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A 3 -year-old boy presented with a forehead nodular mass, which was excised and confirmed histologically as Juvenile Xanthogranulomma (JXG). It affects children with a predilection for the head and neck region. A relatively rare, benign, histiocytic proliferative cutaneous disorder with a potential for malignancy. A prompt and wide resection is recommended.

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BACKGROUND: Cerebral palsy (CP) is a non-progressive neuromuscular condition diagnosed in childhood. CP as a form of disability, does not cause any specific oral disease. However, some oral conditions are more commonly associated with people with CP compared to the general population. The overarching aim of the current study was to determine the oral hygiene status, gingival status, and the prevalence of dental caries in children with CP attending a leading hospital institution for children with disabilities in Kampala, Uganda. Additionally, we determined the barriers faced by children with CP in accessing oral healthcare. METHODS: This cross-sectional study was carried out at the Comprehensive Rehabilitation Services Uganda hospital in Kampala, Uganda. Our study population consisted of a convenient sample of 90 children diagnosed with CP aged 3-17 years and their caregivers. A validated and interviewer administered structured questionnaire was used to collect socio-demographic data of the participants. A modified World Health Organization oral health assessment form for those aged 3-17 years was used to gather data on oral health status (plaque score, gingival bleeding and dental caries.) The data was subjected to statistical tests with critical value set up at 5%. RESULTS: Only 32.2% of the children evaluated had adequate oral hygiene, while 44.4% of the children experienced gingival bleeding. The prevalence of dental caries for both deciduous and permanent dentition was 63.3%, with DMFT values of 3.8 ± 4.5. The most common barrier reported by the caregivers was the challenge in modality of transportation availability from the children's homes to the health facilities (34.4%). CONCLUSIONS: Children with CP in the study population have a significant prevalence of oral diseases and face several barriers to oral healthcare. Results from this study aim to provide relevant support to advocate for a nationwide change in policy to improve access to dental care to decrease the burden of oral diseases in children with special healthcare needs.

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BACKGROUND: One of the World Health Organisation (WHO) global health goals stated that the global average for dental caries should not have been more than 3 DMFT at 12 years of age by the year 2000. However, the prevalence of dental caries, gingivitis and dental treatment needs among 12-year-old children in many regions of the developing world had then hardly been investigated. OBJECTIVE: To determine the prevalence of dental caries and gingivitis and the dental treatment needs among 12-year-old children in Kitale Municipality in North- Western Kenya. DESIGN: Descriptive cross-sectional study. SETTING: Primary schools in Kitale Municipality. SUBJECTS: Two hundred and ninety two children aged 12 years were randomly selected from eight schools that were also randomly selected. Data were collected according to the WHO Oral Health Survey Methods. The children were examined for decayed (D), missing due to decay (M) and filled teeth and the caries experience using the DMFT index was computed. Gingivitis and treatment needs were assessed using the CPITN index. RESULTS: The overall prevalence of dental caries was 50.3% while its prevalence when only the permanent teeth were considered was 44.5% with a mean DMFT of 0.92 +/-50 1.36. Girls had a significantly higher caries experience (DMFT) than boys (p<0.05). The main treatment need indicated for decayed teeth was one surface restoration with 46.9% of all the children requiring this kind of treatment. Endodontics was indicated in 7.5% of the children while extractions were the least required treatment with 5.1% of the children examined requiring this treatment. The prevalence of gingivitis was 77.7%. Out of these 38.7% of the children required professional dental care entailing scaling and oral prophylaxis. CONCLUSION: The prevalence of dental caries and gingivitis was high hence there was greater need for one surface restoration and full mouth scaling for these children. School based oral health programme to improve oral hygiene of these children is recommended.

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BACKGROUND: United states Agency for International development-Academic Model for Providing Accesses to Healthcare (USAID-AMPATH) cares for over 80,000 HIV-infected patients. Express care (EC) model addresses challenges of: clinically stable patient's adherent to combined-antiretroviral-therapy with minimal need for clinician intervention and high risk patients newly initiated on cART with CD4 counts < or = 100 cells/mm3 with frequent need for clinician intervention. OBJECTIVE: To improve patient outcomes without increasing clinic resources. DESIGN: A descriptive study of a clinician supervised shared nurse model. SETTING: USAID-AMPATH clinics, Western Kenya. RESULTS: Four thousand eight hundred and twenty four patients were seen during the pilot period, 90.4% were eligible for EC of whom 34.6% were enrolled. Nurses performed all traditional roles and attended to two thirds and three quarters of stable and high risk patient visits respectively. Clinicians attended to one third and one quarter of stable and high risk patient visits respectively and all visits ineligible for express care. CONCLUSION: The EC model is feasible. Task shifting allowed stable patients to receive visits with nurses, while clinicians had more time to concentrate on patients that were new as well as more acutely ill patients.

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