Validation of maternal report of early childhood caries status in Ile-Ife, Nigeria
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Date
2020
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BMC Oral Health
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, specifcity, positive and negative predictive values, absolute bias, relative bias and
infation factor were calculated. Statistical signifcance was determined at p<0.05.
Results: The clinically-determined ECC prevalence was 4.6% (95% Confdence 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 specifcity
(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 infation 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.
Conclusions: Mothers 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 specifcity 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.
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Citation
Folayan, M. O., Alimi, P., Alade, M. O., Tantawi, M. E., Adeniyi, A. A., & Finlayson, T. L. (2020). Validation of maternal report of early childhood caries status in Ile-Ife, Nigeria. BMC Oral Health, 20(1), 1-9.