TEETHING: BELIEFS AND PRACTICES AMONG MOTHERS OF INFANTS AGED 6-24 MONTHS IN NAIROBI, KENYA.

INVESTIGATOR: REGINA J. MUTAVE BDS (NBI) MRes (St. Andrews) W61/60481/2009

E-mail contact: mutave@uonbi.ac.ke Telephone contact: 2713618/ 2728312/ 0722 754481

SUPERVISOR: DR. JAMES KIARIE MBchB, MMED Obs/Gyn (NBI), MPH E-mail: jkiarie@swiftkenya.com Telephone Contact: 0733771288

RESEARCH PROJECT REPORT SUBMITTED IN PARTIAL FULFILMENT OF THE POSTGRADUATE DIPLOMA IN BIOMEDICAL RESEARCH METHODOLOGY. OCTOBER 2011

ABSTRACT Introduction: Teething, an expression commonly encountered during early childhood has been defined in professional terms as the biological expression of tooth movement, in a predominantly axial direction, from the tooths developmental position within the jaws to its emergence in the oral cavity . However, many communities had and still have strong beliefs about the relationship between teething and common febrile and diarrhoeal diseases in childhood, sleep disturbance, restlessness, drooling of saliva and runny nose. This

association could cause delay in seeking medical attention for the common childhood diseases, and contribute to high infant mortality rate. Objective: To determine the beliefs and practices about teething among mothers of children aged 6 24 Months in Nairobi. Methodology: This was a descriptive cross sectional study using interviewer administered questionnaires to mothers of babies aged 6 24 months attending Maternal Health Clinics in three randomly selected health centres in Nairobi. Data on demographic characteristics was collected as well as the living conditions, birth weight of baby, birth order and belief and practice of traditional teething. Data Analysis: Data was entered in SPSS version 13, and analysed to give descriptive statistics. Cross tabulations were done and Chi-square tests performed for the categorical variables. Tests for significance were set at 95% confidence level. Results: A total of 438 mothers were interviewed. The age range of the mothers was from 17 years to 46 years of age; the mean age was 24.45 years (Std.dev.4.2, n=435). Thirty percent of mothers had attained primary level education, 55.5 % had secondary education while 14.2% had tertiary education. Very high numbers of mothers associated teething with common childhood illnesses with 95% associating teething to Fever, 93% to diarrhoea, 83.5% to loss of appetite while 80% associated vomiting to teething. There was no significant

relationship using Fishers Exact test between ethnic background and association of teething with diarrhoea (p=0.075), vomiting (p= 0.349), but there was a significant relationship between ethnic background and the association of Fever with teething (p=0.001). Methods of handling teething by mothers included consulting health clinic nurse (62.8%), applying commercially available teething gels (37.4%) while combined use of traditionally prepared teething powders, taking child for gum incision and removal of offending plastic teeth were reported by 13.5% of the mothers. Two tribes had higher percentages of those who would consider utilisation of traditional healers namely the Kisii (30%) and the Kamba (26%) and this was statistically significant. (2 =14.44, p=0.013 at 95% confidence level). Thirty two mothers (7.3%, n=437) had ever taken their children to the traditional healers, and another 54 (12.4%, n=436) of mothers would consider making a visit to the traditional healer if the childs medical condition did not respond to conventional medicine. Conclusion: Mothers in Nairobi associate teething with systemic childhood illnesses especially diarrhoea, fever, loss of appetite and vomiting. Although most of the mothers interviewed would consult the health clinic nurses in case of suspected teething related symptoms, some of them would use commercially available teething gels. Some mothers had already utilised the services of traditional healers for services ranging from traditional teething powders, incision of gum and even tooth bud enucleation (removal of plastic teeth), while more would consider utilising these services if their children did not respond to conventional medicine.