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Caries experience and oral health related quality of life in a cohort of Ugandan HIV-1 exposed uninfected children compared with a matched cohort of HIV unexposed uninfected children.
BMC Public Health ( IF 3.5 ) Pub Date : 2020-03-30 , DOI: 10.1186/s12889-020-08564-1
Nancy Birungi 1 , Lars T Fadnes 1, 2 , Ingunn M S Engebretsen 3 , Stein Atle Lie 1 , James K Tumwine 4 , Anne Nordrehaug Åstrøm 1 ,
Affiliation  

Very few studies consider the oral health status and quality of life in HIV-1 exposed uninfected (HEU) children. The aim of this study was to estimate the prevalence of caries in primary teeth and its oral health related quality of life impacts in HEU children compared to HIV-unexposed-uninfected (HUU) children, whilst adjusting for confounding covariates. This study uses data from the Ugandan site of the ANRS 121741 PROMISE- PEP trial (ClinicalTrials.gov, number NCT00640263) conducted in 2009–2013 that recruited mothers with HIV-1 and their uninfected children. Of 244 HEU-children-caretaker pairs available at the end of the one-year trial, 166 were re-enrolled in the ANRS 12341 PROMISE-PEP M&S study at 5–7 years and 164 were included in this study. These were age and sex-matched with 181 HUU children-caretaker comparators. Caries experience was recorded using World Health Organization’s Decayed, Missed and Filled teeth (dmft/DMFT) indices. The Early Childhood Oral health Impact Scale (ECOHIS) was used for assessment of oral health related quality of life. Mixed effects logistic regression was conducted with dmft and ECOHIS scores as outcomes and HIV-1 exposure status as the main exposure. Forty-eight percent of HEU children and 60% of HUU had dmft> 0. Corresponding figures for ECOHIS> 0 were 12% of HEU and 22% of HUU. The crude analysis showed differences related to HIV-1 exposure in caries experience and oral health related quality of life. Mixed effect logistic regression analyses were not significant when adjusted for use of dental care and toothache. If caregivers’ DMFT> 0, the adjusted odds ratio for caries experience (dmft> 0) was 1.6 (95% CI: 1.0–2.8) while if dmft> 0 the adjusted odds ratio for quality of life impacts (ECOHIS> 0) was 4.6 (95% CI: 2.0–10.6). The prevalence of untreated caries in primary teeth and quality of life impacts was high in this study population. HIV-1 exposed uninfected children were not more likely than HUU children to experience dental caries or have impaired oral health related quality of life. Given the global expansion of the HEU child population, the present findings indicating no adverse effect of pre- and post-natal HIV-1 exposure on caries in deciduous teeth are reassuring.

中文翻译:

与未感染艾滋病毒的未配对艾滋病毒配对人群相比,在乌干达暴露于HIV-1的未感染儿童队列中与龋齿相关的经验以及与口腔健康有关的生活质量。

很少有研究考虑暴露于HIV-1的未感染(HEU)儿童的口腔健康状况和生活质量。这项研究的目的是评估未感染HIV(HUU)的儿童与HEU儿童相比,乳牙龋齿的患病率及其与口腔健康相关的生活质量影响,同时对混杂变量进行调整。这项研究使用了2009年至2013年进行的ANRS 121741 PROMISE-PEP试验的乌干达站点数据(ClinicalTrials.gov,编号NCT00640263),该数据招募了感染HIV-1的母亲及其未感染儿童。一年期试验结束时有244对HEU儿童看护人对,其中166人在5-7岁时重新加入ANRS 12341 PROMISE-PEP M&S研究,其中164人被纳入研究。这些年龄和性别与181个HUU儿童看守比较者匹配。使用世界卫生组织的龋齿,缺牙和缺牙(dmft / DMFT)指数记录龋病的经历。幼儿口腔健康影响量表(ECOHIS)用于评估与口腔健康相关的生活质量。以dmft和ECOHIS得分为结局,以HIV-1暴露状态为主要暴露量进行混合效应逻辑回归。48%的HEU儿童和60%的HUU的dmft>0。ECOHIS> 0的相应数字是12%的HEU和22%的HUU。粗略分析显示,龋齿体验和与口腔健康有关的生活质量与HIV-1暴露有关。调整牙科护理和牙痛的使用后,混合效应逻辑回归分析并不显着。如果看护者的DMFT> 0,则龋齿经历的调整后优势比(dmft> 0)为1.6(95%CI:1。0-2.8),而如果dmft> 0,则生活质量影响的经调整比值比(ECOHIS> 0)为4.6(95%CI:2.0-10.6)。在该研究人群中,未经处理的龋齿在乳牙中的患病率和生活质量影响很高。暴露于HIV-1的未感染儿童比HUU儿童更不可能出现龋齿或与口腔健康相关的生活质量受损。鉴于HEU儿童人口的全球增长,目前的发现表明,出生前和出生后HIV-1暴露对乳牙龋齿没有不利影响,这令人放心。暴露于HIV-1的未感染儿童比HUU儿童更不可能出现龋齿或与口腔健康相关的生活质量受损。鉴于HEU儿童人口的全球增长,目前的发现表明,出生前和出生后HIV-1暴露对乳牙龋齿没有不利影响,这令人放心。暴露于HIV-1的未感染儿童比HUU儿童更不可能出现龋齿或与口腔健康相关的生活质量受损。鉴于HEU儿童人口的全球增长,目前的发现表明,出生前和出生后HIV-1暴露对乳牙龋齿没有不利影响,这令人放心。
更新日期:2020-03-31
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