RESUMO
OBJECTIVE: The objective of this retrospective cohort study was to determine the effects of early childhood protein-energy malnutrition (EC-PEM) and current nutritional status as defined by anthropomorphic measures on the exfoliation and eruption patterns of teeth among adolescents. METHODS: Oral clinical examinations were conducted in 2005 using World Health Organization (WHO) diagnostic criteria on 498 11- to 13-year-old Haitians for whom early childhood malnutrition data were available. Anthropomorphic records (weight-for-age) from the Haitian Health Foundation computerized database on children from birth through 5-years old were utilized. Current heights and weights were ascertained. Both sets of data were converted to z-scores based on the National Center for Health Statistics (NCHS) referent database. Based upon these z-scores, EC-PEM and current malnutrition categories were developed for this study. The analyses separately regressed the number of primary and permanent teeth on age, gender, EC-PEM status and current nutritional status. RESULTS: Both a delayed exfoliation of primary teeth and a delayed eruption of permanent teeth were associated with EC-PEM and current stunting in adolescence. The observed associations were either direct and statistically significant or indirectly demonstrated by presenting evidence of confounding. The overall interpretation of the models is that malnutrition beginning in the earliest years and extending throughout childhood influences the exfoliation and eruption of teeth. CONCLUSION: These findings present evidence of an association between tooth exfoliation/eruption patterns and both EC-PEM and nutritional insufficiency (stunting) throughout childhood. This observed delay in the exfoliation of the primary dentition and in the eruption of the permanent dentition has practical significance in interpreting age-specific dental caries data from populations with different malnutrition experiences.
Assuntos
Transtornos da Nutrição Infantil/complicações , Transtornos do Crescimento/etiologia , Desnutrição Proteico-Calórica/complicações , Erupção Dentária/fisiologia , Esfoliação de Dente/fisiopatologia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Haiti , Humanos , Lactente , Transtornos da Nutrição do Lactente/complicações , Análise de Regressão , Estudos Retrospectivos , Fatores SexuaisRESUMO
OBJECTIVE: Studies of dental caries should account for sugar consumption as a potential confounder or effect modifier of other exposure-caries associations. The purpose of this study was to assess the reliability of a sugar consumption score for rural Haiti through correlation of test-retest scores derived from a structured, interviewer-administered questionnaire. METHODS: A structured, interviewer-administered questionnaire of sugar consumption was developed for rural Haiti to achieve contextual validity. The resulting questionnaire had two parts; one part captures the child's consumption of sugar products frequency; the second part captures sugar additions to the child's food preparation. A test-retest, one week apart, was conducted on a sample of 30 mother-child pairs (children ages 9-17). Test-retest correlations and paired t-testing was conducted to assess the questionnaire's reliability. RESULTS: All test-retest (Part 1, children's questions; Part 2, mother's questions; the combined scores) had Pearson product correlation coefficients of 0.7 or greater, respectively. All test-retest scores had paired t-test p-values3 0.95. CONCLUSIONS: A reliable, contextually valid relative sugar consumption questionnaire specific for rural Haiti is presented. The questionnaire and methodology employed in its development and testing may have utility for dental caries researchers in investigations in less developed countries.
Assuntos
Adolescente , Feminino , Humanos , Masculino , Sacarose Alimentar , Inquéritos e Questionários , Haiti , Mães , Reprodutibilidade dos Testes , População Rural , Sacarose Alimentar/administração & dosagemRESUMO
In industrialized countries, the zoonotic disease anthrax has been virtually eradicated because of effective public health measures including animal vaccination and quality control of animal products. In developing parts of the world, however, anthrax remains an occupational hazard of herdsmen and workers who have direct contact with infected animals or who process animal hides, hair, bone and bone products, and wool. For clinicians unfamiliar with this interesting infectious disease, the major dermatologic characteristics and clinical evolution of five cases of cutaneous anthrax are reviewed in this study in both descriptive and photographic forms, to define the clinical spectrum of cutaneous disease.