David Meless1,2, Boubacar Ba3, Malick Faye4, Jean-Serge Diby5, Serge N'zoré6, Sébastien Datté6, Lucrèce Diecket7, Clémentine N'Diaye8, Edmond Addi Aka9, Kouadio Kouakou10, Abou Ba4, Didier Koumavi Ekouévi1,11, François Dabis11,12, Caroline Shiboski13, Elise Arrivé11,12. 1. Programme PAC-CI/CHU de Treichville, Abidjan, Côte d'Ivoire. 2. Département de Santé Publique, UFR Odontostomatologie, Université FHB, Abidjan, Côte d'Ivoire. 3. CHU d'Odonto-Stomatologie, Bamako, Mali. 4. Hopital d'Enfants Albert Royer, Dakar, Sénégal. 5. PMI Yopougon-Attié, Abidjan, Côte d'Ivoire. 6. CCTOS, Abidjan, Côte d'Ivoire. 7. CHU de Yopougon, Abidjan, Côte d'Ivoire. 8. Hôpital Gabriel Touré, Bamako, Mali. 9. CePReF Enfant, Abidjan, Côte d'Ivoire. 10. CIRBA, Abidjan, Côte d'Ivoire. 11. Inserm U897, Equipe VIH et Santé Globale, Bordeaux, France. 12. Université Bordeaux Segalen, Bordeaux, France. 13. University of California, San Francisco, CA, USA.
Abstract
OBJECTIVE: To estimate the prevalence of oral mucosal diseases and dental caries among HIV-infected children receiving antiretroviral treatment (ART) in West Africa and to identify the factors associated with the prevalence of oral mucosal lesions. METHODS: Multicentre cross-sectional survey in five paediatric HIV clinics in Côte d'Ivoire, Mali and Sénégal. A standardised examination was performed by trained dentists on a random sample of HIV-infected children aged 5-15 years receiving ART. The prevalence of oral and dental lesions and mean number of decayed, missing/extracted and filled teeth (DMFdefT) in temporary and permanent dentition were estimated with their 95% confidence interval (95% CI). We used logistic regression to explore the association between children's characteristics and the prevalence of oral mucosal lesions, expressed as prevalence odds ratio (POR). RESULTS: The median age of the 420 children (47% females) enrolled was 10.4 years [interquartile range (IQR) = 8.3-12.6]. The median duration on ART was 4.6 years (IQR = 2.6-6.2); 84 (20.0%) had CD4 count<350 cells/mm(3). A total of 35 children (8.3%; 95% CI: 6.1-11.1) exhibited 42 oral mucosal lesions (24 were candidiasis); 86.0% (95% CI = 82.6-89.3) of children had DMFdefT ≥ 1. The presence of oral mucosal lesions was independently associated with CD4 count < 350 cells/mm(3) (POR = 2.96, 95% CI = 1.06-4.36) and poor oral hygiene (POR = 2.69, 95% CI = 1.07-6.76). CONCLUSIONS: Oral mucosal lesions still occur in HIV-infected African children despite ART, but rarely. However, dental caries were common and severe in this population, reflecting the need to include oral health in the comprehensive care of HIV.
OBJECTIVE: To estimate the prevalence of oral mucosal diseases and dental caries among HIV-infectedchildren receiving antiretroviral treatment (ART) in West Africa and to identify the factors associated with the prevalence of oral mucosal lesions. METHODS: Multicentre cross-sectional survey in five paediatric HIV clinics in Côte d'Ivoire, Mali and Sénégal. A standardised examination was performed by trained dentists on a random sample of HIV-infectedchildren aged 5-15 years receiving ART. The prevalence of oral and dental lesions and mean number of decayed, missing/extracted and filled teeth (DMFdefT) in temporary and permanent dentition were estimated with their 95% confidence interval (95% CI). We used logistic regression to explore the association between children's characteristics and the prevalence of oral mucosal lesions, expressed as prevalence odds ratio (POR). RESULTS: The median age of the 420 children (47% females) enrolled was 10.4 years [interquartile range (IQR) = 8.3-12.6]. The median duration on ART was 4.6 years (IQR = 2.6-6.2); 84 (20.0%) had CD4 count<350 cells/mm(3). A total of 35 children (8.3%; 95% CI: 6.1-11.1) exhibited 42 oral mucosal lesions (24 were candidiasis); 86.0% (95% CI = 82.6-89.3) of children had DMFdefT ≥ 1. The presence of oral mucosal lesions was independently associated with CD4 count < 350 cells/mm(3) (POR = 2.96, 95% CI = 1.06-4.36) and poor oral hygiene (POR = 2.69, 95% CI = 1.07-6.76). CONCLUSIONS:Oral mucosal lesions still occur in HIV-infected African children despite ART, but rarely. However, dental caries were common and severe in this population, reflecting the need to include oral health in the comprehensive care of HIV.
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