Prevalence, correlates and treatment needs of dental caries among people on antiretroviral therapy in Uganda: a cross sectional study

Wilfred Arubaku; Godfrey Kwizera; Deusdedit Tusubira; Michael Kanyesigye; Steffany Chamut; Brittany Anne Seymour; Mark J Siedner; Vallence Niyonzima; Josephine N Najjuma; Samuel Maling

doi:10.1186/s12903-022-02256-5

Prevalence, correlates and treatment needs of dental caries among people on antiretroviral therapy in Uganda: a cross sectional study

BMC Oral Health. 2022 Jun 10;22(1):231. doi: 10.1186/s12903-022-02256-5.

Authors

Affiliations

¹ Department of Dental Surgery, Mbarara University of Science and Technology, Mbarara, Uganda.
² Department of Biochemistry, Mbarara University of Science and Technology, Mbarara, Uganda.
³ Mbarara Regional Referral Hospital, Mbarara, Uganda.
⁴ Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, USA.
⁵ Department of Medicine, Massachusetts General Hospital, Boston, USA.
⁶ Department of Medicine, Harvard Medical School, Boston, USA.
⁷ Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
⁸ Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda.
⁹ Department of Psychiatry, Mbarara University of Science and Technology, P O Box 1410, Mbarara, Uganda. sammaling@must.ac.ug.

Abstract

Background: Oral diseases are estimated to affect half of people living with HIV in the western world, and are often marked by pain, discomfort, disfigurement and reduced quality of life. Both HIV-specific and antiretroviral therapy-associated oral diseases have been found in this population. However, the prevalence, correlates and treatment needs of dental caries among people on antiretroviral therapy has not been well studied in rural Africa where majority of people living with HIV reside. Moreover, health behaviors and access to dental care vary significantly from high-income countries in the global north.

Methods: A cross-sectional study was conducted among people living with HIV attending a high-volume HIV clinic with an enrollment of 10,000 patients in a regional referral hospital in Southwestern Uganda. The clinic is located in an urban setting with a large rural catchment area. Oral health data was collected using the modified World Health Organization oral health questionnaire for adults. Dental examinations were conducted to identify and classify dental caries using the decayed, missing, filled, teeth (DMFT) index and compute the treatment need. Logistic regression models were employed to identify correlate of dental caries.

Results: A total of 194 participants were included in the study. The majority were female (124/194, 63.9%) with a median age of 42 years (IQR 36-49). The prevalence of dental caries experience among study participants was 67%, (130/194, 95% CI 60-75%). The mean DMFT index score was 4 (IQR 2-6) and treatment need was 96% (192/200). A higher CD4 count was associated with the presence of dental caries (OR 0.403, 95% CI 0.175-0.932) although it was not significant in multivariate analysis.

Conclusion: There is a high prevalence of dental caries among people living with HIV on ART in Uganda. Our data demonstrate a high oral treatment need among this population. We recommend inclusion of preventive and therapeutic oral care into HIV care in this region.

Keywords: Antiretroviral therapy; Dental caries; HIV; Oral diseases.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cross-Sectional Studies
DMF Index
Dental Caries* / complications
Dental Caries* / epidemiology
Female
HIV Infections* / complications
HIV Infections* / drug therapy
HIV Infections* / epidemiology
Humans
Male
Middle Aged
Mouth Diseases* / epidemiology
Oral Health
Prevalence
Quality of Life
Uganda / epidemiology