%) were aware of HIV/AIDS and they knew (92.3%) a virus was the direct cause of AIDS. Teachers were well informed of the general symptoms of HIV/AIDS, although oral symptoms were mentioned less often. In all, 17.6% of schoolteachers reported that children suffering from HIV/AIDS were found in their classes and 10.3% of teachers were conscious of students receiving anti-retroviral therapy (ART). Knowledge about the disease seemed to reflect mass media as a source, while teacher colleagues and health personnel played a somewhat lesser role in communication. In total, 83.2% emphasised that they should teach children about HIV/AIDS and the mouth. Schoolteachers from Tanzania (70.5%) were more often engaged in classroom-based oral health education than were the Burkinabe teachers (53.9%).

CONCLUSION

The study confirms that schoolteachers may be a relevant source in the fight against HIV/AIDS among children. However, they would benefit from interaction with health personnel.

Prevalence of oral lesions in patients with AIDS: a systematic review and meta-analysis

Background Oral lesions are considered to be early clinical signs which may predict the progression of patients with acquired immune deficiency syndrome (AIDS). Due to the lack of a comprehensive study that includes oral lesions in people with AIDS, the global prevalence of oral lesions in people with AIDS was estimated by combining preliminary studies' results using meta-analysis.Material and methods Databases including PubMed, Science Direct and Scopus were searched using keywords as 'HIV', 'AIDS', 'oral candidiasis', 'Kaposi Sarcoma', 'LinearGingival Erythema' and OR operators, AND and NOT. After the elimination of duplicate documents, articles that met the inclusion criteria were selected. Quality assessment was performed based on the Newcastle-Ottawa Scale. After combining the results of preliminary studies, an overall estimate of each lesion was reported. Ninety-five studies met the criteria for inclusion in this meta-analysis.Results The global prevalence of 21 oral lesions in HIV-infected patients was estimated. The overall prevalence of oral candidiasis, pseudomembranous candidiasis, oral hairy leukoplakia, Kaposi sarcoma and erythematous candidiasis was as follows: 35% (95% CI: 28-42), 19% (95% CI: 15-22), 12% (95% CI: 11-14), 5% (95% CI: 4-6) and 18% (95% CI: 14-22).Conclusion The present meta-analysis showed that oral lesions have a high prevalence in patients with AIDS. Dentists should consider that the clinical appearance of the oral cavity reflects the overall systemic health of the patient. As such, oral lesions may be linked to underlying immunosuppression caused by AIDS.