title: Knowledge of Nairobi East District Community Health Workers concerning HIV-related orofacial lesions and other common oral lesions.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) related orofacial lesions (HROLs) impact negatively on the health of patients and could be managed at primary healthcare (PHC) level. Community health workers (CHWs) are crucial in optimal patient management through patient identification, education and early referral for professional care. The study objective was to assess knowledge of Nairobi East district CHWs regarding HROLs and other common oral diseases.
  
  
  METHODS
  Of the total population of CHWs, 815 [94.5%] completed a 56-item questionnaire covering 5 topics: general dental knowledge, knowledge about HROLs, past encounters with HROLs, current care at community level, opinions regarding oral health problems; and items concerning background characteristics and past training activities. Confirmatory factor analysis revealed Cronbach's alpha coefficient values of 0.45, 0.59, 0.79, 0.50 and 0.09 respectively. The first four topics were confirmed as domains. Mean minimum score was 0 and mean maximum score was 1 for each variable. However, for 'past encounters with HROLs, the minimum score was 0 and maximum score was 5.
  
  
  RESULTS
  CHWs had moderate knowledge about general oral health (mean = 0.47) and HROLs (mean = 0.43). None had been formally trained in oral health aspects. Although they had high opinions regarding their role in identifying, educating and referring patients with HROLs (mean = 0.80) to the health facilities, they actually rarely referred such patients.
  
  
  CONCLUSIONS
  CHWs need training for building competence in promoting oral health among general and HIV patients in their communities and in early identification and management of non-HIV oral lesions.
authors.forename: Lucina N
authors.initials: LN
authors.lastname: Koyio
authors.affiliation: Department of Global Oral Health, College of Oral Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Wil.vanderSanden@radboudumc.nl.
authors.forename: Wil J M
authors.initials: WJ
authors.lastname: van der Sanden
authors.forename: Elizabeth O
authors.initials: EO
authors.lastname: Dimba
authors.forename: Jan
authors.initials: J
authors.lastname: Mulder
authors.forename: Andre J A M
authors.initials: AJ
authors.lastname: van der Ven
authors.forename: Matthias A W
authors.initials: MA
authors.lastname: Merkx
authors.forename: Jo E
authors.initials: JE
authors.lastname: Frencken
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D003153:Community Health Services / Q000706:statistics & numerical data; D003150:Community Health Workers / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007630:Kenya; D008297:Male; D009056:Mouth Abnormalities / Q000175:diagnosis* / Q000209:etiology; D009909:Oral Health; D010608:Pharyngeal Diseases / Q000175:diagnosis* / Q000209:etiology; D011361:Professional Competence; D024382:Professional Role; D018461:Soft Tissue Infections / Q000175:diagnosis* / Q000209:etiology; D011795:Surveys and Questionnaires