Ndayisabye Halifa, Ndagijimana Albert, Biracyaza Emmanuel, Umubyeyi Aline
Epidemiology and Biostatistics Department, School of Public Health, University of Rwanda, Kigali, Rwanda.
Department of Clinical and Public Health Services, Ministry of Health, Government of Rwanda, Kigali, Rwanda.
Front Oral Health. 2022 Mar 18;3:844254. doi: 10.3389/froh.2022.844254. eCollection 2022.
Oral cancer (OC) is one of the most common cancers that remain global public health concerns in low- and middle-income countries. The epidemiology of OC in Africa endures uncertain. Earlier reports suggested a relatively low incidence of OC among Africans. Acting on behavioral factors and setting early diagnosis and treatments of OC can tremendously reduce morbidity and mortality related to it. This study determined factors associated with the OC adverse outcome and death in the Rwanda Military Hospital. A cross-sectional study was conducted among 311 medical records of patients who consulted in the Oral and Maxilla Facial Department between January 1, 2007 and December 31, 2019. Associated factors were estimated by use of odds ratios (OR) with their 95% confidence intervals (CI) in bivariate and multivariate logistic regression analyses to estimate predictors of an OC adverse outcome and death. Almost three quarters of the participants were from rural areas ( = 229, 73.6%) and alcohol users ( = 247, 79.1%). Concerning primary site infection, 54.02% of the participants had the intra-oral cavity within the past 5 years. Muslims had greater odds to experience an OC adverse outcome and death [aOR = 6.7; 95% CI (3.8-11.9), < 0.001] than the Catholics. Those with no formal education significantly had greater likelihoods to have an OC adverse outcome and death [aOR = 2.6; 95% CI (1.3-5.3), = 0.005] than those with higher education or university. Those with primary education had greater likelihoods [aOR = 1.8; 95% CI (1.1-3.1), = 0.03] to have an OC adverse outcome than those with higher or university education. Those with oral hygiene had less risk to have an OC adverse outcome and death [aOR = 0.2; 95% CI (0.0-0.9), = 0.039] than their counterparts. Using multi-sectorial approaches, including policy makers, clinicians, and researchers from public and private institutions, may be of an added value to promote clinical research on OC for earning knowledge, contributing to combat risk behaviors and improve the population's information and education on OC prevention.
口腔癌（OC）是中低收入国家中仍受全球公共卫生关注的最常见癌症之一。非洲口腔癌的流行病学情况尚不确定。早期报告显示非洲人口腔癌发病率相对较低。针对行为因素并尽早进行口腔癌的诊断和治疗，可大幅降低与之相关的发病率和死亡率。本研究确定了卢旺达军事医院中与口腔癌不良结局和死亡相关的因素。对2007年1月1日至2019年12月31日期间在口腔颌面科就诊的311例患者的病历进行了横断面研究。在二元和多变量逻辑回归分析中，通过使用比值比（OR）及其95%置信区间（CI）来估计相关因素，以评估口腔癌不良结局和死亡的预测因素。近四分之三的参与者来自农村地区（n = 229，73.6%）且为饮酒者（n = 247，79.1%）。关于原发部位感染，54.02%的参与者在过去5年内患有口腔内疾病。与天主教徒相比，穆斯林出现口腔癌不良结局和死亡的几率更高[aOR = 6.7；95% CI（3.8 - 11.9），P < 0.001]。未受过正规教育的人出现口腔癌不良结局和死亡的可能性显著高于受过高等教育或大学教育的人[aOR = 2.6；95% CI（1.3 - 5.3），P = 0.005]。与受过高等教育或大学教育的人相比，小学教育程度的人出现口腔癌不良结局的可能性更大[aOR = 1.8；95% CI（1.1 - 3.1），P = 0.03]。保持口腔卫生的人出现口腔癌不良结局和死亡的风险低于未保持口腔卫生的人[aOR = 0.2；95% CI（0.0 - 0.9），P = 0.039]。采用多部门方法，包括政策制定者、临床医生以及来自公共和私立机构的研究人员，可能有助于促进口腔癌临床研究，以获取知识、应对危险行为并提高民众对口腔癌预防的信息了解和教育水平。
