Application of the Kvaal method with cone beam for the determination of a local formula for the age estimation of adult African melanoderma subject, Côte d'Ivoire

BACKGROUND

Age estimation by invasive dental methods is a destructive, costly and time-consuming approach, whereas, age estimation methods using dental radiographs are simple, non-destructive and provide reliable information. Age estimation by the Kvaal radiographic method has proven to be a reliable method, but possible ethnic variations may limit its uses in other populations. The objective of this study was to reproduce the original Kvaal method with CBCT for the estimation of the age of the adult melano-African subject in Côte d'Ivoire, in order to propose an age estimation formula, specific to our study population, by taking into account the measurements of tooth and pulp ratios.

METHODS

A cross-sectional study used 102 radiographic data from a CBCT Planmeca® examination in a private dental clinic in Abidjan. It was data from subjects of at least 18 years of age. Dental measurements in length and width of the entire tooth, root and pulp were performed on maxillary central incisors and the different ratios were calculated according to the Kvaal method. The correlation between age and ratios was also assessed. Age estimated using the Kvaal formula was compared to the chronological age. A linear regression equation was developed using ratios and age predictive factors to evaluate the accuracy of the Kvaal formula.

RESULTS

In all, a total of 102 radiographs of 102 subjects, of whom 55 (53.9%) were females, were analyzed. The median age was 51 years (inter-quartile range [IQR] 41- 58). Using the Kvaal formula, the Standard error of the estimated age was higher in the African melanoderma population compared to the Kvaal population. The new formula derived from that of the Kvaal formula was developed and applied to our study population (Age = 84.7- 114.2 (M) - 29.4 (W - L) gave more than double the standard error of estimated age by Kvaal (26.03).

CONCLUSION

Our study showed that the measurements made by Kvaal are reproducible with CBCT and there is a correlation between age and the dental parameters studied. However, the age estimation formula determined by Kvaal et al. is not valid for African melanoderma subjects living in Côte d'Ivoire.

Accessibility to oral health care of precarious and non precarious populations in Côte d’Ivoire

Introduction

The purpose of any health system is to guarantee access to care for the entire population served. However, the socio-economic insecurity situation of people in precarious situations, raises the problem of their access to oral health care considered to be expensive. The objective of this study was to compare the dental status and modalities of oral health care use by people in precarious situations to group of non-precarious population in Abidjan, in Côte d’Ivoire.

Methods

The cross-sectional study was conducted at the University Hospital Center of Treichville. It concerned all users of the dental office of this hospital. Subjects in precarious situations were identified using a screening tool. Was considered to be in a precarious situation, a person living with less than 1.5 USD/day, having no fixed address, looking for a job, having no health insurance or having difficulties in dealing with medical and pharmaceutical costs. We have identified variables for the modalities of oral health care use and follow-up. The frequencies of these variables were calculated and comparisons were made between subjects in precarious and non- precarious situations using the Chi2 test.

Results

256 people participated in the study. The tool for identifying precariousness made it possible to distinguish 128 subjects classified in precarious situations and 128 others in non- precarious situations. The number of missing teeth in people in precarious situations was twice as high as in non-precarious subjects. Renunciation of dental care was more common in the precarious group (46%) than in the non- precarious group (32%). Absenteeism rates at the first two appointments were higher among the precarious (54%) than among the not precarious (46%).

Conclusions

These results show the need to sensitize the population on the importance of oral health and the establishment of social protection mechanisms to ensure greater accessibility to care for people in precarious situations.

Key messages

Improving the oral health of populations, especially vulnerable population groups, requires the establishment of social protection mechanisms to remove the financial barrier to access to care. Educating the public about the importance of oral health for overall good health is essential to improving the use of dental care.

Evaluation of the oral health of pregnant women in prenatal consultations in Côte d’Ivoire

Background

Despite the proven links between oral health status and adverse pregnancy outcomes, oral examination is not systematically integrated into prenatal examinations in Côte d’Ivoire. In addition, there are no prevention messages specifically targeted at pregnant women. Objective: To assess the oral health of pregnant women in Côte d’Ivoire.

Methods

A cross-sectional survey was conducted at the Maternal and Child Health Department of the National Public Health Institute in Abidjan. The data collected were: age, education level, marital status, source of income, trimester of pregnancy, gestational age, oral hygiene habits and the fact that they whether or not received oral health information. A clinical examination was conducted to assess oral hygiene (OHIS index), periodontal condition (CPI index), dental condition (DMFT index), as well as the presence of epulis, erosion or dental mobility. Frequencies and counts were calculated for the different variables in the study.

Results

A total of 207 women were observed. The age range was 15 to 44 years with 14.0% under 19 years old. The majority were in couple (76.8%), multi-gesture (77.3%), and more than half had no education (52.2%) or source of income (56.0%); 50.7% snacked between meals and 33.3% had vomiting. They brushed their teeth at least twice a day (70.0%) and had not changed their oral hygiene habits (77.3%) during this pregnancy. Only 3.4% had information on oral health conditions during pregnancy. The frequency of caries was 75.4%, dental erosions 13.0%, gingivitis 57.0%, periodontitis 6.8% and epulis 3.4%.

Conclusions

The results suggest the integration of systematic dental consultation into prenatal consultations in order permit the sensitization of these women, screening and management of their oral conditions.

Key messages

Oral diseases of pregnant women are a reality without their knowledge in Côte d’Ivoire. A systematic dental visit is essential during prenatal consultations in Côte d’Ivoire.

Discrimination of people living with hiv/aids: a survey with dentists in Abidjan, Côte d’Ivoire

Background

Despite several decades of fighting HIV infection, discrimination against people living with this infection persists, even among health professionals. Understanding the determinants of discriminatory attitudes of dentists is a first step towards access to oral health care and improved care for people living with HIV (PLHIV).

Objectives

To analyse the determinants of discriminatory attitudes towards people living with HIV among dentists in Côte d’Ivoire.

Methods

A cross-sectional survey was conducted among dentists in Abidjan in 2016. In addition to socio-professional characteristics, a questionnaire collected information on their knowledge about HIV (transmission, hiv-related oral diseases) and their individual perception (fear of being contaminated, cross-contamination...). The chi2 test for independent sampling was used to identify factors associated with discriminatory attitudes (threshold α = 5%).

Results

A total of 120 dentists were interviewed: 61.3% from the public sector; 56.7% men; 54.2% in couple; 53.3% had participated in continuing education on HIV; 29.2% did not know HIV-related diseases and transmission modes and 69.2% reported fear of being infected during care; 44.2% reported informing staff of the patient’s HIV status. The proportion of dentists with discriminatory attitudes was estimated at 69.2%. The main associated factors were: female gender (p = 0.001), living in couple (p = 0.000), lack of knowledge of the risk of HIV transmission after a blood exposure accident (p = 0.000), the law protecting people living with HIV in Côte d’Ivoire (p = 0.009) and fear of being infected (p = 0.000).

Conclusions

The results of this study show that the determinants of discriminatory attitudes among dentists result from their lack of knowledge of the disease, justifying the need to strengthen their continuing education on HIV/AIDS infection.

Key messages

Dentists discrimination towards people living with HIV infection result from their lack of knowledge about the infection. It’s essential to strengthen their knowledge about HIV in order to improve access to care for people living with HIV.

Illness-related behaviour and sociodemographic determinants of oral health care use in Dabou, Côte d'Ivoire

OBJECTIVES

The aims of this study were to describe adults' oral health behaviour and identify the sociodemographic determinants that influence people to seek oral care in Côte d'Ivoire, in a context of promoting a more accessible health care system.

METHODS

The design was a cross-sectional pilot survey undertaken in the department of Dabou, Côte d'Ivoire. A stratified sampling procedure with proportional allocation size was used, based on four different criteria: place of residence; type of dwelling; distance between the chosen locality and the dental clinic; and, the presence of a medical centre in the locality. The sample consisted of 927 people (18 years or older) who were interviewed by questionnaire. Data were collected at face to face interviews, using the method of itineraries.

RESULTS

34% of the population had not accessed a dental practitioner during the past 12 months. The reasons for not seeking care were: self-medication, lack of money and a perception of not needing care. A dentist or a traditional healer had been sought by 33%. The choice of therapy was influenced by educational level and having health insurance (p < 0.05). The main reasons for attending a traditional healer were linked to educational level, the type of dwelling and the participants' place of residence (p < 0.05). Choosing to see a dentist was associated with age, the type of dwelling and the distance between the chosen locality and the dental clinic (p < 0.05

CONCLUSION

The socioeconomic situation of the participants was a determining factor for seeking care. Improving access to health care should be part of the global fight against poverty and the reduction of social inequalities.

[Traditional practices and exploitation of medicinal plants in odontostomatology in Ivory Coast]

Traditional medicine of which is a part traditional odontology occupies an important place within the African societies. It often constitutes the first appeal (80 % of the population) because of the high cost of the care, the incapacity of the human and material resources but also the faiths of the populations. This reality makes valuation of the traditional odontology a necessity. This study comes within this framework. It's a contribution for a better knowledge of practices and plants used in traditional odontology in Ivory Coast. So, after a presentation of some traditional knowledge's and their fields of application, the authors review studies made on the efficiency of plants in the prevention of tooth decay and the treatment of some oral diseases. The objective of these researches is to elaborate effective and financially affordable traditional improved drugs.

[Oral health care practices in Abidjan]

Abidjan, the economical capital of Ivory Coast has a CAO of 2.7 with index O practically nil. The professional density is one surgeon for 12.000 inhabitants. Abidjan population, despite the requirements in increasing care has not recourse to the dental surgeons for their assumption of responsibility. The general objective of our study is to describe the therapeutic itinerary in odonto-stomatology of the Abidjan population. We have realised a questionnaire survey beside of population sample. The results show that 25 per cent of our population gives up care despite the presence of pain or embarrassment. Our study has allowed highlighting all the other recourses to the care. Indeed, the people who give up the care have much other recourse which has be identified in order of importance: the modern and traditional self-medication. Let us note in our study, that the choice of dental surgeon knows a constant evolution from the first to the third recourse. The lack of financial means constitutes however the first obstacle at the accessibility to the oral care in Ivory Coast.

[Causes of late odontostomatologic consultations in Ivory Coast]

In Africa, particularly in Ivory-Coast, dental patients present late with life threatening complications. The authors designed a questionnaire to be filled by each patient who presented with serious dental pathology whose only remedy was tooth extraction. Causes of late consultation including financial deprivation, fear of dentist, self medication are some of the factors identified by the authors as the most frequent factors. Dental health education and a comprehensive, social policy are advanced as possible ways of prevention.

[Evaluation of the level of endemic tuberculosis in a survey of Banqui (Central African Republic)]

A cluster sample survey on tuberculosis has been carried out in Bangui in February 1988. The bimodal distribution of the diameters of IDR on children aged between 5 to 9, gives evidence of a circulation of some non typical mycobacteriae and enables to fix the limit of positivity at 14 mm. The prevalence rate of the tuberculotic infection is 7.9 +/- 1.7% in the surveyed children population at school. The annual risk of infection is evaluated at 1.09% that ranks the Centrafrican Republic in the countries with a low prevalence rate.