Fatusi Olawunmi Adedoyin, Ogunbodede Eyitope, Sowole Christiana Ayomide, Folayan Morenike Oluwatoyin
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Department of Preventive Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria.
Indian J Dent Res. 2018 Sep-Oct;29(5):622-626. doi: 10.4103/ijdr.IJDR_734_16.
The study investigated the common dental conditions of children seen in a Nigerian tertiary hospital. The referral patterns were also determined to know how many of the patients had sought care at the lower levels of health before visiting a tertiary hospital.
All the children aged 0-15 years seen at the Dental hospital, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria over a 4-year period were included in the study. Information retrieved from their case notes including patterns of referral, presenting complaints, diagnosis, and treatment were extracted from the case records of the patients. Treatment plans for patients seen at this tertiary hospital were categorized into primary, secondary, and tertiary health-care services.
A total of 1,866 children sought treatment over a 4-year period at this tertiary hospital of which 1715 (91.9%) sought treatment without referral from lower levels of care. Only 102 (5.4%) children were referred from primary health care (PHC) centers. Six hundred and seventy-five (36.2%) children presented with pain while 502 (26.9%) attended for a "check-up." Furthermore, 779 (41.8%) children were diagnosed with periodontal disease (including gingivitis) and 539 (28.9%) with dental caries. Scaling and polishing with oral hygiene instruction was the most common treatment recommended. Only 5% of children seen at this tertiary health facility required specialized oral health-care services provided by tertiary health institutions.
The range of oral health care needed and service provided by and for patients who visited this tertiary health-care institution can be effectively provided in a primary or secondary oral health-care delivery center. The poor integration of oral health care into PHC services in Osun State burdens the tertiary health-care institutions to provide nonspecialized oral health-care services.
本研究调查了一家尼日利亚三级医院中儿童的常见口腔疾病情况。同时还确定了转诊模式，以了解有多少患者在前往三级医院就诊之前曾在较低级别的医疗机构寻求过治疗。
纳入了在尼日利亚伊费市奥巴费米·阿沃洛沃大学教学医院综合院区牙科医院4年期间就诊的所有0至15岁儿童。从他们的病历中检索到的信息，包括转诊模式、就诊主诉、诊断和治疗情况，均从患者的病例记录中提取。在这家三级医院就诊患者的治疗计划被分为初级、二级和三级医疗服务。
在这4年期间，共有1866名儿童在这家三级医院接受治疗，其中1715名（91.9%）在未从较低级别医疗机构转诊的情况下前来治疗。只有102名（5.4%）儿童是从初级卫生保健（PHC）中心转诊而来。675名（36.2%）儿童主诉疼痛，而502名（26.9%）是来进行“检查”。此外，779名（41.8%）儿童被诊断患有牙周疾病（包括牙龈炎），539名（28.9%）患有龋齿。推荐的最常见治疗方法是进行洗牙和抛光并给予口腔卫生指导。在这家三级医疗机构就诊的儿童中，只有5%需要三级医疗机构提供的专门口腔保健服务。
对于前来这家三级医疗机构就诊的患者所需的口腔保健范围以及该机构所提供的服务，在初级或二级口腔保健服务中心即可有效提供。奥孙州口腔保健服务与初级卫生保健服务整合不佳，这给三级医疗机构带来了提供非专科口腔保健服务的负担。
