Knowledge, attitudes and practices of oral health care workers in Lesotho regarding the management of patients with oral manifestations of HIV/AIDS.

Lesotho has the third highest prevalence of HIV in the world with an estimated 23% of the adult population infected. At least 70% of people living with HIV/AIDS (PLWHA) have presented with oral manifestation of HIV as the first sign of the disease. Oral health workers regularly encounter patients presenting with oral lesions associated with HIV disease and therefore need to have adequate knowledge of these conditions for diagnosis and management. The aim of the present study was to determine the knowledge, attitudes and practices of oral health care workers (OHCW) of Lesotho regarding the management of oral manifestations of HIV/AIDS. A descriptive cross-sectional survey was conducted on all 46 OHCW in 26 public and private care facilities in all ten districts of Lesotho. A self-administered questionnaire was used to gather information. The response rate was 100%. Nearly all (94.7%) agreed that oral lesions are common in people living with HIV and/or AIDS. The majority (91.3%) named oral candidiasis (OC) as the most common lesion found in PLWHA while Kaposi's Sarcoma (KS) (34.7%) and Oral Hairy Leukoplakia (OHL) (32.6%) were mentioned as the least common oral lesions of HIV. Most correctly identified the images of oral candidiasis (97.8%), angular cheilitis (86.9%) and herpes zoster (80.4%). Only 16.7% felt they had comprehensive knowledge of oral HIV lesions, although 84.8% reported having previously received training. Almost three quarters (71%) reported that there was no need to treat HIV positive patients differently from HIV negative patients. OHCW in Lesotho demonstrated high confidence levels in their competence in managing dental patients with oral lesions associated with HIV, however, they lacked an in-depth knowledge in this regard. Amongst this group there is a need for comprehensive training with regards to diagnosis and management of oral lesions of HIV including the training of other cadres of health care workers together with nurses and community health workers.

Oral hygiene in stroke survivors undergoing rehabilitation: does upper extremity motor function matters?

Background: Traditionally, stroke rehabilitation outcomes are based on indicators of physical function, such measures may underrate the all-inclusive impact of stroke such as oral health.Objectives: To investigate the relationship between upper extremity motor function and oral hygiene status as well as the impact of stroke on Oral Health-Related Quality of Life (OHRQoL).Methods: Sixty stroke survivors were included in this cross-sectional survey. Spasticity and motor function/mobility of the affected upper extremity were assessed using the Modified Ashworth Scale and Action Research Arm Test, respectively. Oral hygiene was assessed using the Simplified Oral Hygiene Index and oral health impact was assessed using the 14-item Oral Health Impact Profile. Pearson's moment correlation coefficient was used to determine the relationship between oral hygiene and upper extremity motor function variables.Results: There were significant relationships between the oral hygiene index and Shoulder muscles spasticity (r = 0.374, p = .01), wrist muscles spasticity (r = 0.352, p = .01), as well as basic mobility (r = 0.423, p = .01). An estimated 8% (n = 5) of study participants have their QoL strongly impacted by their oral health.Conclusions: Upper extremity motor function variables such as spasticity and basic mobility matters in determining oral hygiene status after stroke. Stroke has little impact on oral health-related quality of life.