Validation of maternal report of early childhood caries status in Ile-Ife, Nigeria

Morenike Oluwatoyin Folayan,Micheal O Alade,Maha El Tantawi,Abiola A Adeniyi,Peter Alimi,Tracy L Finlayson

doi:10.1186/s12903-020-01288-z

Abstract

BackgroundTo determine the validity of maternal reports of the presence of early childhood caries (ECC), and to identify maternal variables that increase the accuracy of the reports.MethodsThis secondary data analysis included 1155 mother–child dyads, recruited through a multi-stage sampling household approach in Ile-Ife Nigeria. Survey data included maternal characteristics (age, monthly income, decision-making ability) and maternal perception about whether or not her child (age 6 months to 5 years old) had ECC. Presence of ECC was clinically determined using the dmft index. Maternally reported and clinically determined ECC presence were compared using a chi-squared test. McNemar's test was used to assess the similarity of maternal and clinical reports of ECC. Sensitivity, specificity, positive and negative predictive values, absolute bias, relative bias and inflation factor were calculated. Statistical significance was determined at p < 0.05.ResultsThe clinically-determined ECC prevalence was 4.6% (95% Confidence interval [CI]: 3.5–5.0) while the maternal-reported ECC prevalence was 3.4% (CI 2.4–4.6). Maternal reports underestimated the prevalence of ECC by 26.1% in comparison to the clinical evaluation. The results indicate low sensitivity (9.43%; CI 3.13–20.70) but high specificity (96.9%; CI 95.7–97.9). The positive predictive value was 12.8% (CI 4.3–27.4) while the negative predictive value was 95.7% (CI 94.3–96.8). The inflation factor for maternally reported ECC was 1.4. Sensitivity (50.0%; CI 6.8–93.2) and positive predictive value were highest (33.3%; CI 4.3–77.7) when the child had a history of visiting the dental clinic.ConclusionsMothers under-reported the presence of ECC in their children in this study population. The low sensitivity and positive predictive values of maternal report of ECC indicates that maternal reporting of presence of ECC may not be used as a valid tool to measure ECC in public health surveys. The high specificity and negative predictive values indicate that their report is a good measure of the absence of ECC in the study population. Child’s history of dental service utilization may be a proxy measure of presence of ECC.

Highlights

To determine the validity of maternal reports of the presence of early childhood caries (ECC), and to identify maternal variables that increase the accuracy of the reports
ECC was significantly higher for mothers with the highest income, mothers who could make more independent decisions, and those who had utilized dental services before
The study findings indicated that maternal-reported ECC presence exhibited low sensitivity but high specificity

Summary

Introduction

To determine the validity of maternal reports of the presence of early childhood caries (ECC), and to identify maternal variables that increase the accuracy of the reports. Population-based health surveys are increasingly utilizing self-reported health measures to obtain information about disease prevalence [3]. They have been used to measure the prevalence of cancer and cardiovascular diseases [4], juvenile rheumatoid arthritis [5], general health [6,7,8,9,10] and oral health [11, 12]. Self-reported measures were adopted for obtaining information on the oral health of adults in Australia [13] and the United Kingdom [14]. These self-measures have been used among ethnically and age-diverse populations [15, 16]. A few studies used maternal reports of children’s oral health status to assess children’s oral health status [17, 18]

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