Ashu Michael Agbor

Purpose The aim of the present study was to determine the prevalence and identify factors associated with oral pathologies amongst children and adolescents with cerebral palsy (CP) in Cameroon. Methods A descriptive cross-sectional study with an analytical component was conducted between December 2023 and June 2024 in four specialised institutions. A structured questionnaire, developed specifically for the present study and adapted from WHO oral health survey protocols, was the tool used to collect three types of data from participants: their sociodemographic profile, their oral hygiene practices, and the results of their clinical examinations for oral pathologies. Comorbidities were assessed to identify potential risk factors associated with oral pathologies in this population. Binary logistic regression was performed to identify risk factors, with odds ratios (OR) and p values calculated to assess associations, considering a p value < 0.05 as statistically significant. Results 126 children and adolescents with CP (54.8% boys) aged 2–17 years, with a mean age of 6.3 ± 3.6 years were recruited. Spastic CP was the most common type (88.9%). The prevalence of dental caries was 55.5% (95% CI 46.8, 63.9%), with a mean DMFT index of 2.96 ± 2.5. The prevalence of periodontal diseases was 81% (95% CI 73.5, 87.3%). Common comorbidities included drooling (53.2%), epilepsy (17.5%), visual impairment (10.3%), and hearing impairment (7.1%). Regarding oral health, 17.5% of caregivers received prior oral health education, 84.1% of children had never had a dental consultation, and 21.4% lacked a toothbrush. Multivariate analysis revealed visual impairment as an independent risk factor for dental trauma (aOR = 3.33, p = 0.033), MACS level 4 for orthodontic anomalies (aOR = 0.346, p = 0.02), and GMFCS level 2 for dental dyschromia (aOR = 0.268, p = 0.007). Conclusion Oral pathologies are highly prevalent amongst Cameroonian children with CP. Improving oral health requires caregiver education, regular dental visits, and incorporating functional motor assessments into oral health screening protocols.

Background and Objective: Pregnancy is characterized by complex physiological and psychological changes that can affect the oral health of women. There is a paucity of literature on the oral health status of pregnant women in Cameroon. The objective of our study was to describe the oral health status of pregnant women attending the Laquintinie antenatal clinic in Douala, Cameroon. Methods: A descriptive cross-sectional study from January 2021 to June 2021 was conducted involving pregnant women who attended the antenatal clinic at Laquintinie Hospital and provided informed consent. A pretested questionnaire was administered in both French and English. Intraoral and extra-oral examinations were carried out to identify oro-facial pathologies. Results: Two hundred ninety-four pregnant women participated in our study, with ages ranging from 17 to 45 years (mean age = 26 years ± 5.1 standard deviation). Of these 144 (51.7%) were employed, 195 (70%) were married, and 168 (60.6%) had tertiary education. More than 20 (70%) were multiparous, and 111 (40%) were in the first trimester of pregnancy. Three-quarters, 210 (75%), had good knowledge of tooth cleaning, 182 (65.2%) brushed their teeth once daily, and 189 (68%) brushed only in the morning. Only a few 9 (3.2%) knew how to take care of their baby’s teeth, and 84 (30.1%) had been to a dentist. Halitosis was observed in 82 (29.3%), and all our participants had calculus deposits. The predominant oral pathologies were dental caries 168 (60.2%), gingivitis 143 (51.3%), and periodontitis 126 (45.2%). A third, 92 (33%) of the women had swelling of the gums during pregnancy, while 68 (24.5%) did not experience any change. In addition, 62 (22.2%) experienced bleeding, 43 (15.4%) pain, 10 (3.6%) ulcerations, and 10 (3.6%) epulis (pyogenic granuloma). Three out of four 210 (75.3%) of the women needed restoration for carious lesions. Conclusion and Global Health Implications: The oral health status of pregnant women in the Laquintinie antenatal clinic was poor, with a higher prevalence of dental caries and periodontal diseases ranging from mild to severe gingivitis and gingival epulis.

Background and Objective: Sickle cell disease is a neglected inherited condition that affects the hemoglobin in red blood cells and impacts at least 2% of the West African population. This hemoglobinopathy presents with high mobility and mortality as a result of infections and vaso-occlusive pain crises as a result of structural abnormality of the red blood, making it fragile and rigid. The objective of our study was to describe the oral health status of sickle cell patients in Yaoundé Central Hospital, Cameroon. Methods: A descriptive cross-sectional study was carried out in the hematology unit of the Yaoundé Central Hospital from June to October 2022. Results: A total of 63 patients, made up of 41 (65%) males and 22 (35%) females, were recruited in the study. The majority, 60 (95%), consumed sugary foods, while 43 (68%) brushed their teeth before meals, and 27 (43%) brushed their teeth once a day. A third, 24 (38%), presented with pallor of the palatal mucosa, and 24 (74.6%) had dental caries. The mean decayed, missing, and filled teeth index of this population was 2.6 (moderate) and 11 (17.5%) periodontitis. Less than a third, 17 (26.9%) of the patients had been to a dentist, 26 (41.3%) did not see it necessary to consult a dentist, while 23 (37%) thought that oral conditions are not serious. Two-thirds, 38 (60.5%), did not receive any treatment for caries. Tooth extraction 18 (27.9%) was the most common treatment given, 5 (7%) conservative treatment, and no treatment was administered for periodontitis. Conclusion and Global Health Implications: There was a high prevalence of periodontal diseases, moderate levels of dental caries, and elevated prevalence of oral mucosal lesions like tonsillar hypertrophy, pallor of the palate, lingual mycosis inflammation, and mucositis among sickle cell patients. The poor oral health-seeking behavior of the patients and poor oral hygiene practices might be responsible for the high burden of carious and periodontal diseases.

Introduction: Dental fluorosis is a developmental disturbance of enamel that results from ingesting high amounts of fluoride during tooth mineralization. Consumption of untreated fluoridated groundwater remains the leading cause of dental fluorosis. Materials and Methods: A descriptive, cross-sectional study conducted between January and September 2021 on individuals who have lived for at least 6 years in the Far North Region of Cameroon using structured questionnaires and oral examination. The Thylstrup and Fejerskov index (TFI) was used to evaluate the severity of dental fluorosis. Fluoride contents of drinking water were analyzed using fluoride electrodes. Results and Discussion: A total of 1971 persons, with a mean age of 17.15 years ± 16.18 standard deviation [SD], were recruited, with 85.64% born in the study area. The prevalence of dental fluorosis was 89.1%. Fluorosis was first observed between the ages of 1 and 10 years; 1781 (90.01%) perceived dental fluorosis as normal, and 1772 (89.90%) did not know the cause of it in their community. A TFI score of 0 was recorded by 10.9% of the population, with higher scores of 3.04 (±2.3 SD) in females and 3.31 (±2.45) among illiterates. 3.49 (±2.3 SD) among farmers and 3.06 (±2.31 SD) for those who lived in their own homes. Sources of drinking water included boreholes 61.6%, 47.4% wells, 2.2% bottled water, while 80% used toothpaste for brushing. One out of five commercial bottled water brands had higher than normal fluoride content (1.60 mgF/L), pipe borne water 1.7 mgF/L, wells 1.90 mgF/L, boreholes 2.80 mgF/L whereas 51.2% of the population presented with mild fluorosis and 23.7% severe fluorosis. Conclusion: The prevalence of dental fluorosis was extremely high. Consumption of groundwater, which is water from boreholes and wells, was the major risk factor for dental fluorosis.

Introduction: Medical records play an important role in the storage and recall of patient’s information, patient’s follow-up, research, teaching, public health policy making and as a medico-legal tool, but less emphasis has been placed on its role in health care delivery. The objective of the study was to appraise the methods of conservation and archiving of medical records in hospitals in the city of Yaoundé.Methodology: A descriptive cross-sectional study was done in the hospitals of Yaoundé between January to June 2023. The Data which was collected from medical record clerks using a self-administered and pre-tested questionnaire included: The profile of the health institution, personal information of the clerks, strategies put in place for the protection of medical records and obstacles in archiving.Results: Twenty hospitals in the city of Yaoundé participated in the study. The public sector represented 65% of the health facilities, 45% had been existing between 21 and 40 years, with a median of 24.5 years. In 70% of the cases, medical records archiving system had been existing between 1 and 10years. In 65% of cases, the conservation of archived records was mainly done at the different services with the paediatric service being the most represented (16.2%). In 87.5% of cases, the means of archiving used was the paper file classified on shelves (73.5%); of which (52.2%) were archived in alphabetical order. The obstacles to archiving medical records were mainly the lack of qualified personnel (82.4%) and the lack of storage space (80.1%).Conclusion: Many obstacles were observed. These results suggest actions to be generated both by the Cameroonian State and by the leaders of private health facilities in order to improve the management of medical records.

An increase in number of motorcycles in Tanzania has resulted in higher rates of motorcycle crashes. The factors associated with the risk of motorcycle crashes include rider characteristics, riding behavior, and riding experience. This study aimed to determine the awareness and practices of commercial motorcyclists regarding motorcycle crash-related risk factors and protective measures in Mbeya, Tanzania. This cross-sectional study targeted 404 commercial motorcyclists in Mbeya, Tanzania. Data were collected using a questionnaire composed of questions on sociodemographic characteristics, and the awareness and practices of motorcyclists regarding motorcycle crash-related risk factors and protective measures. The SPSS computer software version 27 was used for data analysis. For descriptive analysis means, and proportion were used. The outcome variables were level of awareness and degree of practice. Multivariate regression analysis was utilized to analyze how participants’ sociodemographic characteristics influenced their level of awareness and degree of practice. A p-value of less than 0.05 was considered statistically significant. Overall, most (63.4%) participants had a high level of awareness regarding motorcycle crash-related risk factors and protective measures. Whereas, slightly more than half (52.2%) of participants had poor practice. Working experience of < 2 years as a commercial motorcyclist, training in driving teaching institutes, and a history of being involved in motorcycle crashes increased the odds of a high level of awareness by 2-fold. A higher level of education and higher levels of awareness increased the likelihood of good practice by 157% and 184% respectively. Though most commercial motorcyclists have a good level of awareness regarding motorcycle crash-related risk factors and protective measures their practices were not satisfactory. The authorities should consider integrating road safety measures in school programs, use mass media to educate society on road safety, and introduce incentives such as free training for commercial motorcyclists.

Background and Objective: Highly active antiretroviral therapy (HAART) has reduced morbidity related to HIV infection, but HIV infection remains a public health in the era of HAART. The aim of this study was to investigate the oral manifestations of children living with HIV in the city of Bafoussam, Cameroon. Methods: A cross-sectional study was carried out between February and April 2022 on children living with HIV/AIDS. A pretested questionnaire and data capture sheet were used to collect participants’ data after an interview and clinical examination. Results: We recruited 163 children, including 89 (54.6%) boys and 74 (45.4%) girls aged 1–18 years. All participants presented with HIV-1 serology, 143 (88%) at WHO stage 1, all were on HAART, 62 (38%) had been on treatment for six years, 144 (89%) had a viral load of less than 1000 copies/ml, none of the children had an infection opportunistic and only 31.3% were taking cotrimoxazole as prophylaxis, 3 (1.8%) had dermatosis and 20 (12.3%) adenopathies. A third 49 (30%) had mucosal pathologies, 30 (19%) gingivitis, 15 (9%) candidiasis oral, and 40 (24.5%) caries pathology. There was a statistically significant association between viral load and caries pathology. Oral hygiene was poor and 151 (92.6%) of the children had never consulted a dental surgeon. Conclusion and Global Health Implications: This study reveals that irrespective of compliance with HAART, some oral pathology related to HIV still persists. Therefore, early initiation to HAART and improvement of oral hygiene can further reduce these pathologies.

Background: Oral health care affects the quality of life and plays an essential role in the general health of vulnerable populations especially refugees. The purpose of the study was to evaluate the quality of oral health care delivery in the Gado-Badzeré refugee camp in the Eastern region of Cameroon. Methods: We carried out a cross-sectional study between January and July 2020 using a structured questionnaire in French and translated orally to Fulfulde language. Results: A total of 716 refugees from the Central African Republic with ages ranging from 6 to 81 years (29.3years ± 14.6 s.d), made up of 61.2% females, 378(52.8%) unemployed, 342(47.8%) married, 701(97.9%) Muslims, and 511(71.4 %) had no formal education participated. Oral health knowledge was significantly poor, 305 (42.6%) that consulted the health post for their oral health needs were not satisfied, 640(89.50%) had experienced toothache, 592(83.0%) needed restorative treatment, 709(99.0%) periodontal treatment and 215(30.0%) urgent needs like tooth extraction. There were no oral health facilities, no oral health personnel, no oral health outreach had ever been carried out in the camp, and oral pathologies were managed by nurses with medications. Conclusion: The quality of oral health care delivery in this camp was very poor. There is an absence of oral health workforce and basic primary oral health care facilities. Oral health knowledge was very poor and the treatment needs the refugees was very high. Keywords: Oral health care; periodontal diseases; refugees; refugee camps; Cameroon.

Payment for dental services is one of the key determinants of treatment options, access to health care, and treatment decisions. The ability to pay for services directly affects the quality of life of an individual and also their accessibility to oral health services. The aim of the present study was to identify the different methods of payment used to obtain oral health care in Yaoundé, Cameroon. This was a cross-sectional descriptive study carried out in selected dental clinics in Yaoundé using convenient sampling between January 2021 and June 2021. Data was collected using a structured questionnaire. A total of 377 patients aged 8 to 83 years made up of 194 (51.46%) females and 183 (48.54%) males participated in the study. There is no government-assisted package for oral health care in Cameroon and more than two-thirds (66.84%) made direct payments or paid out of pocket without a refund from any insurance company. More than half 147 (58.33%) of the study population did not complete the planned dental care due to insufficient funds. Direct payments covered treatments such as scaling, restorations, root canal therapy, and dental extractions while prostheses (dentures, crowns, bridges, and implants) were only afforded by very few patients. The reasons for the inability to pay for dental services included financial difficulties 107 (72.97%) and lack of time 36 (24.49%). Only half 36 (50%) of the participants employed in the formal sector had access to health insurance and treatments like scaling, dental prosthesis, orthodontics, and dental implants were rarely provided by an insurance company. These procedures were considered to be very expensive with fluctuating prices and were viewed as being for aesthetic purposes. The majority 67 (93.06%) of payments through insurance reported being reimbursed aftercare. Two-thirds 48 (71.64%) of the insured participants said it was difficult to get reimbursed due to the administrative bottlenecks, and as such some preferred to pay out of pocket despite being insured. Late consultations encountered led to caries complications with 105 (52.24%) pulpitis. In general, financial difficulty was reported by 97 (48.26%) as the main reason for not being able to afford dental care. Oral diseases present a huge burden for children and adults due to the high cost of treatment limiting their accessibility and treatment options. There is a need to create compulsory health insurance to enhance greater access to oral health services to encourage the population to seek dental care timeously.

Background and Objective: In Tanzania, roughly 6% of the total population is elderly, which is the age group that is vulnerable to several diseases in the orofacial region. This study aimed to determine the incidence of oral and maxillofacial lesions in elderly Tanzanian patients. Material and Methods: This was a cross-sectional study of histopathological results of patients with oral and maxillofacial lesions attended at Muhimbili National Hospital. All patients aged 60 years and above diagnosed with oral and maxillofacial lesions between 2016 and 2021 were included in the study. The information gathered included the age and sex of the patients, histopathological diagnosis, and anatomical location of the lesion. The Statistical Package for the Social Sciences, version 26 computer program was used for data analysis. Results: A total of 348 histopathological reports of 348 elderly patients with oral and maxillofacial lesions were obtained. There was an equal distribution by sex. Majority (78.2%) of the lesions were malignant, followed by benign ones (12.6%). The frequently affected site was the tongue (18.1%) and the mandible (15.4%). Squamous cell carcinoma was the most (60.3%) frequently encountered lesion. Others included adenoid cystic carcinoma (5.5%) and ameloblastoma (3.7%). Conclusions: The burden of oral and maxillofacial lesions among the elderly Tanzanian population was substantial. There was no sex predilection. A majority of the lesions were malignant, and the tongue was the frequently involved site.