Oral Health Status in Human Immunodeficiency Virus Positive Patients Attending Port Reitz Hospital, Mombasa County, Kenya

Abstract

The HIV/AIDS epidemic is one of the most serious epidemics to ever have affected humanity. About 40 million people were infected with HIV in 2001, and millions have already died of AIDS. Many more people are affected because their parents, other family members, friends and co-workers have died of AIDS or were infected with HIV. The impact of oral health care is of particular importance among people living with HIV/AIDS (PLWHA). Complications of oral health problems associated with HIV were well documented in the literature. Oral manifestations, such as oral ulcers, dental caries, and salivary gland disease, oral warts, Kaposi’s sarcoma, necrotizing ulcerative periodontitis, oral hairy leukoplakia and candidiasis could be strongly associated with HIV infections and might be present in up to 50% of people with HIV infection and up to 80% of people diagnosed with AIDS. The objective of this study was to determine the oral health status in HIV positive patients attending Port Reitz Hospital in Mombasa County. The specific objectives were to find out the prevalence of caries and periodontal disease among HIV positive patients attending Port Reitz hospital as well as their knowledge attitudes and practice with respect to oral health. The study adopted a descriptive cross-sectional study design. Clients who were 18 years and above and were HIV positive visiting the comprehensive care clinic of Port Reitz Hospital were recruited. A total of 368 patients were interviewed from a possible 385 due to drop outs in the course of clinical assessments and interviews. Clinical data was collected using a WHO oral health assessment questionnaire and observations on knowledge, attitudes and practice and social demographics were made using a second questionnaire. Data collected was cleaned and keyed into an MS Excel spread sheet then exported to SPSS version 20 for analysis. The findings were presented using frequency tables, bar charts and pie charts. Measures of association were computed at the corresponding 95% confidence intervals. The prevalence of dental caries among patients at Port Reitz Hospital was 14.2% with the proportion experiencing decay, missing and filled teeth due to caries being 11.1%, 7.1% and 9.1%, respectively. The DMFT index in this population was not significantly related to age, sex and ART status of the patients. Of the 368 patients, 39.3% had healthy teeth. Conversely, 5.8% had bleeding gums, 13.8% had calculus, 36.5% had pockets (4-5mm) and 0.2% had pockets (6 or more than 6mm). Findings indicated that 6.3% of the patients had access to information on HIV related oral diseases. With regard to knowledge on oral diseases, the three most commonly known oral disease related to HIV were bleeding gums (28.3%), cavities (17.0%) and ulcers (15.1%). Nearly all of the patients interviewed (99.5%) expressed a need for more information on oral diseases related to HIV. Most of the patients (98.9%) regarded treatment of oral diseases as important as treatment in other parts of the body. When asked about their practice, 63.6% 0f clients in the study said that they cleaned their teeth more than once a day using tooth brushes (96.3%). The recommendation from the study is that oral health care and treatment should be included as part of comprehensive care for HIV patients. These patients should be given information on oral diseases related to HIV and oral health care and maintenance.