Browsing by Author "Kutesa, Annet"
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Item Oral Manifestations in HIV/AIDSInfected Children(European journal of dentistry, 2011) Rwenyonyi, Charles Mugisha; Kutesa, Annet; Muwazi, Louis; Okullo, Isaac; Kasangaki, Arabat; Kekitinwa, AddyTo assess factors influencing the distribution of oral manifestations in HIV/AIDS-infected children attending the Paediatric Infectious Disease Clinic in Mulago Hospital, Kampala. This was a cross-sectional study comprising 237 children (males/females: 113/124) aged 1 to 12 years. The parents/guardians were interviewed to obtain demographic information, oral hygiene practices, dietary habits and health seeking behaviours as well as any medications taken. The children were clinically examined for oral lesions based on World Health Organization criteria with modifications. About 71.7% of the children cleaned their teeth. About 16.9% of the children had visited a dentist since birth, mainly for emergency care. One or more oral lesions were recorded in 73% of the children of whom 19.0% experienced discomfort during oral functions. Cervical lymphadenopathy, oral candidiasis and gingivitis were the most common soft tissue oral lesions: 60.8%, 28.3% and 19.0%, respectively. Except for dental caries, the overall frequency distribution of soft tissue oral lesions was significantly lower in children on highly active antiretroviral therapy (HAART) as compared to their counterparts not on HAART. The prevalence of dental caries in deciduous and permanent dentitions was 42.2% and 11.0%, respectively. Tooth brushing and previous visits to the dentist were indirectly and significantly associated with dental caries. About 5.9% (n=14) of the children had <200 CD3 + CD4 T-lymphocyte cells per μl of blood. The majority of the children had one or more oral lesions, particularly in the group not on HAART. Some of the lesions were associated with discomfort during oral functions. (Eur J Dent 2011;5:291-298)Item Periodontal conditions, low birth weight and preterm birth among postpartum mothers in two tertiary health facilities in Uganda(BMC oral health, 2014) Muwazi, Louis; Mugisha Rwenyonyi, Charles; Nkamba, Moses; Kutesa, Annet; Kagawa, Mike; Mugyenyi, Godfrey; Kwizera, Godfrey; Okullo, IsaacLiterature reports have indicated an increase in research evidence suggesting association between periodontal disease and the risk of pre-term birth (PTB) and low birth weight (LBW). Periodontal diseases in Uganda have been documented as a public health problem, but their association to adverse pregnancy outcomes is unknown. This study was conducted to assess the association between periodontital diseases in postpartum mothers and PTB and LBW of babies in Mulago and Mbarara referral hospitals. Methods: This was a cross sectional study using medical records, clinical examination and oral interview of mothers at the two tertiary health facilities. Mothers with singleton babies from Mulago (n = 300) and Mbarara Hospital (n = 100) were recruited for the study. The women were clinically examined for periodontal disease by 2 trained and calibrated dentists. Data on PTB and LBW were retrieved from medical records. The data were analyzed to determine the relationship between the four parameters for periodontal disease (bleeding gingiva, periodontal pockets, gingival recession and calculus with plaque deposits) and the adverse pregnancy outcomes. Frequency distribution was used to describe the data. Bivariate and multivariate analyses were used to study the association between the periodontal diseases and adverse pregnancy outcomes. Results: Approximately 26% and 29% of the postpartum mothers examined had bleeding gingiva and periodontal pockets of 4 mm or more deep, respectively. Advanced periodontitis i.e. pocket depth ≥ 6 mm was recorded in 13 (3.6%) of the mothers. Calculus with plaque deposits were recorded in 86% (n = 343) of the mothers. Gingival recession was recorded in 9.0% of the mothers and significantly and directly related to birth weight (p < 0.05). Conclusion: Periodontal conditions of postpartum mothers in this study were found to be better than previously reported amongst the Ugandan population. Bivariate analysis showed a significant association only between gingival recession and low birth weight. However, this finding should be interpreted with caution as it could have occurred by chance.Item Prediction of Width of Un-Erupted Incisors, Canines and Premolars in a Ugandan Population:A Cross Sectional Study(BMC oral health, 2012) Buwembo, William; Kutesa, Annet; Muwazi, Louis; Rwenyonyi, Charles MugishaAccurate prediction of the space forms an important part of an orthodontic assessment in the mixed dentition. However the most commonly used methods of space analysis are based on data developed on Caucasian populations. In order to provide more accurate local data we set out to develop a formula for predicting the widths of un-erupted canines and premolars for a Ugandan population and to compare the predicted widths of the teeth from this formula with those obtained from Moyers’ tables, and Tanaka and Johnston’s equations.Dental casts were prepared using mandibular and maxillary arch impressions of 220 children (85 boys/135 girls) aged 12–17 years recruited from schools in Kampala, Uganda. The mesio-distal width of the mandibular incisors, mandibular and maxillary canines and premolars were measured with a pair of digital calipers. Based on regression analysis, predictive equations were derived and the findings were compared with those presented in Moyers’ probability tables, and Tanaka and Johnston’s equations. There were no statistically significant differences between the tooth widths predicted by our equations and those from Moyers’ probability tables at the 65th and 75th percentile probabilities for the girls and at 75th level in boys in the mandibular arch. While in the maxillary arch no statistically significant differences at the 75th and 95th levels were noted in girls. There were statistically significant differences between predicted tooth sizes using equations from the present study and those predicted from the Tanaka and Johnston regression equations.In this Ugandan population, Moyers’ probability tables could be used to predict tooth widths at specific percentile probabilities, but generally, Tanaka and Johnston technique tends to overestimate the tooth widths.Item Prevalence and Factors Associated with Dental Caries among Children and Adults in Selected Districts in Uganda(African Health Sciences, 2015) Kutesa, Annet; Kasangaki, Arabat; Nkamba, Moses; Muwazi, Louis; Okullo, Isaac; Rwenyonyi, Charles MugishaThe aim was to determine the prevalence and factors associated with dental caries among adults and children in seven districts of Uganda.Participants aged 11-13 (n=1230) and 35-44 years (n=648) were randomly selected from urban and rural areas of Gulu, Soroti, Jinja, Masaka, Kabale, Kabarole and Hoima districts. They were examined by 4 trained and calibrated dentists for dental caries using Decayed, Missing and Filled teeth index as described by World Health Organisation.Overall mean DMFT score was 0.73 for children and 4.71 for adults. Generally, there was a higher mean DMFT score in the rural (2.19) compared to urban areas (1.97). In all the districts, except Hoima, there was a higher mean DMFT score of children in rural compared to urban. In adults, similar trend was mainly registered in Masaka, Hoima and Gulu districts. Most participants (79.9%, n=1309)occasionally ate sugared snacks. Overall, 95% (n=1795) of the participants cleaned their teeth with plastic tooth brushes (71.7%) and chewing sticks (8.3%).Although the severity of dental caries was low, the disease was widespread in the study population. A high proportion of participants reported consumption of sugared snacks and drinks, which calls for oral health education.Item Prevalence of Latent Tuberculosis Infection among Paramedical Students in Two Hospitals in Uganda(International Journal of Research Studies in Medical and Health Sciences, 2017) Okullo, Isaac; Kaducu, Felix; Katamba, Achilles; Muwazi, Louis; Nkamba, Moses; Kutesa, Annet; Mugisha Rwenyonyi, CharlesThe risk of transmission of Mycobacterium tuberculosis to health-care workers in many low and middle-income countries is greater when large numbers of infectious (smear positive) tuberculosis (TB) patients are managed at health facilities. The present study was carried out in Mulago and Gulu teaching hospitals in Uganda among 291 students on the Public Health Dentistry (n=73), Clinical Officers (n=92) and Nursing (n=126) programmes to determine their latent TB infection status. Socio-demographic factors of the participants were recorded and TST induration was read after 48 to 72 hours. Chi-square statistics were used to compare latent TB infection among pre-clinic and clinical year students in different study programmes. About 87% (n=254) of the respondents had Bacillus Calmette–Guérin vaccination skin scar. Of the 291 respondents (response rate, 89.5%), 92.4% developed an induration after TST. The mean diameter of the induration was 12.61 mm (95% CI: 11.95-13.26). A prevalence of latent TB infection (80.4%) with TST induration reading of ≥10 mm was found among the respondents. Significantly more Nursing had an induration ≥10 mm than the Dental (p=0.046) and the Clinical Officer students (p=0.047). The observed prevalence of latent TB infection was high, indicating a high level of transmission of Mycobacteria tuberculosis among the young health worker students, which is a risk to patients under their care. It is important to screen trainees upon entering into the study programmes in order to determine the magnitude of latent TB infection for better policy guidance.Item Prevalence, Severity and Factors Associated with Dental Caries Among School Adolescents in Uganda: A Cross-Sectional Study(Brazilian dental journal, 2020) Ndagire, Barbara; Kutesa, Annet; Ssenyonga, Ronald; Kiiza, Harriet Mayanja; Nakanjako, Damalie; Rwenyonyi, Charles MugishaDental caries is one of the most prevalent diseases in developing countries. However, there is limited data on the prevalence and factors associated with dental caries in Ugandan adolescents. The purpose of the present study was to describe the prevalence, severity of dental caries and to determine the factors associated with the disease among school adolescents in Uganda. A cross sectional study was conducted at two secondary schools from Kampala (n=197) and Mukono (n=209) districts, Uganda. At both schools, random sampling was used to select the participating classes and the 406 adolescents (11-19 years) eligible to participate in the research. Dental caries was examined using the Decayed, Missing and Filled Teeth (DMFT) index, and a questionnaire was used to collect other relevant data in form of an oral interview. The data were analyzed using STATA version 12. The data was declared as survey data and all analyses were done with svy command. The prevalence of caries was determined as a percentage of individuals with DMFT score ≥1. Modified Poisson regression models were utilized to assess the association between prevalence, severity of dental caries and independent variables. The overall prevalence of dental caries was 66.0% and mean DMFT score of 2.18±2.67. Dental caries prevalence and severity were significantly (p<0.05) associated with tooth cleaning device, age and history of previous dental visit. There was a high prevalence and severity of dental caries among adolescents, which emphasizes the urgent need to develop and design appropriate interventions to reduce the disease burden.Item Root and Canal Morphology of Maxillary First Premolar Teeth in a Ugandan Population(Open J Stomatol, 2011) Rwenyonyi, Charles Mugisha; Kutesa, Annet; Muwazi, Louis; Buwembo, WilliamTo determine the variations in the root and canal morphology of the maxillary first premolar teeth in a Ugandan population. Extracted maxillary first premolar teeth (n = 202) were evaluated in this study. The specimens had their pulp chambers de-roofed. They were decalcified in nitric acid and made transparent with methyl salicylate. Indian ink was injected into the root canals to display their configuration. Results : One hundred and forty eight (73.3%) of the specimens had two roots, of which 16.9% (n =25) had fused roots. About 26.7% (n = 54) of the specimens were single rooted. Eleven (20.4%) of the single rooted specimens had one canal of either Vertucci type I, III, V or VII configuration while 79.6% (n = 43) of the specimens had two canals of either Vertucci type II, IV or VI configuration. The two-rooted specimens exhibited Vertucci type IV and VIII canal configuration: 96.6% and 3.4%, respectively. The single rooted teeth had a higher prevalence of lateral canals, canal intercommunications and multiple apical foramina as compared to the two-rooted specimens. Conclusion : The maxillary first premolar teeth in this Ugandan population showed a higher prevalence of two-root morphology with majority of the roots having Vertucci type IV canal configuration. There was no three-root anomaly recorded in the present material.Item A situation analysis of inter‑professional education and practice for ethics and professionalism training at Makerere University College of Health Sciences(BMC research notes, 2015) Byakika‑Kibwika, Pauline; Kutesa, Annet; Baingana, Rhona; Muhumuza, Christine; Kitutu, Freddy Eric; Mwesigwa, Catherine; Nabirye Chalo, Rose; Sewankambo, Nelson K.Students at Makerere University College of Health Sciences (MakCHS) are introduced to ethics and professionalism using the inter-professional education (IPE) model. Ethics and professionalism should be running themes throughout succeeding years of study during which students are expected to develop qualities and skills for future inter-professional practice (IPP). We performed a situation analysis of IPE and IPP among students and teaching health professionals at MakCHS to guide development of a relevant training curriculum of ethics and professionalism. Methods: A cross sectional study with quantitative and qualitative methods which included questionnaires, focus group discussions and key informant interviews. Results: We interviewed 236 undergraduate students (148, 63 % male) and 32 teaching health professionals (25, 78 % male). Two hundred fifteen (91 %) students indicated they had joint learning activities with students of other professions and 166 (70 %) stated there was benefit in having an IPE model training curriculum. Most students (140, 59 %) strongly agreed that learning with other students will make them more effective members of the health team. Whereas the respondents reported inter professionalism as being well articulated in their course curricula, more than half said IPE is only implemented in the pre-clinical years of study. They noted that IPE and IPP concepts were not well programmed, health professionals engaged in teaching had poor attitudes towards IPE and IPP, there were limited numbers of skilled health care workers to implement IPP and there was poor communication between students and teaching health professionals. Majority of teaching health professionals noted challenges in implementation of IPE such as poor coordination and large student population and major factors influencing ethics and professionalism in healthcare such as limited government support, low pay for the health care workers, disrespect and lack of appreciation of the health workers by the public. Conclusions: Our findings demonstrate that IPE, IPP, ethics and professionalism are not emphasized in the clinical years of study at MakCHS. We recommend increased sensitization on the concepts of IPE and IPP plus enhanced mentorship for both students and teaching health professionals. Innovative strategies of implementation of IPE and IPP for training in ethics and professionalism must be introduced.Item Weight, Height and Eruption Times of Permanent Teeth of Children Aged 4–15 Years in Kampala, Uganda(BMC oral health, 2013) Kutesa, Annet; Nkamba, Eriab Moses; Muwazi, Louis; Buwembo, William; Rwenyonyi, Charles MugishaTooth eruption is a continuous biological process by which developing teeth emerge through the jaws and the overlying mucosa to enter into the oral cavity. Tooth eruption time and sequence are important factors in dental treatment planning, particularly in orthodontics, but also in forensic dentistry to estimate age of a child. Tooth eruption time is influenced by many factors. In this study we set out to determine the timing of eruption of permanent teeth and assess its association with the height and weight of school children aged 4–15 years in Kampala, Uganda.This was a cross sectional study comprising of 1041 healthy Ugandan children: boys/girls (520/521) who were consecutively selected from two primary schools in Kampala. The children were clinically assessed for tooth emergency through the oral mucosa as well as measuring their weight and height. The mean and standard deviation of tooth eruption time was estimated for boys and girls. Bivariate analysis was used to assess any significant association between tooth eruption time and demographic variables. Pearson and partial correlation analyses were used to assess any significant association between the tooth eruption time and anthropometric measurements of the children.Generally, the mean eruption times for girls were lower compared to boys except for three teeth (#25, #32 and #42) which erupted earlier in boys. The average difference in mean eruption times of all teeth between boys and girls was found to be 0.8 (range, 0–1.5) years. In partial correlation analysis, mean tooth eruption times were positively, but not significantly associated with height while controlling for weight except for the mandibular left central incisor (#31). On the other hand, in partial correlation analysis, mean tooth eruption times were positively associated with weight while controlling for height except for tooth #11, #16, #26 and #41. The weight of the child was significantly correlated with mean eruption times in 50% of the teeth.In the present study, the mean tooth eruption times for girls were lower compared to boys except for three teeth (#25, #32 and #42). The height of the child did not show any significant influence on the tooth eruption times while the influence of weight on tooth eruption times was non-conclusive.