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Open Access
Ethics and HIV prevention research: An analysis of the early tenofovir PrEP trial in Nigeria.
(WILEY, 2018-09-10) Peterson, Kristin; Folayan, Morenike O
In 2004, the first ever multi-sited clinical trials studied the prospect of HIV biomedical prevention (referred to as pre-exposure prophylaxis-'PrEP'). The trials were implemented at several international sites, but many officially closed down before they completed. At most sites, both scientists and community AIDS advocates raised concerns over the ethics and scientific rationales of the trial. Focusing on the Nigerian trial site, we detail the controversy that emerged among mostly Nigerian research scientists who scrutinized the research design and protocol. While some of the disputes, especially those pertaining to community engagement mechanisms, were ultimately resolved in international fora and implemented in later PrEP trials, concerns over science rationales and assumptions were never addressed. We argue that scientific rationales should be treated as ethical concerns and suggest that such concerns should be deliberated at host sites before the trial protocol is finalized.
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Open Access
ILLNESS BEHAVIOUR AND UTILIZATION OF ORAL HEALTH CARE FACILITIES AMONG TRADERS IN MUSHIN MARKET
(Unilag Journal of Medicine, Science and Technology (UJMST), 2019) Olu-Awe OI1, Dedeke AA, Alade OT, Uti OG, Sofola OO
Maintenance of good oral hygiene is of paramount importance to oral health, this is due to the fact that oral health is a mirror of overall health and well-being. The use of available oral health facilities is a step in the right direction. The aim of this study was to assess the knowledge, level of utilization, and illness behavior of traders in Mushin market towards use of oral health care facilities. Cross-sectional study comprised of 300 adults traders with stalls in Mushin market. Data was collected using a structured interviewer administered questionnaire, with segments on sociodemographic characteristics, knowledge, level of utilization, and illness behavior towards the use of oral health care facilities. Data was analyzed using Epi-Info, version 7. Test of association was assessed using Chi-square test (P=0.05). A total of 300 adults participated in this study with a mean age of 37.7±12.1. Two hundred and eleven (70.3%) were females, two hundred and sixty one (87.3%) had a good level of knowledge of oral health care facilities. Only ten (3.3%) respondents had any significant level of dental health facility utilization, 90 % had poor illness behaviours as regards oral healthcare. Although most respondent had a good knowledge of dental health facilities in close proximity and availability of dental services, most sought treatment in numerous places apart from the dental clinic
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Open Access
Global Oral Health Policies and Guidelines: Using Silver Diamine Fluoride for Caries Control.
(Frontiers, 2021-07-30) Gao, Sherry Shiqian; Amarquaye, Gwendolyn; Arrow, Peter; Bansal, Kalpana; Bedi, Raman; Campus, Guglielmo; Chen, Kitty Jieyi; Chibinski, Ana Cláudia Rodrigues; Chinzorig, Tselmuun; Crystal, Yasmi O; Duangthip, Duangporn; Ferri, María Laura; Folayan, Morenike Oluwatoyin; Garidkhuu, Ariuntuul; Hamama, Hamdi H; Jirarattanasopha, Varangkanar; Kemoli, Arthur; Leal, Soraya C; Leelataweewud, Pattarawadee; Mathur, Vijay Prakash; Mfolo, Tshepiso; Momoi, Yasuko; Potgieter, Nicoline; Tezvergil-Mutluay, Arzu; Lo, Edward Chin Man; Chu, Chun Hung
Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is a clear solution containing silver and fluoride ions. Because of its anti-bacterial and remineralizing effect, silver diamine fluoride has been used in managing dental caries for decades worldwide. This paper aims to summarize and discuss the global policies, guidelines, and relevant information on utilizing SDF for caries management. SDF can be used for treating dental caries in most countries. However, it is not permitted to be used in mainland China. Several manufacturers, mainly in Australia, Brazil, India, Japan, and the United States, produce SDF at different concentrations that are commercially available around the world. The prices differ between contents and brands. Different government organizations and dental associations have developed guidelines for clinical use of SDF. Dental professionals can refer to the specific guidelines in their own countries or territories. Training for using SDF is part of undergraduate and/or postgraduate curriculums in almost all countries. However, real utilization of SDF of dentists, especially in the private sector, remains unclear in most places because little research has been conducted. There are at least two ongoing regional-wide large-scale oral health programs, using SDF as one of the components to manage dental caries in young children (one in Hong Kong and one in Mongolia). Because SDF treatment does not require caries removal, and it is simple, non-invasive, and inexpensive, SDF is a valuable strategy for caries management in young children, elderly people, and patients with special needs. In addition, to reduce the risk of bacteria or virus transmission in dental settings, using SDF as a non-aerosol producing procedure should be emphasized under the COVID-19 outbreak.
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Open Access
Nigeria's financing of health care during the COVID-19 pandemic: Challenges and recommendations.
(WMHP, 2022-10-03) Aregbeshola, Bolaji S; Folayan, Morenike O
An analysis of the financing of Nigeria's health-care system in response to coronavirus disease 2019 (COVID-19) pandemic was conducted. Nigeria projected that it would need US$330 million to control its COVID-19 pandemic. However, it raised more than US$560.52 million, of which more than 90% came from the private sector and the donor/philanthropist community. The pooled COVID-19 fund is mainly being expended on temporary public health and clinical care measures, with little invested to strengthen the health system beyond the pandemic. The poor turn-around time for COVID-19 test results and the stigma associated with the disease results in most persons with mild to moderate symptoms seeking care from alternatives to the health-care institutions designated for COVID-19 health care. The huge out-of-pocket expenses, and the inability of most Nigerians to earn money because of measures instituted to contain the pandemic, will likely cause many Nigerians to become economically impoverished by the COVID-19 pandemic. COVID-19-related commodity procurement was least responsive to the needs of those most in need of care and support. The government needs to institute several fiscal policies. Immediate response to ease the financial impact of COVID-19 require inclusion of COVID-19 management in health insurance packages and an increase in domestic government health spending.
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Open Access
Perceived Preparedness of Dental Academic Institutions to Cope with the COVID-19 Pandemic: A Multi-Country Survey.
(International Journal of Environmental Research and Public Health., 2021-02-04T00:00:00Z) Ammar, Nour; Aly, Nourhan M; Folayan, Morenike Oluwatoyin; Khader, Yousef; Mohebbi, Simin Z; Attia, Sameh; Howaldt, Hans-Peter; Boettger, Sebastian; Virtanen, Jorma; Madi, Marwa; Maharani, Diah A; Rahardjo, Anton; Khan, Imran; Al-Batayneh, Ola B; Rashwan, Maher; Pavlic, Verica; Cicmil, Smiljka; Noritake, Kanako; Galluccio, Gabriella; Polimeni, Antonella; Shamala, Anas A; Aarheiam, Arheiam; Mancino, Davide; Phantumvanit, Prathip; Kim, Jin-Bom; Choi, Youn-Hee; Dama, Mai A; Abdelsalam, Maha M; Castillo, Jorge L; Nyan, Myat; Hussein, Iyad; Joury, Easter; Vukovic, Ana P; Iandolo, Alfredo; Kemoli, Arthur M; El Tantawi, Maha
Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics' and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics' and institutions' attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = -1.31, = 0.006) and upper-middle income (UMICs) (B = -0.98, = 0.02) countries than in high-income countries (HICs), in teaching only (B = -0.55, < 0.0001) and in research only (B = -1.22, = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving >100 patients (B = -0.38, < 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, < 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care.