Towards the integration of prevention and control of oral diseases within child primary healthcare: The case of Peru

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Community dentistry and oral epidemiology Pub Date : 2024-01-28 DOI:10.1111/cdoe.12945

Ximena Concha Melgar, Diego Azañedo, Fernando Neves Hugo

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Abstract

Objectives

The Peruvian public health norm of primary healthcare (PHC) for growth and development medical check-ups (CRED, Spanish acronym) of children under 5 years of age was updated in 2017 with the inclusion of interdisciplinary prevention and control actions for oral diseases, such as dentist referral. The aim of this study was to explore the association between CRED and oral health services utilization (OHSU), throughout the heterogeneous Peruvian territory.

Methods

A population-based cross sectional study was conducted using the 2021 Demographic and Family Health Survey of Peru and included data from 15 836 children aged 12–59 months. Poisson generalized linear models were used to evaluate the association between any CRED and OHSU, in the 6 months prior to the survey, including sociodemographic characteristics of the children and their mothers as confounding variables. A possible effect modification by natural region of residence (Metropolitan Lima/rest of the Coast/Highlands/Jungle) was evaluated. To examine the robustness of the regression model, a sensitivity analysis was performed using the cumulative number of CRED.

Results

Children who had at least one CRED were almost twice as likely to report OHSU (aPR: 1.95; 95% CI: 1.73–2.21), which was greater in the regions of rest of the Coast (aPR: 2.56; 95% CI: 2.00–3.17) and Jungle (aPR: 2.03; 95% CI: 1.64–2.56). The sensitivity analysis showed consistent results for the association CRED-OHSU. Nevertheless, within the last 6 months, attendance at CRED and OHSU were only achieved by 43.7% and 13.7% of the children respectively.

Conclusions

Integrating oral health into Peruvian Child PHC seems to be a promising public health intervention to increase children's OHSU. For a greater scope, it is crucial to drive greater attendance at CRED and continuous monitoring and strengthening of CRED-based oral health promotion in all Peruvian natural regions with an equity-focused approach.

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将预防和控制口腔疾病纳入儿童初级保健：秘鲁案例。

目标：秘鲁于2017年更新了5岁以下儿童生长发育体检（CRED，西班牙语缩写）的初级医疗保健（PHC）公共卫生规范，纳入了口腔疾病的跨学科预防和控制行动，如牙医转诊。本研究的目的是在秘鲁各地探索 CRED 与口腔健康服务利用率（OHSU）之间的关联：这项基于人口的横断面研究使用了 2021 年秘鲁人口与家庭健康调查的数据，包括 15 836 名 12-59 个月大的儿童的数据。研究采用泊松广义线性模型来评估调查前 6 个月内任何 CRED 与 OHSU 之间的关联，其中包括作为混杂变量的儿童及其母亲的社会人口特征。此外，还评估了自然居住区域（利马大都会区/沿海地区/高地/丛林）可能产生的影响。为了检验回归模型的稳健性，我们使用 CRED 的累积次数进行了敏感性分析：至少有一次 CRED 的儿童报告 OHSU 的可能性几乎是其他儿童的两倍（aPR：1.95；95% CI：1.73-2.21），在沿海其他地区（aPR：2.56；95% CI：2.00-3.17）和丛林地区（aPR：2.03；95% CI：1.64-2.56）报告 OHSU 的可能性更大。敏感性分析表明，CRED-OHSU 的关联结果是一致的。然而，在过去 6 个月中，分别只有 43.7% 和 13.7% 的儿童参加了 CRED 和 OHSU：将口腔健康纳入秘鲁儿童初级保健似乎是一项很有前景的公共卫生干预措施，可以提高儿童的 OHSU 率。为了扩大范围，必须推动更多的儿童参加儿童口腔保健中心，并以公平为重点，在秘鲁所有自然区持续监测和加强以儿童口腔保健中心为基础的口腔保健推广工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.40

自引率

8.70%

发文量

审稿时长

6 months

期刊介绍： The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.