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      Socio-demographic and behavioural correlates of oral hygiene status and oral health related quality of life, the Limpopo - Arusha school health project (LASH): A cross-sectional study

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      1 , 2 , 3 , , 3 , 1 , 2
      BMC Pediatrics
      BioMed Central

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          Abstract

          Background

          Promoting oral health of adolescents is important for improvement of oral health globally. This study used baseline-data from LASH-project targeting secondary students to; 1) assess frequency of poor oral hygiene status and oral impacts on daily performances, OIDP, by socio-demographic and behavioural characteristics, 2) examine whether socio-economic and behavioural correlates of oral hygiene status and OIDP differed by gender and 3) examine whether socio-demographic disparity in oral health was explained by oral health-related behaviours.

          Methods

          Cross-sectional study was conducted in 2009 using one-stage cluster sampling design. Total of 2412 students (mean age 15.2 yr) completed self-administered questionnaires, whereas 1077 (mean age 14.9 yr) underwent dental-examination. Bivariate analyses were conducted using cross-tabulations and chi-square statistics. Multiple variable analyses were conducted using stepwise standardized logistic regression (SLR) with odds ratios and 95% Confidence intervals (CI).

          Results

          44.8% presented with fair to poor OHIS and 48.2% reported any OIDP. Older students, those from low socio-economic status families, had parents who couldn't afford dental care and had low educational-level reported oral impacts, poor oral hygiene, irregular toothbrushing, less dental attendance and fewer intakes of sugar-sweetened drinks more frequently than their counterparts. Stepwise logistic regression revealed that reporting any OIDP was independently associated with; older age-groups, parents do not afford dental care, smoking experience, no dental visits and fewer intakes of sugar-sweetened soft drinks. Behavioural factors accounted partly for association between low family SES and OIDP. Low family SES, no dental attendance and smoking experience were most important in males. Low family SES and fewer intakes of sugar-sweetened soft drinks were the most important correlates in females.

          Socio-behavioural factors associated with higher odds ratios for poor OHIS were; older age, belonging to the poorest household category and having parents who did not afford dental care across both genders.

          Conclusion

          Disparities in oral hygiene status and OIDP existed in relation to age, affording dental care, smoking and intake of sugar sweetened soft drinks. Gender differences should be considered in intervention studies, and modifiable behaviours have some relevance in reducing social disparity in oral health.

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          Most cited references30

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          Inequities among the very poor: health care for children in rural southern Tanzania.

          Few studies have been done to assess socioeconomic inequities in health in African countries. We sought evidence of inequities in health care by sex and socioeconomic status for young children living in a poor rural area of southern Tanzania. In a baseline household survey in Tanzania early in the implementation phase of integrated management of childhood illness (IMCI), we included cluster samples of 2006 children younger than 5 years in four rural districts. Questions focused on the extent to which carers' knowledge of illness, care-seeking outside the home, and care in health facilities were consistent with IMCI guidelines and messages. We used principal components analysis to develop a relative index of household socioeconomic status, with weighted scores of information on income sources, education of the household head, and household assets. 1026 (52%) of 1968 children reported having been ill in the 2 weeks before the survey. Carers of 415 (41%) of 1014 of these children had sought care first from an appropriate provider. 71 (26%) carers from families in the wealthiest quintile knew > or =2 danger signs compared with 48 (20%) of those from the poorest (p=0.03 for linear trend across quintiles) and wealthier families were more likely to bring their sick children to a health facility (p=0.02). Their children were more likely than poorer children to have received antimalarials, and antibiotics for pneumonia (p=0.0001 and 0.0048, respectively). Care-seeking behaviour is worse in poorer than in relatively rich families, even within a rural society that might easily be assumed to be uniformly poor.
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            Validity and reliability of a questionnaire for measuring child oral-health-related quality of life.

            Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ(11-14), a self-report measure of the impact of oral and oro-facial conditions on 11- to 14-year-old children. An item pool was generated with the use of a literature review and interviews with health professionals, parents, and child patients. The 36 items rated the most frequent and bothersome by 83 children were selected for the CPQ(11-14). Validity testing involved a new sample of 123 children. Test-retest reliability was assessed in a subgroup of these children (n = 65). Mean CPQ(11-14) scores were highest for oro-facial (31.4), lower for orthodontic (24.3), and lowest for pedodontic (23.3) patients. There were significant associations between the CPQ(11-14) score and global ratings of oral health (p < 0.05) and overall well-being (p < 0.01). The Cronbach's alpha and intraclass correlation coefficient for the CPQ(11-14) were 0.91 and 0.90, respectively. These results suggest that the CPQ(11-14) is valid and reliable.
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              Developing and evaluating an oral health-related quality of life index for children; the CHILD-OIDP.

              To develop an oral health-related quality of life index in Thai children and evaluate its psychometric properties. Cross-sectional study of children aged 11-12 years, attending the final year of primary school (grade-six). Development and evaluation process was conducted on non-random sample in U-thong District, Suphan-buri province, Thailand. Re-evaluation of the index included all target group children in a municipal area of Suphan-buri province, Thailand. The psychometric properites evaluated in this study refer to face, content and concurrent validity and internal and test-retest reliability. 513 children in the development process. 1,100 children in the re-evaluation. Throughout the development process, the OIDP index was modified and its psychometric properties evaluated. The final test revealed excellent validity and reliability. Weighted kappa was 0.93. There was no negative correlation between any item, corrected item-total correlation coefficients were between 0.4-0.7, Standardised Cronbach's alpha coefficient was 0.82. The index showed very significant associations with perceived oral treatment need (p < 0.001) and perceived oral health problems (p < 0.001). The validity and reliability of the index was confirmed by similar results in the re-evaluation study. This study has demonstated that the CHILD-OIDP index is a valid, reliable and practical measure of oral health-related quality of life in 12 year old Thai children.
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                Author and article information

                Journal
                BMC Pediatr
                BMC Pediatrics
                BioMed Central
                1471-2431
                2010
                30 November 2010
                : 10
                : 87
                Affiliations
                [1 ]Department of Clinical Dentistry, Community Dentistry, University of Bergen, Bergen, Norway
                [2 ]Centre for International Health, University of Bergen, Bergen, Norway
                [3 ]Department of Preventive and Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
                Article
                1471-2431-10-87
                10.1186/1471-2431-10-87
                3001697
                21118499
                615da2be-6108-4305-8011-20444e3d0cad
                Copyright ©2010 Mbawalla et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<url>http://creativecommons.org/licenses/by/2.0</url>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 July 2010
                : 30 November 2010
                Categories
                Research Article

                Pediatrics
                Pediatrics

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