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J, PROFCHINDIAMARK, KAVIN DRWAKOLI.  Submitted.  Koech KJ, Chindia ML, Wakoli KA, Gathece LW. Prevalence of oral lesions in HIV infection and their relationship with CD4 count at a Nairobi centre. African journal of oral health sciences,Vol 5 no2, 4-9.. African Journal of Oral Health Sciences,Vol 5 no2, 4-9. : Korean Society of Crop Science and Springer Abstract
OBJECTIVE: To determine the dental caries experience and knowledge on the causes and preventive measures for dental diseases. DESIGN: A community based cross-sectional descriptive study. SETTING: Elwak sub-district hospital, North Eastern Province, Kenya. SUBJECTS: One hundred and forty one adults who presented themselves during a dental check up at a sub-district hospital and gave written consent. MAIN OUTCOME MEASURES: Dental caries status and knowledge on its causes and preventive measures. The importance of outreach programmes in obtaining information as well as helping to alleviate the pain and suffering caused by dental diseases among communities living in remote areas is also revealed. RESULTS: Of the one hundred and forty one individuals, who were included in the study, 63.1% were women and 36.9% were men. Their ages ranged between 18 and over 65 years. 41.1% were in the 18-24-year age bracket. Regarding the oral health knowledge, 43% did not know any causes of dental diseases while 36%, 17% and 12% knew that diet, "dirt" on teeth and bacteria were possible causes, respectively. Fifty percent did not know any preventive measures for dental diseases while the rest indicated abstention from the consumption of sugary foods; and only 0.8% mentioned use of fluoridated toothpaste as a preventive measure for dental caries. 56.7% of the subjects were caries free. The mean DMFT for all ages was 3.4. Of those with caries 72.1% were women. CONCLUSION: There is a low level of oral health awareness and a moderately high level of dental caries experience in this community with women apparently carrying the biggest burden of dental caries.


Awange, DO, Wakoli KA, Onyango JF, Chindia ML, Dimba EA, W GS.  2009.  Reactive localised inflammatory hyperplasia of the oral mucosa. Abstract

To document the histopathological pattern and distribution of reactive localised inflammatory hyperplastic lesions of the oral mucosa diagnosed at the University of Nairobi Dental Hospital over a 14 year period. DESIGN: A retrospective, cross-sectional descriptive study. SETTING: Division of Oral Pathology and Oral Medicine, histopathology laboratory, School of Dental Sciences, University of Nairobi. SUBJECTS: A total of 3135 oral biopsies were accessioned in the oral diagnostic histopathological Laboratory registry over a period of 14 years from March 1991 to December 2005. RESULTS: Three hundred and thirty three cases were histopathologically diagnosed as reactive inflammatory hyperplasias of the oral mucosa. This constituted 10.6% of the total oral biopsy specimens analysed during this period. Fibrous epulis was the most common histological sub-type with 129 cases (38.7%) followed by pyogenic granuloma with 94 (28.3%) cases. Six (1.8%) cases were peripheral giant cell granuloma and three cases (0.9%) were those of denture irritation hyperplasia. The age distribution ranged from 2 to 78 years (mean = 30.5 years) with a peak at 20-29 years. Gender distribution showed that 107 (32%) cases occurred in males and 226 (68%) cases females. Similar trends were observed in most of the histological sub-types. Fibrous epulis occurred in 41 male (31.8%) cases and in 88 (68.2%) females with an age range of 2 to 78 years (mean = 30.5 years). As for the pyogenic granuloma, 26 (27.7%) lesions occurred in males and 68 (72.3%) in females with an age range of 2 to 75 years (mean = 30.1 years). Among all the histopathological sub-types it was shown that 223 (67.0%) cases were fibrous, 104 (31.2%) vascular and six (1.8%) peripheral giant cell granuloma. Gingival lesions were the most common with 257 (77.2%) cases followed by 28 (8.4%) in the tongue, 16 (4.8%) lips, 15 (4.5%) cheek, six (1.8%) palate and the rest on the floor of the mouth and other mucosal sites. The duration of these lesions was recorded in 182 (54.7%) cases and ranged from 1 week to 16 years (mean = 1.8 years). Only 15 (4.5%) cases were reported to have recurred and all of them were gingival lesions. CONCLUSION: The present study has shown that the prevalence of reactive localised inflammatory hyperplasia (RLIHs) of the oral mucosa was 10.6% with fibrous epulis and pyogenic granuloma having been the most common histopathological sub-types predominantly affecting females. Although RLIHs are distinguished on clinical or histopatholocal grounds, it is important to appreciate that they are variations of the same basic process



KAVIN, DRWAKOLI.  2007.  Butt FM, Chindia ML, Wakoli KA.Problems in diagnosing odontogenic myxoma: case report.East Afr Med J. 2007 Mar;84(3):141-5.. East Afr Med J. 2007 Mar;84(3):141-5.. : Korean Society of Crop Science and Springer Abstract
Tumours and tumour-like growths arising from odontogenic tissues constitute a heterogenous group of lesions whose diagnosis can be particularly challenging on the part of both surgeons and pathologists. In children, these lesions are even more difficult to clinically and histopathologically diagnose definitively because of the concurrent diverse embryologic differentiation of dental tissues. A case is presented of a 12 year-old boy who was subjected to inappropriate primary management of a left mandibular mass, due apparently to inadequate consultation to establish an accurate diagnosis.
KAVIN, DRWAKOLI.  2007.  Dimba EA, Gichana J, Limo AK, Wakoli KA, Chindia ML, Awange DO.An audit of oral diseases at a Nairobi centre, 2000-2004.Int Dent J. 2007 Dec;57(6):439-44.. Int Dent J. 2007 Dec;57(6):439-44.. : Korean Society of Crop Science and Springer Abstract
OBJECTIVES: To describe oral diseases diagnosed in an urban referral centre in Kenya in terms of age, gender and anatomical distribution and to compare this with reports in the literature. METHODOLOGY: A retrospective histopathological audit. SETTING: Oral Pathology Laboratory at the University of Nairobi Dental Hospital, a tertiary referral centre in Kenya. RESULTS: 548 (53.83%) patients were diagnosed with oral and maxillofacial tumours. Benign tumours (mean age +/- SD = 29.93 +/- 18.27 years) peaked in the third decade and tended to affect men at a younger age (p = 0.001). The most common benign tumour was the ameloblastoma (50.23%: n = 109), which predominantly affected the mandible, and also occurred in male patients at a younger age (p = 0.023). Peak incidences for malignant disease were observed in the sixth decade (mean age +/- SD = 46.94 +/- 18.99 years). Oral squamous cell carcinoma (OSCC) was the most common malignant tumour (59.55%; n = 187); occurring in the tongue, floor of the mouth, buccal mucosa and palate. 10.30% of OSCC occurred in patients under 40 years of age. 147 patients presented with cysts, which were mainly (68.10%) of odontogenic origin. Reactive lesions, infections, salivary gland diseases and autoimmune conditions constituted 26.60% of the case load. CONCLUSION: The tendency of oral squamous cell carcinoma to occur in younger age groups may be an indication of carcinogenic factors that could be peculiar to this population. There is an urgent need for the expansion of reporting systems for oral diseases as an integral part of development of appropriate strategies in the improvement of general health in Kenya.


KAVIN, DRWAKOLI.  1998.  Chindia ML, Guthua SW, Awange DO, Wakoli KA.Osteosarcoma of the maxillofacial bones in Kenyans.J Craniomaxillofac Surg. 1998 Apr;26(2):98-101.. J Craniomaxillofac Surg. 1998 Apr;26(2):98-101.. : Korean Society of Crop Science and Springer Abstract
Osteosarcoma (OS) is a highly malignant tumour and is the most common primary neoplasm of bone; although rare, especially in the maxillofacial skeleton. This article presents 14 Kenyan cases of OS of the maxillofacial bones seen between January 1991 and July 1997: 11 in the mandible, two in the maxilla and one in the right zygomatic arch. Patients ranged in age from one week to 50 years (Mean = 29.7), with an equal gender distribution. While pain and rapid swelling were the commonest clinical features, the radiographic and histopathological characteristics were as varied as has been described elsewhere. Generally, effective management of most of the cases was poor due to late presentation for treatment.

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