Objectives 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 factors associated with the prevalence of oral mucosal lesions. Methods Multi-center cross-sectional survey in 5 pediatric HIV clinics in Côte d’Ivoire, Mali and Sénégal. A standardized examination was performed by trained dentists on a random sample of HIV-infected children aged 5 to 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/mm3. 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/mm3 (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.

BackgroundWorldwide, female sex workers (FSW) represent a vulnerable population for oral diseases due to many risk factors including HIV infection and drug abuse. In sub-Saharan Africa, little is known about the burden of oral diseases and their determinants in vulnerable populations. The aim of the study was to estimate the prevalence and associated factors of oral diseases among FSW.MethodsA cross sectional study was conducted among FSW who attended a dedicated non-profit clinic in Abidjan, Côte d’Ivoire from June to August 2013. Data about the presence of dental caries, periodontitis and oral-mucosal lesions were collected by a dentist during an oral examination. Behavioural information related to oral hygiene habits as well as tobacco and alcohol consumption were collected through a standardized questionnaire. Information related to HIV infection including HIV diagnosis, last known CD4 count and antiretroviral therapy were documented through a medical chart review. Logistic regression models were used to identify factors associated with oral diseases.ResultsA total of 249 FSW with a median age of 29 years, [Inter Quartile Range (IQR) = 23–36] and a median duration of sex work of 24 months [IQR 9–60]) were included. Current tobacco use and hazardous alcohol use were reported in 21.7 % and 19.7 % of FSW, respectively. The estimated prevalence of HIV infection was 33.7 % [95 % confidence interval (CI); 27.8 – 39.6]) and 82.1 % of HIV-infected FSW were on antiretroviral therapy . The prevalence of dental caries, periodontitis and oral-mucosal lesions were 62.3 % [95 % CI 55.5 – 67.5], 14.5 % [95 % CI 10.2 – 18.9] and 8.2 % [95 % CI 4.8 – 11.5], respectively. In multivariate analysis, periodontitis, oral-mucosal lesions and HIV infection were associated with odds ratio of 2.6 [95 % CI, 1.2–5.8]) and 50.0 [95 % CI; 6.4–384.6].ConclusionsThis study showed a high prevalence of oral diseases among FSW in Abidjan. HIV infection was common and significantly associated with periodontal diseases and oral-mucosal lesions. There is a need to integrate regular screening and treatment of oral lesions into the medical follow-up of FSW along with strategies for HIV prevention.Electronic supplementary materialThe online version of this article (doi:10.1186/s12903-015-0129-0) contains supplementary material, which is available to authorized users.

Although preventable, the burden of dental disease was high in children from families affected by HIV in West Africa and was associated with HIV infection and immunosuppression.

The impact of antiretroviral therapy in HIV-infected children has raised novel challenging questions in the field of oral health warranting future research.

Setting Drug resistance threatens tuberculosis (TB) control, particularly among HIV-infected persons. Objective We surveyed antiretroviral therapy (ART) programs from lower-income countries on prevention and management of drug-resistant TB. Design We used online questionnaires to collect program-level data in 47 ART programs in Southern Africa (14), East Africa (8), West Africa (7), Central Africa (5), Latin America (7) and Asia-Pacific (6 programs) in 2012. Patient-level data were collected on 1,002 adult TB patients seen at 40 of the participating ART programs. Results Phenotypic drug susceptibility testing was available at 36 (77%) ART programs, but only used for 22% of all TB patients. Molecular drug resistance testing was available at 33 (70%) programs and used for 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the whole treatment, 16 (34%) during intensive phase only and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line TB regimens; 18 (38%) reported TB drug shortages. Conclusions Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower income countries. DOT was not always implemented and drug supply was regularly interrupted, which may contribute to the global emergence of drug resistance.

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Introduction: Although there are evidence-based associations between oral health status and adverse pregnancy outcomes, oral health screening is not systematically included in antenatal consultations in Côte d'Ivoire. Furthermore, there are no oral health promotion activities specifically targeting pregnant women. Objective: Assessing the oral status of pregnant women in Côte d'Ivoire. Methods: A cross-sectional survey was conducted at the maternal and child health service of the National Institute of Public Health in Abidjan. Data collected were: demographic information, education level, income category, stage of pregnancy, oral hygiene and dietary habits and oral health information received. Clinical examination was performed to assess: oral hygiene practices (OHI-S index), periodontal status (CPI Index), recording dental status by DMFT index (Decayed, Missing and Filled Teeth), and the frequencies of epulis, dental erosion or tooth mobility. Absolute and relative frequencies were calculated for the different variables of the study. Results: Overall, 207 pregnant women were included in the study and assessed for their overall oral health status. The age range was 15 -44 years and 14.0% of the women were under 19 years. Most of them were: in a couple (76.8%); multi-gestational (77.3%); and more than half had no school education (52.2%), and had very low income status (56.0%); 50.7% were snacking between meals and 33.3% had emesis during pregnancy. They were cleaning their teeth at least twice a day (70.0%) and had not modified their oral hygiene practices (77.3%). Only 3.4% had received knowledge about oral health during pregnancy. The estimated prevalence of the oral diseases was: dental caries 75.4%; dental erosions 13.0%; gingivitis 57.0%; periodontitis 6.8%; and epulis 3.4%. Conclusion: The results suggest the relevance of integrating a systematic oral examination into antenatal consultations, to raise awareness among pregnant women and to screen and manage their oral health conditions.

Introduction several adverse pregnancy outcomes have been reported in gestations with associated hypothyroidism. The prevalence of hypothyroidism has not been frequently reported in Black Africans. This study sorts to report the prevalence and associated factors of hypothyroidism in Black African pregnant women. Methods this was a hospital-based cross-sectional study, including all pregnant women attending the gynecologic unit of Bouget General Hospital Abidjan. Serum thyroid-stimulating hormone and T4 were obtained from all participants and analyzed using a fluorescent Immunochemistry assay. Data were analyzed using R version 4.05. Univariable and multivariable logistic regression was used to assess factors associated with hypothyroidism and statistical significance considered as p < 0.05. Results overall there were 693 participants, mean age of 28.1(SD 6.4) years with an average gestational age of 24.1 (SD 8) weeks, and a majority of study participants were in the second trimester of gestation. The prevalence of hypothyroidism was 12.1% (n = 84) (10.8% subclinical hypothyroidism and 1.3% clinical hypothyroidism) whereas 1.9% (n = 13) had hyperthyroidism. In addition, patients with reported type 1 diabetes mellitus had an increased risk of hypothyroidism (aOR: 12.6, 95% CI 1.9-100.8; p ≤ 0.01). Conclusion this study revealed a high prevalence of hypothyroidism, though mostly in the subclinical form. Further research is warranted to confirm these findings which may have implications on early screening of hypothyroidism in black African women.