The online version of this article (doi:10.1186/s12903-015-0129-0) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
MN, DGM, PAC, EA, AJ, designed the study. The survey form was developed and validated by MN, DGM, PAC, EA, AJ. Data collection was made and supervised by MN, DGM, PAC, EA, DKE, BKT, CA, SPE, AJ. Analysis and interpretation of data was performed by MN, DGM, PAC, EA, DKE, AJ. The manuscript was drafted by MN, and critical revision for important intellectual content was provided by MN, DGM, PAC, EA,BKT, DKE, FD, AJ. All authors read and commented on the original manuscript and all agreed on the version finalized by MN for submission.
For the IeDEA West Africa collaboration.
Worldwide, female sex workers (FSW) represent a vulnerable population for oral diseases due to many risk factors including HIV infection and drug abuse. In sub-Saharan Africa, little is known about the burden of oral diseases and their determinants in vulnerable populations. The aim of the study was to estimate the prevalence and associated factors of oral diseases among FSW.
A cross sectional study was conducted among FSW who attended a dedicated non-profit clinic in Abidjan, Côte d’Ivoire from June to August 2013. Data about the presence of dental caries, periodontitis and oral-mucosal lesions were collected by a dentist during an oral examination. Behavioural information related to oral hygiene habits as well as tobacco and alcohol consumption were collected through a standardized questionnaire. Information related to HIV infection including HIV diagnosis, last known CD4 count and antiretroviral therapy were documented through a medical chart review. Logistic regression models were used to identify factors associated with oral diseases.
A total of 249 FSW with a median age of 29 years, [Inter Quartile Range (IQR) = 23–36] and a median duration of sex work of 24 months [IQR 9–60]) were included. Current tobacco use and hazardous alcohol use were reported in 21.7 % and 19.7 % of FSW, respectively. The estimated prevalence of HIV infection was 33.7 % [95 % confidence interval (CI); 27.8 – 39.6]) and 82.1 % of HIV-infected FSW were on antiretroviral therapy . The prevalence of dental caries, periodontitis and oral-mucosal lesions were 62.3 % [95 % CI 55.5 – 67.5], 14.5 % [95 % CI 10.2 – 18.9] and 8.2 % [95 % CI 4.8 – 11.5], respectively. In multivariate analysis, periodontitis, oral-mucosal lesions and HIV infection were associated with odds ratio of 2.6 [95 % CI, 1.2–5.8]) and 50.0 [95 % CI; 6.4–384.6].
This study showed a high prevalence of oral diseases among FSW in Abidjan. HIV infection was common and significantly associated with periodontal diseases and oral-mucosal lesions. There is a need to integrate regular screening and treatment of oral lesions into the medical follow-up of FSW along with strategies for HIV prevention.
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2014 The Gap Report UNAIDS: http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf.
The World Oral Health Report 2003 Continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme. http://www.who.int/oral_health/media/en/orh_report03_en.pdf. Accessed 23 august 2013.
WHO Strategy for cooperation with Republic of Côte d’Ivoire, 2004-2007. Overview of Oral health in Côte d’Ivoire, 2004. http://www.who.int/countryfocus/cooperation_strategy/countries/ccs_civ_final_fr.pdf. [Accessed 23 oct 2015].
Leao JC, Ribeiro CMB, Carvalho AAT, Frezzini C, Porter S. Oral complications of HIV disease. Clin São Paulo Braz. 2009;64(5):459–70.
Jaquet A, Ekouevi DK, Aboubakrine M, Bashi J, Messou E, Maiga M, et al. Tobacco use and its determinants in HIV-infected patients on antiretroviral therapy in West African countries. Int J Tuberc Lung Dis Off J Int Union Tuberc Lung Dis. 2009;13(11):1433–9.
Pesci-Bardon C, Prêcheur I. Addictive behaviour: Tobacco, psychotropic alcohol and illicit drugs. Impact on oral health. EMC, Médecine buccale, 28-915-M-10, 2010, Odontologie, 23-760-A-40, 2011. http://www.infosdentistesaddictions.org/EMC_addictions_santeBD.pdf.
Knutson JW, Klein H, Palmer CE. Studies on Dental Caries. VIII. Relative Incidence of Caries in the Different Permanent Teeth. J Am Dent Assoc Dent Cosm. 1938;25(12):1923–34. CrossRef
Petersen PE, Organization WH, Baez RJ. Oral health surveys: basic methods [Internet]. World Health Organization; 2013. Available from: http://www.who.int/oral_health/publications/9789241548649/en/. [Accessed 23 oct 2015]
Greene JC, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc 1939. 1964;68:7–13. CrossRef
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addict Abingdon Engl. 1993;88(6):791–804. CrossRef
Ghys PD, Diallo MO, Ettiègne-Traoré V, Kalé K, Tawil O, Caraël M, et al. Increase in condom use and decline in HIV and sexually transmitted diseases among female sex workers in Abidjan, Côte d’Ivoire, 1991–1998. AIDS Lond Engl. 2002;16(2):251–8. CrossRef
Taiwo OO, Okeke EN, Otoh EC, Danfillo IS. Prevalence of HIV--related oral lesions in Nigerian women. Niger J Med J Natl Assoc Resid. 2005;14(2):132–6.
Samba M, Guinan JC, Sangare A, Da-Danho V, Bakayoko-Ly R. Oral health care practices in Abidjan. Odonto-Stomatol Trop Trop Dent J. 2004;27(107):37–40.
Vázquez L, Swan JH. Access and attitudes toward oral health care among Hispanics in Wichita, Kansas. J Dent Hyg JDH Am Dent Hyg Assoc. 2003;77(2):85–96.
Phiri R, Feller L, Blignaut E. The severity, extent and recurrence of necrotizing periodontal disease in relation to HIV status and CD4+ T cell count. J Int Acad Periodontol. 2010;12(4):98–103. PubMed
Feller L, Lemmer J. Necrotizing periodontal diseases in HIV-seropositive subjects: pathogenic mechanisms. J Int Acad Periodontol. 2008;10(1):10–5. PubMed
Eriksen M, Mackay J, Ross H. The tobacco atlas. Fifth edition. The American Cancer Society, ISBN 978-1-60443-235-0: http://3pk43x313ggr4cy0lh3tctjh.wpengine.netdna-cdn.com/wp-content/uploads/2015/03/TA5_2015_WEB.pdf.
Young P, Boyd C, Hubbell A. Prostitution, drug use, and coping with psychological distress. J Drug Issues. 2000;30:789–800. CrossRef
- Oral health and HIV infection among female sex workers in Abidjan, Côte d’Ivoire
Marcellin N. Nouaman
David G. Meless
Patrick A. Coffie
Boris K. Tchounga
Didier K. Ekouévi
Serge P. Eholié
the IeDEA West Africa collaboration
- BioMed Central
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