The prevalence and severity of dental caries in Chad: a pilot study.

OBJECTIVE: This study was undertaken to determine the prevalence and severity of dental caries among a cross section of a sample from different locations in Chad as part of a general assessment of their oral health status. METHODS: A cross-sectional descriptive survey of a nationwide sample included volunteers, 10 years or older, for a total of 1,011 participants. The survey consisted of a brief interview followed by a 1-2 minute oral examination of each subject. RESULTS: The mean age of the participants was 29.61 ±12.59 years and the total mean value for Decayed/Missing/Filled Teeth (DMFT)=1.96 ±1.78. Females had a higher mean DMFT (2.72 ±1.88); decayed (2.82 ±1.07); missing teeth (1.81 ±1.14) than males (1.61 ±1.60): decayed (2.11 ±1.09); missing (1.45 ±0.89, respectively; all p<0.001). The older group (>30 years) had higher DMFT (2.79 ±1.93) than the younger group (d"30 years; p<0.001). Urban area showed lower DMFT (1.81 ±1.68) than rural areas (2.31 ±1.95). CONCLUSION: In this study, the prevalence of dental caries is very low which is similar to the most of the African Saharan and sub-Saharan countries. However, there is need to establish caries control programs to prevent tooth decay in the future and help people maintain lifelong dental health.

The oral health status and the treatment needs in Chad: a pilot study.

AIMS AND OBJECTIVES: This study was designed to evaluate dental conditions, factors contributing to these conditions, and treatment needs among a population from different places in Chad, as part of a general assessment of their oral health. PATIENTS AND METHODS: A cross-sectional nationwide survey was conducted with 1,011 participants. The survey consisted of a brief health interview (conducted by dental students and public health specialists) followed by a 1-2 minutes oral examination (conducted by dental students and dentists). RESULTS: Sixty four per cent of the subjects had experienced dental pain, 66.7% had decayed teeth, and 56.6% had gum diseases. Dental pain was found to be distributed according to age, gender and locations (p<0.001). Only 25% of the participants had ever visited a dentist. Males were show to engage in more tobacco use than females (19.2% vs. 0.3%), while females were more likely to have visited a dentist than males (30.8% vs. 22.8%). Brushing of teeth occurred more often in urban than in rural locations (p<0.001), while date, sugar cane and cola nut intake were statistically significant in the older generation compared to the younger subjects (p<0.001). CONCLUSION: There was a significant need for dental treatment and care in the sample population. In addition, the availability of sugar, combined with poor knowledge, utilisation of preventive and restorative oral health care services have been contributed to have several dental conditions.

Relationships of mortality with the fine and coarse fractions of long-term ambient PM10 concentrations in nonsmokers.

In a cohort of 6338 California Seventh-day Adventists, we previously observed for males associations between long-term concentrations of particulate matter (PM) with an aerodynamic diameter less than 10 microm (PM10) and 15-year mortality due to all natural causes (ANC) and lung cancer (LC) listed as underlying causes of death and due to nonmalignant respiratory disease listed as either the underlying or a contributing (CRC) cause of death. The purpose of this analysis was to determine whether these outcomes were more strongly associated with the fine (PM2.5) or the coarse (PM2.5-10) fractions of PM10. For participants who lived near an airport (n=3769), daily PM2.5 concentrations were estimated from airport visibility, and on a monthly basis, PM2.5-10 concentrations were calculated as the differences between PM10 and PM2.5. Associations between ANC, CRC, and LC mortality (1977-1992) and mean PM10, PM2.5, and PM2.5-10 concentrations at study baseline (1973-1977) were assessed using Cox proportional hazards models. Magnitudes of the PM10 associations for the males of this subgroup were similar to those for the males in the entire cohort although not statistically significant due to the smaller numbers. In single-pollutant models, for an interquartile range (IQR) increase in PM10 (29.5 microg/m3), the rate ratios (RRs) and 95% confidence intervals (CI) were 1.15 (0.94, 1.41) for ANC, 1.48 (0.93, 2.34) for CRC, and 1.84 (0.59, 5.67) for LC. For an IQR increase in PM2.5 (24.3 microg/m3), corresponding RRs (95% CI) were 1.22 (0.95, 1.58), 1.64 (0.93, 2.90), and 2.23 (0.56, 8.94), and for an IQR increase in PM2.5-10 (9.7 microg/m3), corresponding RRs (95% CI) were 1.05 (0.92, 1.20), 1.19 (0.88, 1.62), and 1.25 (0.63, 2.49), respectively. When both PM25 and PM2.5-10 were entered into the same model, the PM2.5 estimates remained stable while those of PM2.5-10 decreased. We concluded that previously observed associations of long-term ambient PM10 concentration with mortality for males were best explained by a relationship of mortality with the fine fraction of PM10 rather than with the coarse fraction of PM10.

Organ procurement and the donor family.

The need for transplantable cadaveric organs for outweighs the supply. Improvements in the relatively new field of transplantation have dramatically improved success rates. Legislation at the state and federal levels has removed many legal roadblocks to donation. The network for the recovery and distribution of organs is well-developed and effective. OPOs, whose sole responsibility is the recovery and distribution of transplantable organs, can guide the medical staff through the process with minimal disruption of hospital routine. The recognition and referral of all potential organ donors is the responsibility of all health care professionals and helps alleviate the current shortage of transplantable organs. When simple and caring techniques are used, family consent rates for donation can approach 75%. Health care professionals remain the key to closing the imposing gap between a patient's need for transplantation and those suitable for donation.

Chronic respiratory disease associated with long-term ambient concentrations of sulfates and other air pollutants.

Seventh-day Adventist (SDA) non-smokers who had resided since 1966 within five miles of their 1977 residence (n = 3914) completed a standardized respiratory symptoms questionnaire in 1977 and again in 1987. For each participant, cumulative ambient concentrations from 1977 to 1987 of suspended sulfates (SO4) in excess of several cutoffs as well as mean concentrations were estimated by interpolating monthly ambient concentration statistics from state air monitoring stations to the individual's residential and workplace zip codes. There were significant associations between ambient concentrations of suspended sulfates and development of new cases of asthma, but not new cases of overall airway obstructive disease (AOD) or chronic bronchitis. Comparison of previous analyses, in this population, of respiratory disease symptoms and total suspended particulates (TSP), ozone, and sulfur dioxide (SO2), and multipollutant analyses of these pollutants with SO4, indicated these results were not due to a surrogate relationship with other air pollutants. Development of definite symptoms of AOD and chronic bronchitis was most strongly related to TSP.

Long-term ambient concentrations of total suspended particulates and oxidants as related to incidence of chronic disease in California Seventh-Day Adventists.

Cancer incidence and mortality in a cohort of 6000 nonsmoking California Seventh-Day Adventists were monitored for a 6-year period, and relationships with long-term cumulative ambient air pollution were observed. Total suspended particulates (TSP) and ozone were measured in terms of numbers of hours in excess of several threshold levels corresponding to national standards as well as mean concentration. For all malignant neoplasms among females, risk increased with increasing exceedance frequencies of all thresholds of TSP except the lowest one, and those increased risks were highly statistically significant. For respiratory cancers, increased risk was associated with only one threshold of ozone, and this result was of borderline significance. Respiratory disease symptoms were assessed in 1977 and again in 1987 using the National Heart, Lung and Blood Institute respiratory symptoms questionnaire on a subcohort of 3914 individuals. Multivariate analyses which adjusted for past and passive smoking and occupational exposures indicated statistically significantly (p less than 0.05) elevated relative risks ranging up to 1.7 for incidence of asthma, definite symptoms of airway obstructive disease, and chronic bronchitis with TSP in excess of all thresholds except the lowest one but not for any thresholds of ozone. A trend association (p = 0.056) was noted between the threshold of 10 pphm ozone and incidence of asthma. These results are presented within the context of standards setting for these constituents of air pollution.