Associations of Interleukin-1 Polymorphisms with Chronic Periodontitis in Two Different Kenyan Ethnic Groups: A Case Control Study.

OBJECTIVE: The aim of this study was to investigate the association between IL-1ß and IL-1α isoforms with chronic periodontitis in two Kenyan ethnic groups, Taitas and Swahilis. METHODS: A case-control study in which participants were assessed for dental plaque, gingival inflammation, pocket depth and gingival recession after informed consent. Buccal swab samples were obtained and deoxyribonucleic acid was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction amplification using specific primers to IL-1 α rs1800587 (-889) and rs17561 (+4845) and IL-1ß (rs16944 (-511) and rs11443624 (+3954). Restriction fragment length polymorphisms were recorded and association with clinical data was assessed. RESULTS: Three hundred and ninety participants were recruited; four loci (-511, -889, +3953 and +4845) were analyzed per subject, equivalent to 1560 analysis events. No deviation from Hardy Weinberg equilibrium 1df was observed. Frequency of allele 2 at IL-1ß +3954 was associated with chronic periodontitis in Taitas (OR = 1.94, 95% CI = 1.01 - 3.70, p = 0.045), whereas frequency of allele 1 at IL-1α -889 was associated with chronic periodontitis in Swahilis (OR = 3.16, 95% CI = 1.644 - 6.083, p less than 0.001). Allele 1 at locus IL-1α -889 was also associated with mild, (OR = 5.2, 95% CI = 1.445 - 18.71, p = 0.005), moderate (OR = 4.51, 95% CI = 2.08 - 9.79, p less than 0.001) and severe disease (OR = 2.19, 95% CI = 1.013 - 4.738, p = 0.042) in Swahilis. Haplotype 3 (allele 1 at all four loci) was significantly associated with chronic periodontitis in Taitas (OR = 2.4, 95% CI = 1.1 - 5.14, p = 0.022) and Swahilis (OR = 4.2, 95%CI = 1.35 - 13.3, p = 0.008). CONCLUSIONS: This study has shown that in the African population of Bantu origin, the two polymorphisms associated with chronic periodontitis are IL-1ß +3954 in Taitas and IL-1α-889 in Swahilis. Additionally, haplotype 3 was associated with chronic periodontitis in both ethnic groups.

Oral health in Kenya.

This paper gives general information on the location of Kenya, its demography, economy, organisation of health services, general health policy, health financing, oral health infrastructure, problems that hamper health financing and proposals on how to solve these problems. Further, a summary of health status of the Kenyan people is given based on the results of studies. The mean DMFT for the rural and urban populations is low and there is no evidence of an increase or decrease. Similarly, the prevalence of periodontitis is low (1-10%), with no increase. Ulcerative lesions are rare (0.12%). The most common birth defects are cleft lip and palate. Oral cancer is very low, accounting for 2% of all malignancies. Comparative studies have not demonstrated any dramatic change in the frequency of oral cancer for the last 25 years. Oral candidiasis is the most prevalent oral lesion amongst HIV/AIDS patients. In June 2003, Kenya formulated a National Oral Health Policy, which gives direction on how to improve the oral health status of the citizens.

Prevention of cross-infection in dental surgeries in East Africa and a review of the literature

In view of the increase in recent years increase in the number of children and adults infected with human immunodeficiency virus (HIV) world over, there is an urgent need to respond to this pandemic by strengthening prevention and control measures against HIV at national and global levels. Equally important is the prevention and control of viral hepatitis and tuberculosis in dental surgeries. This paper looks at some of the studies that have been carried out in East Africa to assess the preventive measures against cross-infection taken by dental surgeons. Based on the results of these studies, it is concluded that preventive measures against cross-infection in dental surgeries in the region are inadequate. It is recommended that this problem be addressed urgently and in a realistic manner, given the prevailing financial circumstances of each country in the region.(AU)

Occurrence of ulcerative oral lesions at Kenyatta National Hospital, Nairobi, Kenya.

This study was done as part of a WHO international survey of orofacial mutilations and NOMA cases referred to out-patient clinic and care centers in 1992. Files of 16,000 patients who were treated at the Dental Unit of Kenyatta National Hospital (KNH) were scrutinized for the occurrence of NOMA and other ulcerative oral lesions. Of these, 30% had acute necrotizing ulcerative gingivitis with a male to female ratio of 5:1. 25% had aphthous ulcers with a male to female ratio of 3:2. Equal numbers of patients (10%) had angular cheilitis, aspirin burn and oral candidiasis. Similarly, equal numbers of patients (5%) had NOMA, atypical ulceration and radiotherapy induced ulceration. It was concluded that NOMA and other ulcerative oral lesions were rare among the patients who were treated at the Dental Unit of KNH.

Knowledge, attitudes and practices towards HIV positive and AIDS patients among public service dentists in Nairobi.

The purpose of this study was to assess the knowledge, practices and attitudes towards HIV Positive/AIDS patients among 112 dentists from public institutions in Nairobi using a self-administered questionnaire. 94(83.9%) responded. Over 74% had managed HIV positive/AIDS patients. In general, respondents' knowledge and preventive measures against HIV infection were satisfactory. 8.5% did not find use of protective eye wear absolutely necessary. 33% used protective covers routinely. 52.1% advocated for the screening of all suspected cases of AIDS before treatment. 27.7% felt that HIV positive health workers and those with AIDS should not be allowed to treat patients. 53.2% felt that they should be given the right to decide on treating HIV Positive/AIDS patients. 10.6% supported the idea that AIDS patients be isolated from uninfected individuals. It is concluded that a substantial number of dentists were wanting in their attitudes towards HIV positive/AIDS patients.