Deciduous canine tooth bud extraction and nutritional status of children aged 2-5 years in Kajiado District, Kenya

Abstract

Deciduous Canine Tooth Bud Extraction (DCBE) is a harmful practice prevalent among pastoral communities in Kenya. The communities blame the canine tooth for ‘causing’ diarrhoea, fevers and growth retardation in their babies. As a remedy, DCBE is performed to ‘increase child survival’. The practice which involves forceful extraction of teeth using un-sterile knives, bicycle wires, razor blades or bare hands, predisposes the babies to serious complications and even death. Malnutrition is also common among children in the pastoralist communities due to their nomadic way of life. Women and children who depend mainly on livestock for milk, meat and blood as their staple food, are left without food when the livestock move to other areas in search of pasture. The situation results in poor infant feeding practices, predisposing the child to common illnesses such as diarrhoea. The purpose of this study was to determine the relationship between prevalence of Deciduous Canine Tooth Bud Extraction (DCBE) and nutritional status of the children under five years in Kajiado District. This was a descriptive cross-sectional study carried out among the Maasai in Ngong and Magadi Divisions of Kajiado District, Rift Valley Province, Kenya between April and October 2009. A total of 420 Maasai mothers each with a child of under five year old living in manyattas (homesteads) were randomly selected from five (5) sub locations in Ngong and Magadi Divisions of Kajiado District. The study also included an average of 10 men, women and children from each sub location for focus group discussion, and a total of 10 key informants for in- depth interview. Multistage and simple random sampling was used to select manyattas, and mothers with their children respectively. The respondents were interviewed using structured interview schedule guide. Child nutritional status was assessed using standard anthropometric techniques. Data was analyzed using Statistical Package for Social Science (SPSS) Version 14 software. Nutritional data was thereafter transferred from Nutri-Survey, 2007(ENA, SMART) to SPSS and Excel programme was used to generate figures. The findings showed the prevalence of DCBE was 24.5%. Ngong Division had an average prevalence of 27.8% which was higher prevalence compared to Magadi Dvision (21.3%). The prevalence was significantly different (p ≤ 0.05) between the selected sub-locations in the study. Respondents’ awareness and support for the practice was high. Although consumed foods by the children were milk, porridge, ugali, tea with milk and sugar, chapati, fats, and beans. There was limited consumption of meat, fruits, and vegetables; the degree of chronic undernutrition with 15.0% classified as moderate stunting and 19.5% as severe stunting. The prevalence of Global Acute Malnutrition (GAM) was 20.7 %, Moderate Acute Malnutrition (MAM) was 13.3% and Severe Acute Malnutrition (SAM) was 7.4%. Although there was no significant relations between the practice of DCBE and nutritional status (p>0.05), the trend of undernutrition was higher among those that had undergone DCBE than those that had not. There were indications that children were targeted for DCBE due to their poor nutritional status. On the other hand, the complications due to DCBE affect the child nutritional status. These results therefore show that the practice of DCBE could be a nutritionally related out come among the children in the Maasai community living in Kajiado.