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

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RESEARCH ARTICLE

Validation of maternal report of early childhood caries status in Ile‑Ife, Nigeria Morenike Oluwatoyin Folayan1*  , Peter Alimi2, Micheal O. Alade3, Maha El Tantawi4, Abiola A. Adeniyi5 and Tracy L. Finlayson6

Abstract  Background:  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. Methods:  This 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, decisionmaking 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  N60,000 (168)/month [31]. Mothers’ educational status was defined as no formal education, primary school only, secondary school only, or tertiary (post-secondary) education. Women decision‑making ability

Data about women’s participation in making decisions concerning (1) their own health care, (2) major household purchases, and (3) visits to family or relatives without having to get permission were extracted from the primary study dataset. The questions exploring women’s decision-making ability were adopted from the Nigeria Demographic and Health Survey [32]. When others make any of these decisions on behalf of the mother, the mother was regarded as having no decision-making ability for the item scored. Child dental visit history and ECC status

Data on children’s dental visit history were extracted from the primary study dataset. Mothers were asked if their children had ever visited the dentist (yes or no), and if the child had a hole in their teeth (yes or no). The prevalence of ECC was determined as the proportion of children reported by their mothers to have caries. Oral examination

Data on the early childhood caries profile of the 1155 children generated in the primary study by five calibrated dentists who conducted the oral examination for each child were extracted for this study. Calibration of the five

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dentists was conducted by first training them on caries assessment using a colored picture chart with varying presentations of decayed, missing and filled teeth, followed by examining a group of five children with caries and making a diagnosis using the World Health Organization scoring criteria. The scoring for each of the five children was repeated three times with an interval of one week between each visit. Intra-examiner agreement for each of the dentists was calculated using Cohen’s Kappa and the inter-e