Association between early childhood caries and parental education and the link to the sustainable development goal 4: a scoping review.

BACKGROUND: The goal of the United Nations Sustainable Development Goal (SDG) 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The aim of this scoping review was to map the current evidence on the association between the prevalence of early childhood caries (ECC) and parental education; and to identify possible pathways by which parental education may protect against ECC. METHODS: The two questions that guided this review were: what is the existing evidence on the association between maternal and paternal education and ECC; and what are the pathways by which parental education protects against ECC? The initial search was conducted in January 2023 in PubMed, Web of Science and Scopus. Articles published in English between January 2000 and October 2022 that reported on the association between parental education and ECC were screened, and the extracted data were compiled, summarized, and synthesized. Review papers and non-primary quantitative research papers were excluded from the full-text review. Open coding was applied to develop a conceptual framework. RESULTS: In total, 49 studies were included: 42 cross-sectional, 3 case-control and 4 cohort studies. The majority (91.8%) reported on the associations between ECC and maternal (n = 33), paternal (n = 3), and parental (n = 9) level of education, and 13 (26.7%) reported on the association between parental education and the severity of ECC. Mothers with more than primary school education (n = 3), post-secondary/college/tertiary education (n = 23), and more than 4-12 years of education (n = 12) had children with lower risk for ECC. Two studies reporting on parental education found an association between maternal but not paternal education and ECC. The review suggests that achieving the SDG 4.1 may reduce the risk of ECC. Possible pathways by which maternal education protects from ECC were feeding practices, oral hygiene practices, and the use of dental services. CONCLUSION: The study findings suggests that higher maternal educational level may reduce the risk for the consumption of cariogenic diet, poor oral hygiene practices and poor use of dental services for caries prevention. However, the association between paternal education and ECC was not consistently observed, with significant associations less frequently reported compared to maternal education. Future studies are needed to define the magnitude and modifiers of the impact of maternal education on the risk for ECC.

Scoping review on the link between economic growth, decent work, and early childhood caries.

BACKGROUND: Early Childhood Caries (ECC) is a prevalent chronic non-communicable disease that affects millions of young children globally, with profound implications for their well-being and oral health. This paper explores the associations between ECC and the targets of the Sustainable Development Goal 8 (SDG 8). METHODS: The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In July 2023, a search was conducted in PubMed, Web of Science, and Scopus using tailored search terms related to economic growth, decent work sustained economic growth, higher levels of productivity and technological innovation, entrepreneurship, job creation, and efforts to eradicate forced labor, slavery, and human trafficking and ECC all of which are the targets of the SDG8. Only English language publications, and publications that were analytical in design were included. Studies that solely examined ECC prevalence without reference to SDG8 goals were excluded. RESULTS: The initial search yielded 761 articles. After removing duplicates and ineligible manuscripts, 84 were screened. However, none of the identified studies provided data on the association between decent work, economic growth-related factors, and ECC. CONCLUSIONS: This scoping review found no English publication on the associations between SDG8 and ECC despite the plausibility for this link. This data gap can hinder policymaking and resource allocation for oral health programs. Further research should explore the complex relationship between economic growth, decent work and ECC to provide additional evidence for better policy formulation and ECC control globally.

A scoping review on the links between sustainable development goal 14 and early childhood caries.

BACKGROUND: The Sustainable Development Goal (SDG) 14 addresses life below the waters, an important source of protein and contributor to global food security and economic development. Our aim was to explore possible evidence on the links between life below water and early childhood caries (ECC). METHODS: This scoping review identified articles on the link between life below water and caries according to the PRISMA-ScR guidelines. Three electronic databases (PubMed, Web of Science, and Scopus) were systematically searched in January 2023, using specific search terms. Studies written in English, with full text available, addressing life under water, focusing on dental caries in humans, with results that can be extrapolated to control ECC in children less than 6 years of age were included in the review. Descriptive statistics were used to summarize the retrieved papers and graphical presentation was used for visualization. RESULTS: There were 224 publications retrieved of which 13 studies, published between 1960 and 2022, were included in the analysis. The papers originated from Asia (7/13), North America (3/13), Europe (1/13), and 2/13 had multi-country authorship. Also, four laboratory studies extracted agents from marine products to determine their efficacy in preventing caries formation and preventing/slowing plaque formation; four letters discussed the caries prevention potential of sea salt as a source of fluoride; and two review articles about the positive effects of extracted marine products for caries prevention. Most (11/13) studies addressed target 14.1 concerned with enriching the marine environment with nutrients and minerals; two addressed target 14.4 focused on ensuring fish stocks are within biologically sustainable levels; two addressed target 14.7 aimed at increasing the economic benefits through sustainable use of marine resources such as fisheries; and one focused on target 14.5 aimed at conserving marine areas by increasing protected areas. In addition, one ecological study assessed the association between the ecosystem and ECC. CONCLUSIONS: Currently, there is little known about the impact of protection of marine and coastal ecosystem from pollution and ocean acidification on the risk of ECC. Further evidence on possible associations between life below water and ECC management is needed.

Utilization of Pneumococcal Vaccine and Penicillin Prophylaxis in Sickle Cell Disease in Three African Countries: Assessment among Healthcare Providers in SickleInAfrica.

Sickle cell disease is a genetic disease with a predisposition to infections caused by encapsulated organisms, especially Streptococcus pneumoniae. Pneumococcal vaccines and prophylactic penicillin have reduced the rate of this infection and mortality in sickle cell disease. However, implementation of these interventions is limited in Africa. The objectives of the study were to assess health care providers' behaviors with the implementation of pneumococcal vaccination and penicillin prophylaxis and to identify barriers to their use. A 25-item online questionnaire was administered through SickleinAfrica: a network of researchers, and healthcare providers, in Ghana, Nigeria, and Tanzania, working to improve health outcomes of sickle cell disease in Africa. Data was collected and managed using the Research Electronic Data Capture (REDCap), tools and data analysis was done using STATA version 13 and R statistical software. Eighty-two medical practitioners responded to the questionnaire. Only 54.0 and 48.7% of respondents indicated the availability of published guidelines on sickle cell disease management and pneumococcal vaccine use, respectively, at their facilities. The majority (54.0%) perceived that the vaccines are effective but over 20.0% were uncertain of their usefulness. All respondents from Ghana and Tanzania affirmed the availability of guidelines for penicillin prophylaxis in contrast to 44.1% in Nigeria. Eighty-five percent of respondents affirmed the need for penicillin prophylaxis but 15.0% had a contrary opinion for reasons including the rarity of isolation of Streptococcus pneumoniae in African studies, and therefore, the uncertainty of its benefit. Lack of published guidelines on the management of sickle cell disease and doubts about the necessity of prophylactic measures are potential barriers to the implementation of effective interventions.

Quantifying How Different Clinical Presentations, Levels of Severity, and Healthcare Attendance Shape the Burden of Influenza-associated Illness: A Modeling Study From South Africa.

BACKGROUND: Burden estimates of medically and nonmedically attended influenza-associated illness across syndromes and levels of severity are lacking. METHODS: We estimated the national burden of medically and nonmedically attended influenza-associated illness among individuals with different clinical presentations (all-respiratory, all-circulatory, and nonrespiratory/noncirculatory) and levels of severity (mild, fatal, and severe, nonfatal) using a combination of case-based (from laboratory-confirmed influenza surveillance) and ecological studies, as well as data from healthcare utilization surveys in South Africa during 2013-2015. In addition, we compared estimates of medically attended influenza-associated respiratory illness, obtained from case-based and ecological studies. Rates were reported per 100 000 individuals in the population. RESULTS: The estimated mean annual number of influenza-associated illness episodes was 10 737 847 (19.8% of 54 096 705 inhabitants). Of these episodes, 10 598 138 (98.7%) were mild, 128 173 (1.2%) were severe, nonfatal, and 11 536 (0.1%) were fatal. There were 2 718 140 (25.6%) mild, 56 226 (43.9%) severe, nonfatal, and 4945 (42.8%) medically attended should be after fatal episodes. Influenza-associated respiratory illness accounted for 99.2% (10 576 146) of any mild, 65.5% (83 941) of any severe, nonfatal, and 33.7% (3893) of any fatal illnesses. Ecological and case-based estimates of medically attended, influenza-associated, respiratory mild (rates: ecological, 1778.8, vs case-based, 1703.3; difference, 4.4%), severe, nonfatal (rates: ecological, 88.6, vs case-based, 75.3; difference, 15.0%), and fatal (rates: ecological, 3.8, vs case-based, 3.5; difference, 8.4%) illnesses were similar. CONCLUSIONS: There was a substantial burden of influenza-associated symptomatic illness, including severe, nonfatal and fatal illnesses, and a large proportion was nonmedically attended. Estimates, including only influenza-associated respiratory illness, substantially underestimated influenza-associated, severe, nonfatal and fatal illnesses. Ecological and case-based estimates were found to be similar for the compared categories.

The effects of the attributable fraction and the duration of symptoms on burden estimates of influenza-associated respiratory illnesses in a high HIV prevalence setting, South Africa, 2013-2015.

BACKGROUND: The attributable fraction of influenza virus detection to illness (INF-AF) and the duration of symptoms as a surveillance inclusion criterion could potentially have substantial effects on influenza disease burden estimates. METHODS: We estimated rates of influenza-associated influenza-like illness (ILI) and severe acute (SARI-10) or chronic (SCRI-10) respiratory illness (using a symptom duration cutoff of ≤10 days) among HIV-infected and HIV-uninfected patients attending 3 hospitals and 2 affiliated clinics in South Africa during 2013-2015. We calculated the unadjusted and INF-AF-adjusted rates and relative risk (RR) due to HIV infection. Rates were expressed per 100 000 population. RESULTS: The estimated mean annual unadjusted rates of influenza-associated illness were 1467.7, 50.3, and 27.4 among patients with ILI, SARI-10, and SCRI-10, respectively. After adjusting for the INF-AF, the percent reduction in the estimated rates was 8.9% (rate: 1336.9), 11.0% (rate: 44.8), and 16.3% (rate: 22.9) among patients with ILI, SARI-10, and SCRI-10, respectively. HIV-infected compared to HIV-uninfected individuals experienced a 2.3 (95% CI: 2.2-2.4)-, 9.7 (95% CI: 8.0-11.8)-, and 10.0 (95% CI: 7.9-12.7)-fold increased risk of influenza-associated illness among patients with ILI, SARI-10, and SCRI-10, respectively. Overall 34% of the estimated influenza-associated hospitalizations had symptom duration of >10 days; 8% and 44% among individuals aged <5 and ≥5 years, respectively. CONCLUSION: The marginal differences between unadjusted and INF-AF-adjusted rates are unlikely to affect policies on prioritization of interventions. HIV-infected individuals experienced an increased risk of influenza-associated illness and may benefit more from annual influenza immunization. The use of a symptom duration cutoff of ≤10 days may underestimate influenza-associated disease burden, especially in older individuals.