Prevalence of Complete Edentulism in Adults and Older Nigerian Population.

INTRODUCTION: The prevalence of complete edentulism varies from country to country and from one region to another region, and making comparisons between national data challenging because of the impact of lifestyle, socio-economic and educational factors. There is no reported national data for Nigeria. AIMS AND OBJECTIVES: The study was to determine the prevalence of complete edentulism among adult (35-44 years) and older (65-74 years) Nigerians, being part of a national oral health survey of Nigerians conducted in 2014. METHODOLOGY: The study was a cross-sectional survey of oral diseases, specifically dental caries, periodontal diseases, dental trauma, and tooth loss, among adult and older Nigerian populations using a multi-stage stratified sampling technique for all 36 states and the FCT, and clinical examination in field situations using daylight settings, with findings collected using data entry forms (WHO 1997). Ethical approvals were obtained from the FMOH, SMOH and SMLGCA. Data was analysed using SPSS-11 and nominal variables compared using chi-square. A p-value of 0.05 was considered significant. RESULTS: A total of 5,038 adults and 4,658 older Nigerians were examined, of which 4(0.08%) and 84 (1.8%), respectively had complete edentulism. Among the adults, it was reported exclusively in Northern Nigeria; whereas among the older population, 66(2.8%) and 18(0.8%) participants in Northern and Southern Nigeria respectively, were reported to be edentulous (p<0.05). 45 cases (4.7%) of edentulism in older Nigerians were reported from the North West geopolitical zone alone. Edentulism is higher in the older population than the adult population in both Northern and Southern regions (p<0.05). Socio-demographic variation was significant in the North, with a higher prevalence in the rural localities among the older population (p<0.05). CONCLUSION: The study showed that there are variations in the prevalence of edentulism in Nigeria, reflecting lower prevalence in comparison with global trends. National prevalence values did not reflect variations along geographical and socio-political divide.

INTRODUCTION: La prévalence de l'édentation complète varie d'un pays à l'autre et d'une région à l'autre, ce qui rend les comparaisons entre les données nationales difficiles en raison de l'impact des facteurs liés au mode de vie, à la situation socio- économique et à l'éducation. Il n'existe pas de données nationales pour le Nigéria. BUTS ET OBJECTIFS: L'étude visait à déterminer la prévalence de l'édentation complète chez les Nigérians adultes (35-44 ans) et plus âgés (65-74 ans), dans le cadre d'une enquête nationale sur la santé bucco-dentaire des Nigérians menée en 2014. MÉTHODOLOGIES: L'étude était une enquête transversale sur les maladies bucco-dentaires, en particulier les caries dentaires, les maladies parodontales, les traumatismes dentaires et la perte de dents, parmi les populations nigérianes adultes et âgées, en utilisant une technique d'échantillonnage stratifiée à plusieurs niveaux pour les 36 États et le FCT, et un examen clinique dans des situations de terrain utilisant des environnements de lumière du jour, avec des résultats recueillis à l'aide de formulaires de saisie de données (OMS 1997). Les autorisations éthiques ont été obtenues auprès de la FMOH, de la SMOH et de la SMLGCA. Les données ont été analysées à l'aide du logiciel SPSS -11 et les variables nominales ont été comparées à l'aide du chi-carré. Une valeur p de 0,05 a été considérée comme significative. RÉSULTATS: Au total, 5 038 adultes et 4 658 Nigérians âgés ont été examinés, dont 4 (0,08 %) et 84 (1,8 %), respectivement, souffraient d'édentation complète. Chez les adultes, l'édentation a été signalée exclusivement dans le nord du Nigeria, tandis que chez les personnes âgées, 66 (2,8 %) et 18 (0,8 %) participants du nord et du sud du Nigeria respectivement ont été déclarés édentés (p<0,05). 45 cas (4,7%) d'édentulisme chez des Nigérians âgés ont été signalés dans la seule zone géopolitique du Nord-Ouest. L'édentulisme est plus élevé dans la population âgée que dans la population adulte, tant dans les régions du Nord que du Sud (p<0,05). Les variations sociodémographiques étaient significatives dans le Nord, avec une prévalence plus élevée dans les localités rurales parmi la population âgée (p<0,05). CONCLUSION: L'étude a montré qu'il existe des variations dans la prévalence de l'édentation au Nigéria, reflétant une prévalence plus faible par rapport aux tendances mondiales. Les valeurs de prévalence nationale ne reflètent pas les variations géographiques et sociopolitiques. Mots-clés: Édentulisme, Prévalence, Adultes, Personnes âgées, Nigérians.

Dental Trauma in Adult and Elderly Nigerians: A National Survey.

BACKGROUND: Various studies on Traumatic Dental Injuries (TDI) have been carried out in different small localities and mostly among children and adolescents in Nigeria, but there has not been any national study to determine its prevalence. This national survey was carried out to understand the complexities of dental trauma epidemiology among adult and elderly Nigerians. MATERIAL AND METHODS: A national cross-sectional survey of TDI among adult and elderly Nigerians, following WHO recommendations. RESULTS: A total of 5,067 adults (35-44 years) and 4,680 elderly (65-74 years) Nigerians were examined, and the prevalence of dental trauma among the adult and elderly was 15.9 % and 22.1%, respectively. Gender comparison showed males were more affected than females in the North (p<0.05), while TDIs occurred more among females in Southern Nigeria (p<0.05). In Nigeria, Type 2 injuries were most prevalent among the adults and elderly (53.9% and 55.7%, respectively). Among the elderly, while Type 1 injuries were more common in the North, Type 2 injuries were more prevalent in Southern Nigeria (p<0.05). Types 3-10 injuries were more prevalent in the South (p<0.05). TDI 1,2 occurred more in the anterior teeth among adults (p<0.05) and in posterior teeth among the elderly, especially in Southern Nigeria (p<0.05); while TDI 3-10 affected mostly the anterior teeth in both age groups (p<0.05. CONCLUSIONS: The observed pattern of dental trauma among the adults and elderly Nigerians could reflect the diverse dietary and socio-cultural practices. Advocacy for prevention of, relevant education on, research into and improvement of access to treatments for dental trauma is recommended.

CONTEXTE: Diverses études sur les traumatismes dentaires (TDI) ont été menées dans différentes petites localités et principalement chez des enfants et des adolescents au Nigéria, mais aucune étude nationale n'a été menée pour déterminer sa prévalence. Cette enquête nationale a été menée pour comprendre les complexités de l'épidémiologie des traumatismes dentaires chez les Nigérians adultes et âgés. MATÉRIEL ET MÉTHODES: Une enquête nationale transversale sur le TDI parmi les Nigérians adultes et âgés, conformément aux recommandations de l'OMS. RÉSULTATS: Un total de 5 067 adultes (35 à 44 ans) et 4 680 personnes âgées (65 à 74 ans) Nigérians ont été examinés, et la prévalence des traumatismes dentaires chez les adultes et les personnes âgées était de 15,9% et 22,1%, respectivement. La comparaison entre les sexes a montré que les hommes étaient plus touchés que les femmes dans le Nord (p <0,05), tandis que les IDT se produisaient davantage chez les femmes du sud du Nigeria (p <0,05). Au Nigéria, les blessures de type 2 étaient les plus fréquentes chez les adultes et les personnes âgées (53,9% et 55,7%, respectivement). Chez les personnes âgées, alors que les blessures de type 1 étaient plus fréquentes dans le nord, les blessures de type 2 étaient plus fréquentes dans le sud du Nigéria (p <0,05). Les blessures de type 3 à 10 étaient plus fréquentes dans le Sud (p <0,05). Le TDI 1,2 s'est produit davantage dans les dents antérieures chez les adultes (p <0,05) et dans les dents postérieures chez les personnes âgées, en particulier dans le sud du Nigéria (p <0,05); tandis que le TDI 3-10 affectait principalement les dents antérieures dans les deux groupes d'âge (p <0,05). CONCLUSIONS: Le modèle observé de traumatisme dentaire chez les adultes et les Nigérians âgés pourrait refléter les diverses pratiques alimentaires et socioculturelles. Il est recommandé de plaider en faveur de la prévention, de l'éducation pertinente, de la recherche et de l'amélioration de l'accès aux traitements des traumatismes dentaires. MOTS CLÉS: Blessures dentaires traumatiques, types, dentaires, traumatismes, adultes, personnes âgées, Nigéria.

Discriminatory attitudes towards patients with HIV/AIDS by dental professionals in Nigeria.

AIMS AND OBJECTIVES: The study sought to investigate whether there are discriminatory practices towards HIV/AIDS patients among dental professionals in Nigeria, how receptive are dental professionals and institutions to treating People Living With Aids (PLWA), and what underlying factors if any that may contribute to any discriminatory practices. METHODS AND MATERIALS: It was a cross-sectional study conducted in one randomly selected State in each of the six geo-political zones of Nigeria. Data collection was by self administered questionnaire. The questionnaire asked about demographic information, general knowledge of HIV/AIDS, adequacy of infection control, fear of occupational exposure, attitudes towards HIV positive patients and areas of need for further training. A total of 75 dental professionals participated in the study. RESULTS: The results of the study suggest that significant number of dental professionals in Nigeria reported attitudes and behaviour towards HIV patients which are discriminatory. CONCLUSION: Further efforts should be made to promote accessibility of discrimination-free quality oral and dental care to this population.

Intra-oral carcinomas in Maiduguri, north-eastern Nigeria.

OBJECTIVE: To document the pattern of intra-oral carcinomas diagnosed in north-eastern Nigeria. DESIGN AND SETTING: A retrospective clinical and histopathological review seen in a tertiary care hospital (January 1987-December 2002). MATERIALS AND METHODS: Information on socio-demographic characteristics of patients and details of cancer management were retrieved from the files and histopathology records of cases diagnosed at the hospital. RESULTS: A total of 378 biopsies, 317 primary cancers including 279 carcinomas of the head and neck were diagnosed during the study period. Intra-oral carcinomas constitute 43 (15.4%) of all head and neck carcinomas reported, with no occurrence in children. The overall mean age of occurrence was 51.2 +/- 15.6 years (male = 56.2 +/- 13.7 years; females = 47.5 +/- 16.2 years) and an overall male-female ratio of 3:4. Carcinomas were commonly reported in the palate 19 (44.2%) and lip six (13.9%) and floor of mouth four (9.3%). Squamous cell carcinoma 28 (65.1%), adenoidcystic carcinoma seven (16.3%) and mucoepidermoid carcinoma five (11.6%) were the commonly reported carcinomas. Squamous cell carcinoma was the most common carcinoma in all sites, in the sixth decade of life, of equal gender distribution and commonly reported in users of kola nuts and tobacco. The occupation of patients diagnosed with oral carcinoma and squamous cell carcinoma was farming (50%, 61.5%). All the staged cancers patients (n = 7) reported in the late stages (III/IV) of the disease. The mean interval between symptoms and presentation for the different carcinomas ranged between 9 and 25 months, with the least interval reported for mucoepidermoid carcinoma. CONCLUSIONS: Squamous cell carcinoma was the most common oral carcinoma, commonly reported in the palate, among farmers and in the sixth decade of life. Its occurrence in under 40 year olds is three to six times greater than reported for the USA and Europe and may be associated with poor diet and the habitual use of kola nuts and tobacco. The survival rates of patients diagnosed with intra-oral carcinomas, although not available, would be expectedly low in view of the prognostic indicators recorded in this series. The routine oral cancer screening of each patient, and counselling of patients with high-risk habits, by dentists is recommended to improve the prognosis of the disease.

Salivary gland neoplasms in Maiduguri, north-eastern Nigeria.

OBJECTIVE: To document the pattern of salivary gland neoplasia in Maiduguri, Nigeria. DESIGN AND SETTING: A retrospective clinical and histopathological review (January 1987-December 2002) of cases diagnosed at a tertiary care hospital. MATERIALS AND METHODS: Information on demographics, diagnosis and cancer management in the hospital were retrieved from biopsy reports and case notes of patients. RESULTS: The palatal (71.9%) and parotid (78.3%) glands were the most common minor and major salivary glands involved, with a benign-malignant ratio of 1:1 and 1.4:1, respectively. Pleomorphic adenoma (44.3%) was the most common salivary gland neoplasm recorded. It was commonly reported in the third decade (mean 30.4 years) and among males (M:F, 1.4:1). Ectopic lesions (17.1%) were reported in the neck, nose and cervical nodes. Mucoepidermoid carcinoma (10.1%) was the most common salivary gland malignancy, occurring in the second and sixth decades; of equal gender distribution and predominantly in the palate (50%). The squamous cell carcinoma (10.9%) and adenoidcystic carcinoma (21.9%) were the most common malignancies in the major and minor glands respectively. There was a higher prevalence of malignancies of the parotid than previously reported for northern Nigeria (P = 0.036). CONCLUSION: Pleomorphic adenoma and mucoepidermoid carcinoma were the most commonly reported benign and malignant neoplasia in this series. The prevalence of mucoepidermoid carcinoma contrasts with reported findings in other African studies.

Anticlastogenic effects of Hibiscus sabdariffa fruits against sodium arsenite-induced micronuclei formation in erythrocytes in mouse bone marrow.

An in vivo micronucleus assay using albino mice was used to examine the anticlastogenic effects of a crude aqueous extract of Hibiscus sabdariffa fruits in bone marrow cells of mice. Various doses of freshly prepared crude extract of Hibiscus sabdariffa (50, 100 and 150 mg/kg b.w.) were given by gavaging to male laboratory bred Swiss albino mice for 7 days as a dietary supplement followed by a single dose of sodium arsenite (2.5 mg/kg b.w.) After 24 h, the animals were killed and bone marrow smears were prepared and stained in Giemsa. The results show that sodium arsenite effectively induced micronuclei in polychromatic erythrocytes (PCEs). Administration of a crude extract of Hibiscus sabdariffa led to a significant reduction of micronuclei in PCEs. The results also show that a combination of Hibiscus sabdariffa and sodium arsenite reduced significantly the frequencies of micronucleated PCEs induced by sodium arsenite.

Primary head and neck cancers in North Eastern Nigeria.

BACKGROUND: To document the pattern of primary head and neck cancers in North Eastern Nigeria. STUDY DESIGN: A record-based study of primary head and neck cancers histologically diagnosed at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, North Eastern Nigeria between 1987 and 2002. RESULTS: A total of 317 cases (20 cases per year) were diagnosed. The most common cancer sites were the oral cavity (15.1%) and nasopharynx (11.7%). Carcinomas (68.4 %) were the most common cancers reported, mostly affecting the oral cavity (20.3%). Carcinomas were associated with farmers, kola nut chewers and tobacco users in this region, while kaposi sarcoma was the only cancer associated with HIV-positive patients. The overall mean duration of symptoms for cancers was 29.1+/-62.2 months. The mean duration for carcinomas was longer than for sarcomas (p>0.05) and lymphomas (p= 0.05). 81 % of the staged cancers reported in the stage IV; while treated cancers required primary radiotherapy (51 %) or an adjuvant radical surgery and chemotherapy (9.4%). CONCLUSION: Intra-oral carcinomas were the most common histological types of cancers in the head and neck. The delay before and the cancer stage at presentation may be due to the lack of cancer management facilities and manpower in most of the hospitals in the region.

Traditional oral health practices among Kanuri women of Borno State, Nigeria.

A structured questionnaire was administered on 495 women (urban 339, rural 156) from two LGAs of Borno State, Nigeria, using the interviewer method. The age range of the subjects was 12 to 80 years with a mean age (+/- SD) of 35.7 +/- 13.44 years. Majority (83.5%) did not have any formal education. Oral hygiene tools used by the respondents included toothbrush/paste 36 (7.9%), chewing stick 250 (54.9%), charcoal 159 (34.9%) and ordinary water 10 (2.2%). Of those using chewing sticks; 168 (67.2%) use Salvadora persica, 36 (14.4%) use Azadirachta indica and 46 (18.4%) use Eucalyptus camaldulensis. Forty (8.1%) of the respondents do not clean their teeth at all. Strong association was found between choice of teeth cleaning material and educational level (P=0.000). Three hundred and one (60.8%) of the respondents stain their teeth with flowers of Solanum incanum or Nicotania tabacum while, 218 (44.0%) perform tattooing of lip or gingivae and of this number 213 (97.7%) performed tattooing before marriage. Tattooing is usually performed without local anaesthesia with thorns of Balanites aegyptiaca and a mixture of charcoal & seeds of Acacia nilotica var. tomentosa as pigments. It is concluded that traditional oral health practices still constitute important part of the lifestyle in the study population.

Prevalence of malnutrition using Z-scores and absolute values in children under five years of age in Utan village, Jos, Plateau State, Nigeria.

OBJECTIVE: To compare the use of Z scores and absolute measurements in determining the prevalence of malnutrition among under-five children in the Plateau State, Nigeria. DESIGN: A community based, cross sectional study of under-five children. SETTING: An urban slum, Utan village, Jos, Plateau State, Nigeria. POPULATION: The village has a projected population of 3,000 people; 15% of whom are under-fives. STUDY POPULATION: Four hundred and twenty six under-five children. MAIN OUTCOME MEASURES: Absolute measures of weight for age, weight for height and height for age; and Z scores for the same indicators. INTERVENTION: Mass chemotherapy (antihelminths) and nutrition education were carried out after the study was done in 1993. RESULTS: Based on absolute measurements, 23.7% of the children had low weight for age; 34.9% of the under-fives were stunted (height for age), while 11.1% had low weight for height. Using Z-scores, 25.3% of the under-fives were malnourished based on weight for age, 37% were stunted (height for age), while 8.7% had low weight for height. CONCLUSION: Stunting is still prevalent in the under-five children surveyed in spite of the siting of the PHC clinic which offers promotive, preventive and curative services. Small scale industry could be set up to empower the women economically so that they can provide enough food for their households. A credit/loan scheme would also be beneficial. Emphasis should be placed on growth monitoring to help the women discover when the weight of their children is faltering. The use of oral rehydration therapy against diarrhoeal diseases and immunisation against the common childhood diseases that also affect the nutritional status of the children is important. Nutrition education and family planning programmes should be effectively organised for mothers.