Abstract
BackgroundHuman immunodeficiency virus (HIV) related orofacial lesions (HROLs) impact negatively on the health of patients and could be managed at primary healthcare (PHC) level. Community health workers (CHWs) are crucial in optimal patient management through patient identification, education and early referral for professional care. The study objective was to assess knowledge of Nairobi East district CHWs regarding HROLs and other common oral diseases.MethodsOf the total population of CHWs, 815 [94.5%] completed a 56-item questionnaire covering 5 topics: general dental knowledge, knowledge about HROLs, past encounters with HROLs, current care at community level, opinions regarding oral health problems; and items concerning background characteristics and past training activities. Confirmatory factor analysis revealed Cronbach’s alpha coefficient values of 0.45, 0.59, 0.79, 0.50 and 0.09 respectively. The first four topics were confirmed as domains. Mean minimum score was 0 and mean maximum score was 1 for each variable. However, for ‘past encounters with HROLs, the minimum score was 0 and maximum score was 5.ResultsCHWs had moderate knowledge about general oral health (mean = 0.47) and HROLs (mean = 0.43). None had been formally trained in oral health aspects. Although they had high opinions regarding their role in identifying, educating and referring patients with HROLs (mean = 0.80) to the health facilities, they actually rarely referred such patients.ConclusionsCHWs need training for building competence in promoting oral health among general and HIV patients in their communities and in early identification and management of non-HIV oral lesions.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1066) contains supplementary material, which is available to authorized users.
Highlights
Human immunodeficiency virus (HIV) related orofacial lesions (HROLs) impact negatively on the health of patients and could be managed at primary healthcare (PHC) level
Detecting HROLs as part of their community duties would increase the probability of early identification of HIV-infected people and those developing highly active antiretroviral therapy (HAART) resistance
Additional written approval was granted by the Nairobi Provincial Medical officer and the respective district heads for the study to be conducted in Nairobi East district, where a linked study for PHC workers was ongoing [10]
Summary
Human immunodeficiency virus (HIV) related orofacial lesions (HROLs) impact negatively on the health of patients and could be managed at primary healthcare (PHC) level. The lesions may be painful and at times persist for long periods, leading to (prolonged) compromised food intake and exacerbation of the ill-health of patients. In Kenya, primary healthcare (PHC) providers (mainly clinical officers and nurses) at health facilities and community health workers (CHWs) in the field are required to integrate oral care of HIV patients into the PHC system [8,9]. These health workers have not been educated on oral diseases. In Kenya, HIV patients might not seek early care, even when the signs and symptoms are overwhelming, owing to social stigma and ignorance about the lesions (LNK personal communication)
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