Faculty of Dentistry, University of Science and Technology, Omdurman, Sudan.
BMC Oral Health. 2009 Nov 16;9:30. doi: 10.1186/1472-6831-9-30.
HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors.
Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH) and University of Science and Technology (UST) during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH) were examined clinically (DMFT) and participated in an interview.
A total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5) were associated with lower odds and females were associated with higher odds (OR = 2.0) for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6) and higher HIV related experience (OR = 0.7) were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3) were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8).
Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to minimize avoidance behaviour and help establish dental health care patterns in Sudan.
艾滋病毒感染者在苏丹牙科保健服务中的就诊频率预计会不断增加。艾滋病毒流行背景下的牙科保健服务利用情况总体上了解甚少。本研究聚焦于报告艾滋病毒感染状况未知的苏丹牙科患者，评估了以倾向因素（社会人口统计学）、促成因素（与艾滋病毒相关的知识、态度和感知风险）和需求相关因素（口腔健康状况）为基础的安德森模型在多大程度上可以预测牙科保健服务的利用情况。研究假设促成因素在解释牙科保健服务的利用情况方面会超出倾向因素和需求相关因素。
2008 年 3 月至 7 月期间，从喀土穆牙科教学医院（KDTH）和科学技术大学（UST）招募了牙科患者。共有 1262 名患者（平均年龄 30.7 岁，56.5%为女性，61%来自 KDTH）接受了临床检查（DMFT）并参加了访谈。
共有 53.9%的患者确认在过去 2 年内至少去过一次牙科诊所接受治疗。逻辑回归分析显示，倾向因素；在苏丹境内旅行（OR = 0.5）与较低的就诊几率相关，而女性则与较高的就诊几率（OR = 2.0）相关。促成因素；更高的艾滋病毒传播知识（OR = 0.6）和更高的艾滋病毒相关经验（OR = 0.7）与较低的就诊几率相关，而对感染者的积极态度和对传染风险的高感知（OR = 1.3）与较高的就诊几率相关。在需求相关因素中，龋齿患病经历与牙科保健服务的利用情况密切相关（OR = 4.8）。
牙科保健服务利用历史的差异不仅超出了社会人口统计学地位和对牙科保健的需求。应该提高公众对艾滋病毒感染控制的认识和对牙医能力的信心，以尽量减少回避行为，并帮助在苏丹建立牙科保健模式。
