Prevalence of dental caries and associated risk factors among HIV-positive and HIV-negative adults at an HIV clinic in Kigali, Rwanda

Abstract

Background Dental caries is among the most frequent oral conditions in HIV-positive (HIV+) persons. There is a lack of baseline information on dental caries prevalence and associated risk factors among HIV+ individuals in comparison to HIV-negative (HIV-) people in Rwanda. Objective This study was conducted to determine the prevalence of dental caries and associated risk factors among HIV+ and HIV- adults at an HIV clinic of Kigali Teaching Hospital (CHUK) in Kigali, Rwanda. Methods A comparative cross-sectional study was conducted among 200 HIV+ and 200 HIV- adults aged 18 years and above attending the HIV clinic of CHUK. An oral examination was performed by a calibrated examiner. Caries was assessed using the WHO Decayed (D), Missing (M), and Filled Teeth (F) index (DMFT). Descriptive statistics, Chi-square, t-tests, and multiple logistic regression were used to analyze data. Results Overall, a higher prevalence (50.5%) of HIV+ adults had dental caries experience (DMFT>0) compared to HIV- counterparts (40.5%) (p=0.045). The prevalence of Decayed teeth (D) was also higher (23.5%) among HIV+ participants compared to HIV- persons (13.6%) (p=0.011). The Mean(SD) DMFT scores among HIV+ and HIV- participant were 2.28 (3.68) and 1.29 (2.21) respectively (p=0.001). After performing multiple logistic regression analysis, the predictors of dental caries in HIV+ persons were being a female (OR= 2.33; 95%CI= 1.14-4.75), frequent dental visits (OR= 4.50; 95% CI=1.46-13.86) and detectable RNA viral load (OR= 4.50; 95% CI=1.46-13.86). In HIV- participants, the middle age range (36-45 years), and frequent dental visits were significantly associated with dental caries (OR= 6.61; 95%CI=2.14-20.37) and (OR=3.42; 95%CI: 1.337-8.760) respectively. Conclusion The prevalence of dental caries was higher in HIV+ adults than in HIV- counterparts. The reported higher prevalence of caries in HIV+ persons was associated with being a female, detectable viral load, and frequent dental visits. Therefore, there is a need for effective oral health interventions specific to HIV+ individuals in Rwanda to raise awareness of the risk of dental caries and provide preventive oral health services among this population. To ensure timely oral health care among HIV+ persons, there is a need for an effort from policymakers and other stakeholders to integrate oral health care services within the HIV treatment program in Rwanda.