Abstract
BackgroundEarly childhood dental caries impacts on the quality of life of children and their families. This study set out to assess the psychometric properties of an oral health related quality of life, OHRQoL, measure, based on items emanating from the Child-and Family impact sections of the Early Childhood Oral Health Impact Scale (ECOHIS), in Kiswahili and Luganda speaking communities. It was hypothesized that the Child- and Family impact scores would discriminate between children with and without clinically defined dental problems and reported good and bad oral health.MethodKiswahili and Luganda versions of the Child- and Family impact scores were derived through translation in pilot studies. Totals of 1221 and 816 child/caretaker pairs attending health care facilities in Manyara, Tanzania and Kampala, Uganda, were recruited into the study. After caretakers completed the interview, their children underwent oral clinical examination.ResultsInternal consistency reliability (Cronbach’s alpha) was > 0.80 with respect to the Child impact score and 0.79 regarding the Family impact score. Multiple variable logistic- and Poisson regression analyses revealed that the Kiswahili and Luganda versions of the Child- and Family impact score associated in the expected direction with child’s oral diseases as with their reported health and oral health status. In Manyara, multiple logistic regression revealed that the ORs of reporting Child impacts were 1.8 (95% CI 1.0-3.4) and 2.2 (1.3-3.4) among caretakers who confirmed linear hypoplasia and teething symptoms, respectively. In Kampala, the ORs for reporting Child impacts were 2.3 (95% CI 1.3-3.9), 1.7 (95% CI 1.1-2.5), 1.6 (95% CI 1.2-2.3) and 2.7 (95% CI 1.3-5.8) among those who confirmed teeth present, hypoplasia, teething symptoms and tooth bud extractions, respectively. The odds ratios for reporting Family impacts were 2.7 (95% CI 1.5-4.7), 1.5 (95% CI 1.1- 2.1) and 4.6 (95% CI 2.0-10.7) if reporting LEH, teething symptoms and toothbud experience, respectively.ConclusionThe Child and Family impact scores demonstrated acceptable internal consistency reliability and reproducibility whereas the discriminative validity was more ambiguous. The OHRQoL scores should be developed further and tested among Kiswahili and Luganda speaking caretakers.
Highlights
Childhood dental caries impacts on the quality of life of children and their families
In Manyara, multiple logistic regression revealed that the ORs of reporting Child impacts were 1.8 and 2.2 (1.3-3.4) among caretakers who confirmed linear hypoplasia and teething symptoms, respectively
Considering that this study focused on caregiver child pairs attending reproductive health care facilities for immunization and weight monitoring in response to an invitation and not for treatment purposes, the strength of this study is the possibility of extrapolating the findings beyond the health care office setting to the general population
Summary
Childhood dental caries impacts on the quality of life of children and their families. Growing global concerns about the consequences of children’s functional status coincides with the development and testing of disability- and health related quality of life measures [1,2]. ECOHIS was originally developed in English, and has been adapted for use in other languages, including French, Chinese, Brazilian and Farsi [11,12,13,14,15] This inventory is administered by children’s caregivers and has been found to be responsive to treatment of ECC and to discriminate between children with various levels of caries experience [8,17]. In light of the Tanzanian and Ugandan health policy prioritizing children below 5 years as target groups for oral health care services and considering the rising profile of childhood disability, ECOHIS is worthy consideration, by identifying groups vulnerable for impaired OHRQoL and by providing information that might aid in planning of health care policy initiatives [2]
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