Browsing by Author "Willumsen, Tiril"

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    Child saliva microbiota and caries:
    (Scientifc Reports, 2022) Muhoozi, K. M. Grace; Li, Kelvin; Atukunda, Prudence; Skaare, B. Anne; Willumsen, Tiril; Enersen, Morten; Westerberg, C. Ane; Morris, Alison; Vieira, R. Alexandre; Iversen, O. Per; Methé, A. Barbara
    Undernutrition is a public health challenge in sub-Saharan countries, including Uganda. In a previous randomized controlled trial (RCT) with a nutrition, hygiene and stimulation education intervention among mothers of 6 months’ old children, we found less caries in the intervention group when the children were 36 months of age. We now examined the efects of (i) the intervention on the microbiota, (ii) microbiota on caries, and (iii) the intervention and microbiota on caries. The original RCT comprised 511 mother/child pairs whereas in the current study we had access to data from 344/511 (67%) children aged 36 months. The saliva microbiota was determined using 16S rRNA gene sequencing. Carious lesions (a proxy for dental health) were identifed using close-up intra-oral photographs of the upper front teeth. Statistical models were used to determine hostmicrobiota associations. The intervention had a signifcant efect on the microbiota, e.g. an increase in Streptococcus abundance and decreases in Alloprevotella and Tannerella. Signifcant associations between the microbiota and dental caries were identifed: Positive associations of Capnocytophaga and Tannerella suggest that these taxa may be deleterious to dental health while negative associations of Granulicatella, Fusobacterium, and Abiotrophia suggest taxa potentially benefcial or benign contributors to dental health. Based on taxonomic profles, the efects of the intervention and microbiota on dental health may be independent of one another. Educational interventions with emphasis on nutrition and oral hygiene may provide a feasible strategy to decrease progression of childhood caries in low-resource settings.
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    Effects of nutrition and hygiene education on oral health and growth among toddlers in rural Uganda:
    (John Wiley & Sons Ltd, 2018-04) Muhoozi, K. M. Grace; Atukunda, Prudence; Skaare, B. Anne; Willumsen, Tiril; Diep, My Lien; Westerberg, C. Ane; Iversen, O. Per
    Objective: To examine the effect of a nutrition and hygiene education intervention on oral health behaviour and whether early onset of caries was related to child growth in rural Uganda. Methods: Follow-up study of a cluster-randomised controlled trial conducted between October 2013 and January 2015. Data were available from 399 mother/child pairs (203 in the intervention and 198 in the control group) of the original trial (78%) when the children were 36 months old. Oral health behaviour was evaluated using questionnaires. Photographs of the maxillary anterior teeth were examined for unmistakably carious lesions, and 115 water samples from the study area were analysed for fluoride concentration. Results: The frequency of cleaning of the child’s teeth at 36 months was about twice as high in the intervention as in the control group (84.3% vs. 46.6%; P = 0.0001). Cavitated carious lesions occurred more frequently in the control than the intervention group (27.8% vs. 18.2%; P = 0.04). Extraction of ‘false teeth’ (ebiino), a painful and crude traditional operation, was profoundly reduced in the intervention group (8.9% vs. 24.7%; P = 0.001). There was no evidence of association between the occurrence of caries and child growth. Conclusions: The education intervention improved oral hygiene practices and reduced the development and progression of caries and extraction of ebiino. Early childhood caries was not clearly associated with child growth. Keywords: Children, nutrition education, oral hygiene, teeth, caries, Uganda
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    Nutrition, hygiene, and stimulation education to improve growth, cognitive, language, and motor development among infants in Uganda:
    (John Wiley & Sons Ltd, 2017-08) Muhoozi, K. M. Grace; Kaaya, N. Archileo; Iversen, O. Per; Atukunda, Prudence; Skaare, B. Anne; Diep, M. Lien; Willumsen, Tiril; Mwadime, Robert; Westerberg, C. Ane
    Stunting is associated with impaired cognitive and motor function. The effect of an education intervention including nutrition, stimulation, sanitation, and hygiene on child growth and cognitive/language/motor development, delivered to impoverished mothers in Uganda, was assessed. In a community‐based, open cluster‐randomized trial, 511 mother/children dyads aged 6–8 months were enrolled to an intervention (n = 263) or control (n = 248) group. The primary outcome was change in length‐for‐age z‐score at age 20–24 months. Secondary outcomes included anthropometry and scores on the 2 developmental scales: Bayley Scales of Infant and Toddler Development‐III and the Ages and Stages Questionnaire. There was no evidence of a difference in mean length‐for‐age z‐score at 20–24 months between the 2 study groups: 0.10, 95% CI [−0.17, 0.36], p = .49. The intervention group had higher mean composite development scores than the controls on Bayley Scales of Infant and Toddler Development‐III, the mean difference being 15.6, 95% CI [10.9, 20.2], p = .0001; 9.9, 95% CI [6.4, 13.2], p = .0001; and 14.6, 95% CI [10.9, 18.2], p = .0001, for cognitive, language, and motor composite scores, respectively. The mean difference in scores from the Ages and Stages Questionnaire were 7.0, 95% CI [2.9, 11.3], p = .001; 5.9, 95% CI [1.2, 10.3], p = .01; 4.2, 95% CI [1.7, 6.7], p = .001; 8.9, 95% CI [5.3, 12.3], p = .0001; and 4.4, 95% CI [0.0, 8.8], p = .05, for communication, gross motor, fine motor, problem solving, and personal–social development, respectively. The intervention education delivered to mothers promoted early development domains in cognitive, language, and motor development but not linear growth of small children in impoverished rural communities in Uganda. Our study showed that child development may be improved with a relatively low cost intervention strategy. This trial was registered at ClinicalTrials.gov as NCT02098031. KEYWORDS: Cognitive development, growth, hygiene, infant, nutrition education, Uganda