Malocclusion and orthodontic treatment need among 12-15-year-old children in nairobi

Objective: To describe the pattern of occurrence of malocclusion and orthodontic treatment need.Design: A descriptive cross-sectional survey.Setting: Six public primary schools in Nairobi, Kenya.Subjects: A randomly selected sample of 1382 children aged 12 to 15 years. Clinical examination for malocclusion was conducted using the Dental Aesthetic Index (DAI). Orthodontic treatment need was derived using the regression equation stated in the DAI.Results: Among the 1382 (672 males and 710 females) children examined, 70 children (5.1%) had missing teeth. Crowding and spacing in the incisal segments occurred in 652 (47.2%) and 644 (46.6%) children respectively. Anterior irregularities were found in 533 (38.6%) of the subjects in the maxilla and 430 (31.1%) in the mandible. Anterior crossbite was found in 86 (6.2%) of the children. The anterior open-bite occurred in 194 (14%) of the children with significantly more open-bite in females than males (p=0007). The maxillary median diastema and antero-posterior molar relation discrepancies were found in 289 (20.2%) and 344 (24.9%) of the sample respectively. The sample mean DAI score was 26.6 (SD 7.8). Seven hundred and thirty two (53.0%) of the children examined had either no need or slight need for treatment whereas 650 (47%) were found with orthodontic treatment needs ranging from elective 318 (23%), highly desireable 176 (12.7%) to mandatory 156 (11.3%).Conclusion: There was an overall high prevalence of malocclusion with 11.3% of the sample exhibiting handicapping malocclusion. Notably, there were no significant gender differences for most of the traits except for anterior open-bite which was found to occur more in females than males

Traumatic dental injuries to permanent anterior teeth in 12 - 15 year old children in Nairobi

Objective: To determine the prevalence and pattern of occurrence of traumatic injuries to permanent anterior teeth.Design: A descriptive cross-sectional survey.Setting: Public primary schools in the City of Nairobi.Subjects: A sample of 1382 children (672 males and 710 females) were interviewed and examined.Results: Among the 1382 children examined, 222(16.1%) had experienced traumatic dental injuries (TDIs). Males had experienced a significantly higher prevalence of trauma 126(18.8%) than females 96(13.5%) p=0.008. Falls were the leading cause of TDIs as reported by 78(35.1%) children. Amongst the, male children, falls were the leading cause of traumatic injuries to the permanent anterior teeth 47(37.3%). Approximately half 43(44.8%) of the females did not remember the cause of injury while 31 (36.5%) had sustained TDIs due to falls. One hundred and seventy two (77.5%) children who had experienced TDIs had no symptoms associated with the traumatised teeth. Ninety six (43.2%) of the children were injured while in the home environment. The maxillary central incisors were the most commonly traumatised teeth accounting for 220(73.5%) out of 299 injured teeth. The most frequently observed type of dental trauma was enamel fracture 206(68.9%) followed by enamel-dentin fracture 71(23.8%). Two hundred (90%) children had not sought treatment for TDIs.Conclusion: Overall traumatised permanent incisors were found to occur fairly frequently with males having experienced significantly more TDIs than females. The prevalence of TDIs was 16.1%; enamel fractures were the most frequently observed injury and falls were the leading cause of trauma

Capacity of non-tertiary Kenyan health facilities selected for decentralised dental training

Objective: To determine the capacity of six non-tertiary Kenyan hospitals enrolled as sites for decentralised dental education.Design: A descriptive cross-sectional study.Setting: The Dental departments of six non-tertiary Kenyan health facilities.Main outcome measures: Capacity of the hospitals to be used as sites for decentralised dental education.Results: Five out of the six facilities had capacity for final year undergraduate students to gain learning experiences in more than 60% of the clinical disciplines studied. All the selected facilities had challenges of lack of specialists, broken down dental equipment and inadequate materials.Conclusion: Although the six hospitals faced various challenges in maintenance of equipment, availability of dental materials and specialist staff, five out of the six facilities had the capacity for dental student learning in more than 60% of the clinical disciplines studied

Antibody responses to crude gametocyte extract predict plasmodium falciparum gametocyte carriage in Kenya

Background: Malaria caused by Plasmodium falciparum remains a serious global public health challenge especially in Africa. Interventions that aim to reduce malaria transmission by targeting the gametocyte reservoir are key to malaria elimination and/or eradication. However, factors that are associated with gametocyte carriage have not been fully explored. Consequently, identifying predictors of the infectious reservoir is fundamental in the elimination campaign. Methods: We cultured P. falciparum NF54 gametocytes (to stage V) and prepared crude gametocyte extract. Samples from a total of 687 participants (aged 6 months to 67 years) representing two cross-sectional study cohorts in Kilifi, Kenya were used to assess IgG antibody responses by ELISA. We also analyzed IgG antibody responses to the blood-stage antigen AMA1 as a marker of asexual parasite exposure. Gametocytemia and asexual parasitemia data quantified by microscopy and molecular detection (QT-NASBA) were used to determine the relationship with antibody responses, season, age, and transmission setting. Multivariable logistic regression models were used to study the association between antibody responses and gametocyte carriage. The predictive power of the models was tested using the receiver operating characteristic (ROC) curve. Results: Multivariable logistic regression analysis showed that IgG antibody response to crude gametocyte extract predicted both microscopic (OR=1.81 95% CI: 1.06-3.07, p=0.028) and molecular (OR=1.91, 95% CI: 1.11-3.29, p=0.019) P. falciparum gametocyte carriage. Antibody responses to AMA1 were also associated with both microscopic (OR=1.61 95% CI: 1.08-2.42, p=0.020) and molecular (OR=3.73 95% CI: 2.03-6.74, p&lt;0.001) gametocytemia. ROC analysis showed that molecular (AUC=0.897, 95% CI: 0.868-0.926) and microscopic (AUC=0.812, 95% CI: 0.758-0.865) multivariable models adjusted for gametocyte extract showed very high predictive power. Molecular (AUC=0.917, 95% CI: 0.891-0.943) and microscopic (AUC=0.806, 95% CI: 0.755-0.858) multivariable models adjusted for AMA1 were equally highly predictive. Conclusion: In our study, it appears that IgG responses to crude gametocyte extract are not an independent predictor of gametocyte carriage after adjusting for AMA1 responses but may predict gametocyte carriage as a proxy marker of exposure to parasites. Serological responses to AMA1 or to gametocyte extract may facilitate identification of individuals within populations who contribute to malaria transmission and support implementation of transmission-blocking interventions.</p