Stroke and periodontal disease in Senegal: case-control study.

OBJECTIVE: To determine the periodontal factors associated with stroke in melanodermic subjects in Senegal. STUDY DESIGN: Case-control study. METHODS: One hundred and twenty cases and 120 controls were included in this study. Cases had been diagnosed with stroke by a neurologist, with the diagnosis confirmed by scanner. Controls had never had any type of stroke. Data were collected regarding sociodemographic characteristics, lifestyle behaviours, general history, type of stroke (ischaemic or haemorrhagic) and periodontal parameters [plaque index, papillary bleeding index, pocket depth, clinical attachment loss, Community Periodontal Index of Treatment Needs and periodontitis (defined by clinical attachment loss >2 mm and pocket depth >3 mm)]. Logistic regression analysis was performed using R software to isolate a final model after adjustment for the 5% threshold. RESULTS: All periodontal characteristics were more common among cases than among controls. Periodontitis (odds ratio 1.58, 95% confidence interval 1.1-3.022) and periodontal parameters were significantly associated with stroke, adjusted for hypertension, sedentary lifestyle, and the interaction between periodontitis and age. CONCLUSIONS: Periodontal disease is associated with stroke in the Senegalese population. Prospective longitudinal studies should be undertaken to improve understanding.

[Dental health status of 15 year-old schoolchildren in Comoros]. / Etat de santé dentaire des élèves de 15 ans aux Comores.

The epidemiological situation of decay evolves differently in the world. In industrialized countries, prevalence has declined significantly due to preventive measures, while in developing countries many studies have shown that caries was increasing. The aim of this study was to assess the state of dental health of schoolchildren aged 15 in Grand Comore (Comoros). This was a descriptive cross-sectional study on 15 year-old schoolchildren in colleges in Grande Comore who agreed to be examined. Four hundred schoolchildren were chosen by a stratified sampling weighted according to the area of living. Three groups of indicators of dental caries were used: the components D, M and F, the average DMFT and prevalence. The WHO modified questionnaire for the assessment of dental health was used to collect data; continuous data were compared by Student t test and qualitative ones by Chi-square test. Fifty two percent of schoolchildren were male and 63.5% lived in urban area. From the 888 teeth bearing the stigmata of decay, 83.2% were decayed, 12.5% missed and 4.3% filled. These components of DMF were associated with sex (p = 0.039) and not with area (p = 0.12). The 2.22 DMFT average was not associated with sex (p = 0.58) neither with area (p = 0.57). The caries prevalence was higher in rural than in urban areas (p = 0.001) and was not associated with sex (p = 0.61). These results suggest that schoolchildren need decay treatments. The dental programs will have much more success when they will be integrated into more comprehensive programs to promote schoolchildren health.

Prevalence of necrotizing ulcerative gingivitis and associated factors in Koranic boarding schools in Senegal.

BACKGROUND: Necrotizing ulcerative gingivitis is the most common clinical syndrome preceding noma. It is found in developing countries and in malnourished children and especially in deprived groups such as children at Koranic boarding schools. The objective of this study was to determine the prevalence of necrotizing ulcerative gingivitis and factors associated with its occurrence in a boarding school population. METHODS: This was a cross-sectional study of children in Koranic boarding schools in the city of Touba, Senegal. A multistage sampling strategy was used and 8 out of 17 schools were selected. The variables collected were gender, age, oral hygiene habits, duration of residence, presence of ulcerative gingivitis and plaque, and gingival bleeding index. A logistic regression analysis with R software using the manual procedure down was used to identify factors associated with the dependent variables. RESULTS: There were 501 participants and boys made up 92% of the study group. The mean age was 9.3 (sd 4.0) years. The mean of duration residence was 3.4 (sd 1.5) years. The prevalence of necrotizing ulcerative gingivitis was 37% and 81% of children did not use a toothbrush or a chewing-stick. The length of residence, school size, hygiene habits and plaque and bleeding indices were significantly associated with necrotizing gingivitis after adjustment for other variables. CONCLUSION: It is necessary to develop oral hygiene programs, to establish policies to manage the oral health of children and to improve health and nutrition at Koranic boarding-schools.

[Pregnant women living in areas of endemic fluorosis in Senegal and low birthweight newborns: case-control study]. / Femme enceinte vivant en zone de fluorose endémique au Sénégal et faible poids du nouveau-né à la naissance : étude cas-témoins.

BACKGROUND: In developing countries, maternal and neonatal mortality is high. Among the causes of death during the neonatal period, low birth weight is crucial. A dose of fluoride beyond 2mg/L causes enamel damage, possibly affecting the fetus. The aim of this study was to search for an association between dental fluorosis in the mother and low birthweight of the newborn. METHODOLOGY: This was a case-control study performed in an endemic area in Senegal (Diourbel). It included 108 mothers who gave birth to newborns weighing less than 2500 g (cases) and 216 mothers with newborns weighing greater or equal to 2500 g (controls). Data on socio-demographic, lifestyle, history and pregnancy variables were collected. Those related to water consumption during pregnancy and dental fluorosis (Dean's index) were measured. The data were analyzed by R software. Logistic regression was used to identify associations and the statistical significance level was set to 0.05. RESULTS: The proportions of mothers consuming well water were 62% among cases versus 43.5% among controls. The score 4 of Dean's Index was reported for 25.9% of cases versus 6.9% of controls. The water consumed and the modal score of Dean's Index were significantly associated with the occurrence of low birthweight adjusted for gender, consanguinity, anemia and hypertension. CONCLUSION: Low birthweight was associated with pregnant women living in endemic areas. Defluoridation programs and access for pregnant women and children to high quality water are necessary in areas of endemic fluorosis.

[Evaluation of preventive care in the dentistry department clinics of the University Cheikh Anta Diop in Dakar]. / Evaluation des actes de prévention dans les cliniques du département d'odontologie de l'Université Cheikh Anta Diop de Dakar.

This was a cross-sectional study of 295 patients treated by dentistry students that aimed to evaluate the preventive care received by patients attending clinics of the dentistry department of the University Cheikh Anta Diop in Dakar. The sociodemographic characteristics of the patients, clinic specialty, patients' brushing technique and the other preventive care was recorded. The study sample comprised 48.5% men and 76.6% adults. Over 32% of the patients were from the conservative dentistry clinic. For 52.2% of the patients, no preventive action was provided. The use of visual aids when teaching oral hygen ne was observed for 17.4% of cases. Attitudes and practices of the dentistry students in relation to care require more vigilance and emphasis on prevention.

[Medicinal plants in Senegal and oral diseases: use and interest]. / Plantes médicinales au Sénégal et affections bucco-dentaires: utilisation et intérêt.

The end of the last century and the present decade is characterized by an evolution of the concept of health and illness in the public domain. The World Health Organization defines traditional medicine as "comprising various practices, approaches, knowledge and beliefs incorporating medicinal herbal, animal and/or mineral, spiritual therapies, applied alone or in combination to maintain well-being and to treat, diagnose or prevent disease. In dentistry, the plants used are numerous. The objective of this work is to describe the herbal medicine used against oral diseases. To conduct this study, 10 articles and theses, a brief, 2 books, 4 reports and 2 clippings on traditional medicine/herbal medicine were consulted. Several African plants, in the form of use, can help relieve or treat dental pain and have positive effects against dental caries and periodontal diseases. The geographic and financial accessibility associated with the lack of qualified personnel are the plants could be an alternative in the management of certain oral diseases.

[Oral benefits for the elderly: results of a one-year implementation of the "Sesame" plan in Senegal]. / Prestations bucco-dentaires chez les personnes âgées: bilan d'une année d'application du plan "Sésame" au Sénégal.

Among the 650,000 persons aged 60 and over in Senegal, only 30% were receiving social security coverage, divided between the Senegalese Retirement Providence Institute and the National Retirement Fund. To fill the social demand, the government has put in place since 1 September 2006 a plan called "Sesame" which gives people aged 60 and older, free access to certain health services provided in public health. The implementation of this plan creates a lot of comments in the health community. The objectives of this study were to describe the dental benefits offered and to identify the difficulties perceived and experienced by the service provider after one year the "sesame" plan was implemented in Ouakam Health Center dental office, benchmark place of Gerontology in the Dakar North health district in Senegal. The study included two components: quantitative and qualitative terms, respectively, consisting of a retrospective study from sheets review and an interview with the health center service provider. The beneficiaries were a total of 42, mean age 68 years, including 66.7% men. Just over a third (35.7%) resided outside Ouakam. Almost 4/5 of the beneficiaries have suffered dental extractions on 1 to 10 teeth per beneficiary. The proportions of people receiving dentine treatment and curetage were respectively 4.8% and 2.4%. Qualitative data showed that the implementation of the plan was not shared between providers and beneficiaries. The "Sesame" plan is a commendable initiative to encourage and improve.

[Dental caries in the carceral middle of Dakar]. / La carie dentaire en milieu carcéral dakarois.

Oral diseases, mainly tooth decay and periodontal disease, are among the most common conditions in the world. The tooth decay is very prevalent in developing countries and particularly in disadvantaged backgrounds where insecurity and its corollaries prevail. Thus, our study focused on one of these places: the prisons, characterized by deprivation of liberty, monotony, boredom, and the difficult conditions of detention, brief by a total dependence of the detainee. The aim of this study was to determine the DMFT (Decayed, Missing, Filled Teeth) in detainees dwelling in prisons in Dakar. This cross sectional study included 754 detainees aged 18 years and more with a stay exceeding more than a year, in one of the four main prisons of the capital city, Dakar. The majority of detainees was males (90%), aged between 18 and 35 years (63%) and was staying at "Camp penal" (65%). The proportion of inmates with at least one tooth cavity was 81.3%, those with teeth sealed was 26.1% and the prisoners with missing teeth reached 70.6%. The highest average DMFT was noted at "Camp penal" (7.3) among men (6.5) and among inmates aged 36 to 45 years (6.1) with a significant difference. The tooth decay is particularly worrying in the prison population, hence the urgency to establish a programme of prevention and care of oral diseases in this environment.

[Evaluation of the need for periodontal treatment in prisons near Dakar, Senegal]. / Evaluation des besoins de traitements parodontaux chez les détenus de la région de Dakar (Sénegal).

INTRODUCTION: Oral diseases qualify as major public health problems due to their high prevalence and incidence. They usually affect poor and marginal segments of the population. This study focused on the prison population that is characterized by poor living conditions and malnutrition. The aim of study was to assess the need for periodontal care in prisoners serving time in the Dakar region of Senegal. METHODS: This cross-sectional study included 375 prisoners serving in three facilities, i.e. the penal camp, Liberte VI prison for women, and Rufisque prison for women. Data were collected using a modified WHO information sheet. The community periodontal index of treatment needs (CPITN) was used for scoring. Statistical analysis with stratification by sex and age was performed and tests were considered as significant for p < or = 0.05. RESULTS: There were 335 men (89.3%) and 40 women (10.7%) with a sex ratio of 8.3. Mean age was 35 years +/- 11.5 (range, 16-88). Mean prison time was 39.29 months +/- 17.73. The proportion of prisoners needing periodontal treatment increased gradually according to prison time with significant differences (p < 0.05) even after stratification. CONCLUSION: Better management taking into account the environment and prison time would reduce the need for periodontal treatment in prisons in Dakar.

[Status of dental caries in the toddlers' residences of the Dakar area, Senegal]. / Situation de la carie dentaire dans les cases des tout-petits de la région de Dakar-Senegal.

Ranked 4th global scourge behind cancer, cardiovascular diseases and AIDS, tooth decay is an infectious post eruptive disease, which remains worrying. In children, it involves eating, sleeping and behaviour disorders. Thus, we conducted a descriptive cross-sectional study, on children in toddler's small dwelling of Dakar area. The objective was to determine the prevalence of tooth decay among children of three toddler's small dwelling functional in Dakar. The majority of children was female (57%) and they were more children aged 61 to 73 months in the toddler's small dwelling of Sahm notary located in the suburbs. The prevalence of tooth decay was important for girls in the age group 49 to 60 months and in Toddler's small dwelling located in popular or suburban areas: 78% to Colobane, 68% Sahm notary, with a significant difference. The DFT (decayed, filled teeth) was lowest in Mermoz (residential area). Efforts to improve the oral health must be strengthened by good prevention policy involving people playing a role in educating and guiding children: parents, teachers, organizations, practitioners.

[Conditions of dental extractions in areas health centers of Senegal]. / Etude des conditions de l'extraction dentaire dans les centres de santé des districts du Sénégal.

Dental extraction is a surgical act frequently carried out in the African dental structures. It requires the rigorous respect of the conditions of asepsis and antisepsis. Equipments and anaesthetic and avulsional products must be also sufficient. Our study undertaken among 46 dental services in areas health centers of Senegal aimed to determine the conditions under which dental extractions are carried out. The principle results of our study showed that 93% of dental practitioners wore sterilized gloves. 49% of the dentist's care activity consisted in dental extractions. 50% of the practitioners re-use anaesthetic needles, 2% re-use anaesthetic carpules. We noticed that the dental structures were facing a deficit of materials and products of extraction. Face to the outbreak of serious illnesses as infections of HIV and Hepatitis B, the practitioner and his team must be sensitized and trained to struggle against the transmissible infections and to carry out the dental extraction only if the conditions of asepsis and antisepsis are joined together. A pleading towards the medical authorities must be done to support the services in equipments and periodic renewals of the materials and products of extractions.

[Prevalence of oro-dental injuries in wrestling in Senegal]. / Prévalence des traumatismes bucco-dentaires dans la lutte avec frappe au Sénégal.

Wrestling is a sport that is deeply-rooted in Senegalese cultural values. It is a popular sport that comes from local traditions but that has been influenced by boxing. This influence has made wrestling evolve to include the practice of boxing without gloves. Howeve, this practice causes many traumas in the mouth and teeth. The general objective of this study is to determine the frequency of the traumas among wrestlers who practice this form of wrestling associated with boxing. The specific objectives are to appreciate the bucco-dental conditions of the wrestlers, to evaluate the frequency and nature of the traumas in the intention to make recommendations and offer perspectives. 63.2% of wrestlers have at least presented a buckle or dental trauma. 28.8% of bucco-dental traumas occur among young wrestlers between 25 and 30 years and, 22.4% relate to the group between 19 and 24 years. 24.8% of bucco-dental traumas occur among wrestlers of the first category, followed by these of the second category with 21.6%, the fourth category with the lowest rate, 4% being last. It has been noted that 60% of buck-dental traumas occur in championship matches. 77.2% of dental and bucco traumas affect the upper jaw while. 22.8% affect the lower jaw. Affect teeth are often the group incisivo-canin. The National committee for the Management of wrestling in Senegal should make mandation the wearing of adapted gloves to attenuate the impact of blows. The Committee could also ban the inclusion of boxing practices in traditional wrestling and make compulsory the wearing of teeth protect in devices to minimize cases of bucco-dental traumas.

[Epidemiologic study of dental caries among students on the campus of the University of Dakar]. / Etude epidémiologique de la carie dentaire chez les étudiants du Centre des Oeuvres Universitaires de Dakar (COUD).

To assess needs of treatment and determine the prevalence of dental decay among students who lived officially in halls of residence in Dakar, a cross-sectional survey from a two-staged sampling was conducted. The following results were obtained: Three hundred and thirty students (78%) had at least one dental decay and among whom 72% presented teeth to fill and 28% teeth to pull out. One hundred and thirty students (32.5%) had at least one missing tooth and one hundred and nineteen students (29.75%) had at least one filled tooth. The average DMF was 3.52. One hundred eighty eight (47%) have needed denture. These relatively high indicators provided with schooling area suggest not only the necessity of improving the existing dental services, but the management of performing prevention programme from Elementary school until University.

48 weeks pegylated interferon alpha-2a is superior to 24 weeks of pegylated interferon alpha-2b in achieving hepatitis B e antigen seroconversion in chronic hepatitis B infection.

BACKGROUND/AIM: Although 48-week therapy with pegylated-interferons has been shown to be effective for the treatment of chronic hepatitis B virus infection, the efficacy of a shorter duration of therapy with pegylated interferons is unknown. METHOD: We reviewed 53 hepatitis B e antigen positive Chinese patients treated with 48 weeks of pegylated interferon alpha-2a or 24 weeks of pegylated interferon alpha-2b. Sustained virological response was defined as hepatitis B e antigen seroconversion and hepatitis B virus DNA <10(5) copies/mL at week 72. RESULTS: Twenty-nine patients were treated with 48 weeks of pegylated-interferon-alpha-2a and 24 patients with 24 weeks of pegylated-interferon-alpha-2b. At the end-of-therapy, hepatitis B e antigen seroconversion and hepatitis B virus DNA <10(5) copies/mL were similar between the two groups of patients [9/29 (31.0%) vs. 2/24 (8.3%), respectively, P = 0.09]. At week 72, 10 of the 29 patients (34.5%) treated with 48 weeks of pegylated-interferon-alpha-2a compared with two of the 24 patients (8.3%) treated with 24 weeks of pegylated-interferon-alpha-2b had sustained virological response (P = 0.04). By logistic analysis, 48 weeks of pegylated-interferon-alpha-2a was independently associated with sustained virological response (P = 0.04 adjusted hazards-ratio 9.37). CONCLUSION: Further studies are required to determine the optimal duration of therapy with pegylated interferons in chronic hepatitis B.

[Injuries of permanent incisors: epidemiology and management in a public health clinic in Dakar]. / Traumatismes des incisives permanentes: épidemiologie et prise en charge en pratique publique à Dakar.

This prospective study done in a dental care center in a near suburb of Dakar during a period between January 1999 and December 2000, bas shown that permanent incisors traumatism's frequency is about 10.30% (61 teeth) which come within common values of the literature; and a sex ratio of 2.25. These traumatisms concern central maxillary incisors (75.41%) on patients less than 20 years old; falls, violence and road accidents are the major etiology. The consulting time limit is quite disadvantaged to preserve pulp vitality and dental re-implant in case of recent traumatisms. 53.33% of old dental traumatisms are observed to patients between 20 and 40 years old. And overall 80.76% of endodontic treatments realised in this case were not finished. The control of pain and anxiety would ease the emergency treatment. The information's of patients about significance of the consulting time limit, their motivation on differed dental treatments and/or endodontic treatments, as well the post traumatic watch would improve the management and the prognostic by setting of a referenced dental care units.

[Asepsis and antisepsis in dental offices in Dakar]. / L'asepsie et l'antisepsie dans les cabinets dentaires de Dakar.

To evaluate hygiene in dental offices in Dakar, the authors questioned 64 public, private and semi-private dentists. From 62 practitioners who completed their questionnaire, it appeared that the dry-heated sterilizer (poupinel) was 5 times more used than the autoclave; The almost practitioners sayed respecting the sterilisation process and 66% of them said wearing gloves, masks and glasses during interventions. In spite of the hope these results give, this study is limited because it doesn't take into account many aspects of asepsis and antisepsis in dental office which require a rigorous application next to a personal who needs to be better trained.

[Dental caries in the public primary schools dependent on the Nabil Choucair Health Center in Dakar, Senegal]. / Etude de la carie dentaire dans les écoles primaires publiques dépendant du Centre de Santé Nabil Choucair de Dakar Sénégal.

It is a holy study of observation and prevalence concerning a population of 268 pupils in first degree of the primary schools depending on the health center Nabil Choucair. 82% of these pupils have dental decay with DMFT egals 3.94. Our results suggest needs of preventive intervention on the intention to reach the objectives health for all by 2000 relatively to dental health in Senegal.

[Waste management from dental care in the health districts of Dakar, Senegal]. / Gestion des déchets issus des soins bucco-dentaires au niveau des districts sanitaires de Dakar au Sénégal.

Management of medical waste is becoming an increasing public health concerns, especially as these waste treatment methods can themselves create both health and environmental risks. The objective of the study was to evaluate the management of waste from dental care in Dakar. A cross-sectional, descriptive study of dental services in Dakar, based on a questionnaire was used to determine the knowledge and attitudes of dentists on the management of dental waste. All practitioners stated that their offices had waste bins, 81.2% using plastic bags; 73.2% reported that the bins were washed and disinfected an average of once a day. Only 7.2% of the offices or facilities had an autoclave, and 5.8% an incinerator. Three quarters of the respondents did not know how to dispose of contaminated waste and none of them had conducted a study to estimate the quantity of their departmental waste. The management of waste from dental care is not structured in Senegal nor in most developing countries. Moreover, the gaps and ineffectiveness of legislation result in major threats to public health and the environment. The government should focus, among other things, on stakeholder awareness and training, by providing facilities with the resources necessary to contribute to sustainable development through the management of dental waste.

[Periodontal treatment needs in prisoners in the region of Dakar (Senegal)]. / Besoins de traitements parodontaux chez les détenus de la région de Dakar (Sénégal).

INTRODUCTION: Oral diseases qualify as major public health problems, because of their high prevalence and incidence. They usually reach the poor and socially marginalized populations. This study looked at the prisoner's population who is characterized by precarious conditions. Thus the aim of this study was to assess periodontal treatment needs in prisoner's population of Dakar. METHODOLOGY: This was a cross sectional study which interested 375 prisoners living in camp penal, in Prisons for Women in Liberte VI and in Rufisque. The data were collected by a modified WHO sheet. The indicator of periodontal treatment needs (CPITN) was used. Statistical analysis with stratification by sex and age was performed and the tests were significant for p < or = 0.05. RESULTS: They were 335 men (89.3%) and 40 women (10.7%) with a sex ratio of 8.3. The age mean was 35 years +/- 11.5 with a maximum of 88 years and a minimum of 16 years. The mean stay was 39.29 months +/- 17.7. The proportion of prisoners with a periodontal treatment need increased gradually according to the prison stay with significant differences (P < 0.05) even after stratification. CONCLUSION: A more developed and taking into account the environment and the prison stay would reduce the periodontal treatment needs in prisoner's population in Dakar.

Cell-substrate contact: another factor may influence transepithelial electrical resistance of cell layers cultured on permeable filters.

Transepithelial resistance (TER) measurement has often been used to study the paracellular transport properties of epithelia grown on permeable filters, especially the barrier function of tight junctions. However, the TER value includes another source, the resistance caused by cell-substrate contact, that may give rise to a high TER value if cell-substrate separation is small. In this study we use electric cell-substrate impedance sensing (ECIS) to measure both paracellular resistance and the average cell-substrate distance of MDCK (II), HEp-2, and WI-38 VA13 cells. Comparing ECIS data with those from TER measurements of cell layers cultured on polycarbonate filters, we can obtain the approximate extra resistance resulting from cell-substrate contact for each cell type. The value of cell-substrate resistance was also estimated by two theoretical calculations that bracket the true values. Our results demonstrate that cell-substrate contact substantially influences the TER data measured using polycarbonate filters and that the extra resistance due to cell-substrate spaces depends on both cell type and filter property.