U.M.E. Chikte

The Africa Center for Biostatistical Excellence: a proposal for enhancing biostatistics capacity for sub-Saharan Africa

Sub-Saharan Africa has a shortage of well-trained biomedical research methodologists, in particular, biostatisticians. In July 2014, a group of biostatisticians and researchers from the region attended a brainstorming workshop to identify ways in which to reduce the deficit in this critical skill. The workshop recognized that recommendations from previous workshops on building biostatistics capacity in sub-Saharan Africa had not been implemented. The discussions culminated with a proposal to setup an Africa Center for Biostatistical Excellence, a collaborative effort across academic and researcher institutions within the region, as a vehicle for promoting biostatistics capacity building through specialized academic masters programs as well as regular workshops targeting researchers.

An Overview of Systematic Reviews Related to Aspects of the Shortened Dental Arch and Its Variants in Adults

PURPOSEnThe aim of this study was to conduct an overview of systematic reviews (SRs) related to aspects of the shortened dental arch (SDA) and its variants and critically appraise the methodologic quality of included SRs using the AMSTAR checklist.nnnMATERIALS AND METHODSnA comprehensive computerized search and a hand search of reference lists were conducted for SRs related to SDAs to identify publications from 2000 to 2016. All the present authors and a research assistant independently screened the results of the electronic searches using an eligibility form and extracted information using a specially designed prepiloted data extraction form. An 11-question AMSTAR checklist was completed for each included SR. Disputes were resolved by discussion between all researchers, and results were collated and interpreted.nnnRESULTSnFor the period of 2007 to 2016, the search yielded nine SRs incorporating 228 related articles. The research questions for each SR differed but were related to SDAs, thus, the included articles were similar across SRs. Characteristics such as aims/objectives, study outcomes, and conclusions of the nine included SRs were compared. The AMSTAR evaluation indicated that five out of nine studies were of a high quality (used a rigorous methodology) and the remaining four were of medium quality. All nine SRs provided designs and characteristics of included studies. None of the SRs assessed publication bias.nnnCONCLUSIONnOf the nine SRs, seven drew positive conclusions regarding the SDA concept, finding it functionally sound, although some suggested that more high-quality primary studies are still needed. The AMSTAR calculation indicated that most included SRs had an acceptable methodologic quality, emphasizing the reliability of their results.

Nursing students' knowledge, attitude and practices of infection prevention and control guidelines at a tertiary institution in the Western Cape: A cross sectional study

BACKGROUNDnNurses in sub-Saharan Africa are particularly at a higher risk of acquiring nosocomial infections, considering the increased prevalence of infectious diseases. It is therefore imperative that these nurses have a sound knowledge and understanding of infection prevention procedures.nnnOBJECTIVEnThe main objective of this study was to describe the knowledge, attitudes and practices concerning infection prevention and control precautions among nursing students in a resource limited setting.nnnMETHODnA cross sectional study design was employed. A self-administered questionnaire concerning infection prevention and control guidelines were made available to students enrolled in a mainstream programme for completion of an undergraduate nursing degree.nnnSETTING AND PARTICIPANTSnA total of 301 students at second, third and final years of study from a tertiary institution in the Western Cape were invited to participate.nnnRESULTSnThe final cohort comprised of 301 students with the majority between the ages of 17-26 (88.2%), with a mean age of 23u202f±u202f4.7 (SD) years and the dominant gender being female (83.4%). According to the classification system used in this study, the majority of the students were overall evaluated as having good level of knowledge (47.4%) and poor attitude (41.7%) scores, with little difference in practice scores observed between different years of study. There was a positive correlation found between students total attitude and total practice scores (ru202f=u202f0.48 pu202f<u202f0.01). Results showed that significant associations between gender and knowledge (pu202f<u202f0.05), attitudes (pu202f<u202f0.05) and practice (pu202f<u202f0.05) exists. There was also a significant association between province and those who repeated a year with total knowledge scores (pu202f<u202f0.05).nnnCONCLUSIONnBased on the results of this study, it is recommended that interactive infection control courses that promote critical thinking are implemented at undergraduate level along with more stringent forms of assessments focusing on infection prevention and control, during clinical training.

Impact of removable partial dental prostheses on the oral health-related quality of life of a South African cohort with varied distributions of missing posterior teeth

PURPOSEnTo determine the impact of removable partial dental prostheses on satisfying the daily functioning and quality of life (QoL) of adult patients with different distributions of missing posterior teeth.nnnMATERIALS AND METHODSnA cross-sectional interventional study was carried out on 80 patients having variously distributed posteriorly shortened and interrupted arches. Treatment comprised provision of partial dentures by senior dental students, supervised by senior clinical teachers who had knowledge of the potential benefits of the shortened dental arch (SDA) concept. The Oral Impacts on Daily Performance Index was completed before and 6 months after prosthetic treatment across groups comprising Kennedy Classes I, II, and III arches. Analysis included descriptive statistics and associations and comparisons between variables.nnnRESULTSnMean age of patients was 57.4 years (SD = 13.1), many were retired (72.2%), and a majority were females (60%). Most patients lived in urban areas (95%), and were largely unemployed (63.3%). At pretreatment, only 31.3% of patients reported having good dental health and satisfaction with their current oral state, while 82.5% said they had a great need for treatment. The negative oral impacts that were most frequently experienced were those of eating (67.5%), smiling (50%), and being emotionally disturbed (63.8%). Post-treatment, 76.3% indicated good oral health and satisfaction with no significant differences between the 3 Kennedy groups. Any further negative impacts were reported mostly for Kennedy Classes I and II.nnnCONCLUSIONSnOverall, significant reductions of negative impacts were observed following treatment with dentures, across the 3 Kennedy groups, with respect to improved function, satisfaction, and oral health-related QoL. The findings confirm the reliance by partially dentate patients in all 3 Kennedy groups on dentures for improved oral health, although the possible benefits of the SDA concept as an alternative treatment option was not specifically explored.

Outcomes with a posterior reduced dental arch: a randomised controlled trial

To compare function, patient satisfaction and quality of life of patients with a posterior reduced mandibular arch with those who had all missing teeth replaced with removable partial dentures. Patients with at least three and not more than six posterior occluding pairs of teeth were enrolled sequentially and randomised into one of two treatment groups: a denture and no-denture group. A research assistant allocated interventions; concealment was ensured using opaque-sealed envelopes. Analysis of data was performed in stages, adding samples of 10 incrementally, and stopping when the relevant statistical tests indicated a clear conclusion as judged by the power set at 80% or above. Study outcomes included patient satisfaction, function and survival of remaining teeth at 3 and 12xa0months post-intervention, using a visual analogue scale and the Oral Impacts on Daily Performance). Statistical analysis was performed by the intention-to-treat principle. Age range of included patients was 23-55xa0years (meanxa0=xa042·3; s.d.xa0=xa09·2), with 78% being females. Most patients (70%) belonged to the low- or no-income group. Nine patients left the study, for different reasons. Primary outcomes for the denture group: 10% of the patients were not satisfied and 20% were unhappy with their function; for the no-denture group: 85% of the patients (with 15% having left the study) were satisfied with both their function and their non-denture status. Patients with posterior reduced mandibular dental arches reported greater perceived satisfaction, function and quality of life compared to those who had received a cobalt-chrome clasp-retained partial removable prosthesis.