Tooth bud extraction and rubbing of herbs by traditional healers in Tanzania: prevalence, and sociological and environmental factors influencing the practices.

The practice by traditional healers in Tanzania of extracting tooth buds or of rubbing herbs on to the gingivae of young children to cure fevers and diarrhoea has been known for many years. The aim of this study was to determine the prevalence of these practices in different regions of Tanzania and to identify sociological and environmental factors influencing belief in their efficacy. A total of 1052 children were examined for missing primary teeth, or scars or wounds on the gingivae, resulting from tooth bud extraction. In addition, 268 parents of children who had received treatment from a traditional healer were interviewed to identify factors that led them to go to a traditional healer. The prevalence of tooth bud extraction in villages in which tooth bud extraction was first reported in the early 1980s was 0.5%, and in villages in which the practice was only recently reported it was 60%; the prevalence of rubbing herbs was 32% and 0.4%, respectively. Persistent fevers and diarrhoea were the major symptoms which led parents to go to a traditional healer. However, 60% of the parents had taken their child to a hospital before going to a healer; 72% of these had attended at least three times but only 5.5% reported that the treatment given in the hospital cured the condition. It is recommended that intensive health education on the causes, treatment and prevention of fevers and diarrhoea should be instituted, in conjunction with effective management of these conditions in hospital facilities.

Missing primary teeth due to tooth bud extraction in a remote village in Tanzania.

The practice by traditional healers of extracting tooth buds as a cure for diarrhoea and fevers in children has existed in Tanzania for many years, but its extent is not known. This paper reports on the prevalence of missing primary teeth due to this practice among children living in Manghweta, a remote village in Tanzania. All children (n = 262) aged 5 years and below were examined for missing primary teeth. Only cases in which mothers confirmed that tooth bud extraction had been performed were recorded. Tooth buds had been extracted from 37.4% of the children. The majority of extractions (60.5%) were from the lower jaw, and almost all (99.4%) were canines. Tooth bud extraction was always bilateral. It is concluded that the practice of extracting tooth buds as a cure for diarrhoea and fevers in children still exists in Tanzania.

Oral candidiasis and hairy leukoplakia correlate with HIV infection in Tanzania.

We report a detailed study on oral lesions and their association with the WHO revised provisional case definition of AIDS as well as serologic signs of HIV infection among 186 patients in Dar Es Salaam, Tanzania. The patient material consisted of 39 hospitalized suspected AIDS patients, 44 medical nonsuspected patients, 53 dental outpatients, and 50 patients with sexually transmitted diseases. The male:female ratio was 2.1:1 on average. Oral examination was done without knowledge of the HIV status of the patients. Among 39 suspected AIDS patients 97% had WHO AIDS criteria and 90% were seropositive for HIV. Among the 147 patients not suspected of having AIDS 18 (12%) had AIDS criteria and 15% had serologic evidence of HIV infection. The presence of WHO AIDS criteria correlated significantly with the presence of HIV antibodies, but not with HIV antigen. Oral lesions were found in 54% of those with AIDS criteria and 52% of HIV-infected patients, as compared to 3% and 6% of the patients without AIDS criteria and HIV infection, respectively (p less than 0.01). Among patients with AIDS atrophic candidiasis occurred in 21%, pseudomembranous candidiasis in 23%, hairy leukoplakia in 36%, herpetic stomatitis in 2%, Kaposi's sarcoma in 4%, and nonspecific ulcer in 4%. The presence of oral lesions had a high predictive value for presence of AIDS criteria as well as for presence of HIV infection in this hospital setting. All patients should have a thorough oral examination and the presence of the aforementioned oral lesions should lead to testing for HIV infection.