HIV Status Impact on Oral Health Related Quality of Life in 3- to 4-year-old Kenyan Children

Abstract

Purpose: This study investigates the impact of HIV status on oral health manifestations and oral health-related quality of life (OHRQoL) in Kenyan children aged 3 to 4 years old. Methods:360 children living in Kisumu County in West Kenya were enrolled in a longitudinal study with recruitment from 31 clinics and hospitals for patients: age 3- to 4-years-old at time of enrollment, with medical clearance, living in Kisumu County the next subsequent 12 months from enrollment, and with parent-caregiver consent. A nested cross-sectional study analyzed scores from Early Childhood Oral Health Impact Scale (ECHOIS) questionnaires given to those same childrens’ parent-caregivers. Equal-sized HIV status groups included: children HIV positive (HIV), exposed to but uninfected (HEU), and unexposed and uninfected (HUU). Parent-caregivers evaluated OHRQoL through nine child-focused questions across four domains: symptoms, function, psychology, and self-image/social interaction. Higher ECOHIS scores indicated a greater perceived negative impact on quality of life. Data was analyzed using descriptive statistics, t-test, and regression analysis (P<.05) for each group. Results: The total population demographics descriptive analysis showed: mean age of 3.4 years, females 51%, majority attending a private school 47% (no school 31%, public school 22%), and a majority live in a rural area 49% (urban 35%, peri-urban 16%). Significant differences were not detected between HIV status groups for all oral manifestations except for abnormal findings. However, the HIV group did have an increased prevalence of abnormal findings with 81% compared to the HEU group at 60% and the HUU group at 54%. The HIV group reported the lowest ECOHIS score (15%) compared to HEU (24.2%) and HUU (34.2%) in the Combined Child Function domain (p=0.003) Within that domain, the HIV group reported the lowest ECOHIS score (8.3%) compared to HEU (12.5%) and HUU (22.5%) for the specific question, Difficulty of drinking cold and hot beverages (p=0.006). Differences for other questions and domains were not statistically significant between HIV groups. Conclusion: Statistically significant findings were limited to the Child Function Domain and the specific question, Difficulty drinking hot or cold beverages, with lower ECOHIS scores in the HIV group. Further research is proposed to assess how life-threatening conditions like HIV influence parental-caregivers’ perception of the oral health and OHRQoL with a longitudinal study design.