Department of Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
Department of Dentistry, School of Dentistry, Makerere University College of Health Sciences, Kampala, Uganda.
BMC Oral Health. 2024 Oct 29;24(1):1314. doi: 10.1186/s12903-024-05074-z.
The impact of periodontitis on large populations of people living with HIV (PLHIV) in resource-constrained settings remains largely un-investigated. This study aims to address this knowledge gap by providing a comprehensive description of the periodontal health status among a sizable cohort of Ugandans living with HIV.
This was a cross-sectional study with 4,449 participants who were over 18-years old with data captured on their reported age, gender, tobacco use, length of time on HAART and alcohol use. Periodontal health was assessed using the WHO periodontal probe and the modified CPI data entry form. Descriptive statistics were reported using frequencies for the affected number of sextants in the surveyed participants. This was followed by additional regression analysis using the R statistical computing environment, with the periodontal health outcomes (bleeding on probing, pocket depth and clinical attachment loss) individually as the dependent, recorded as binary outcomes. A multilevel model was run with clinical attachment loss as the dependant variable controlling for all the other factors. The 95% confidence intervals were used to report the level of significance for each test.
There were 3,103/4,449 (69.7%) female participants. The mean age was 44.3 years (SD 10.1 years) with a range of 18 to 89 years. About 66% of the participants had bleeding on probing at one or more of the examined sites/tooth surfaces. The odds for bleeding on probing were significantly higher for female participants (adjusted Odds ratio: 1.49, 95% CI 1.19 to 1.86), and higher in individuals who reported tobacco use (adjusted odds ratio 1.62, 95% CI 1.09 to 2.41). Slightly under half of our participants (48.2%) had moderate to severe clinical attachment loss.
This study found that among Ugandans living with HIV, periodontal disease is a significant public health concern. The majority of study participants had bleeding on probing and almost half of them recording moderate to severe clinical attachment loss, worsened by age and time on HAART. This highlights the need for comprehensive oral health care and targeted interventions for this population.
牙周炎对资源有限环境中大量艾滋病毒感染者（PLHIV）的影响尚未得到充分研究。本研究旨在通过对相当数量的乌干达艾滋病毒感染者的牙周健康状况进行全面描述来填补这一知识空白。
这是一项横断面研究，共有 4449 名年龄在 18 岁以上的参与者，他们的报告年龄、性别、吸烟、接受抗逆转录病毒治疗（HAART）的时间和饮酒情况均被记录下来。牙周健康状况使用世界卫生组织牙周探针和改良的 CPI 数据输入表进行评估。描述性统计采用受检者中受影响的六分位数数量的频率进行报告。随后使用 R 统计计算环境中的回归分析，将牙周健康结果（探诊出血、牙周袋深度和临床附着丧失）分别作为因变量，记录为二分类结果。使用多水平模型以临床附着丧失为因变量，控制所有其他因素。95%置信区间用于报告每个测试的显著性水平。
3103/4449（69.7%）名参与者为女性。平均年龄为 44.3 岁（标准差为 10.1 岁），年龄范围为 18 至 89 岁。约 66%的参与者在一个或多个检查部位/牙齿表面有探诊出血。女性参与者的探诊出血可能性显著更高（调整后的优势比：1.49，95%CI 1.19 至 1.86），报告吸烟的参与者的探诊出血可能性更高（调整后的优势比 1.62，95%CI 1.09 至 2.41）。略低于一半的参与者（48.2%）有中度至重度临床附着丧失。
本研究发现，在乌干达的艾滋病毒感染者中，牙周病是一个严重的公共卫生问题。大多数研究参与者有探诊出血，几乎一半的参与者有中度至重度临床附着丧失，年龄和接受 HAART 的时间会使情况恶化。这突出表明需要为这一人群提供全面的口腔保健和有针对性的干预措施。
