title: Dental caries management at a rural district hospital in northern Rwanda: a neglected disease.
abstract: METHODS
  While some studies have reported the prevalence of dental caries in sub-Saharan Africa, little is known about care-seeking behavior or how dental caries are managed, particularly at rural district hospitals.
  
  
  OBJECTIVE
  To describe the management of patients seeking care for dental caries at Butaro District Hospital (BDH) in rural Rwanda.
  
  
  METHODS
  This cross-sectional descriptive study was conducted in BDH, in northern Rwanda. A sample of 287 patient encounters for dental caries between January and December 2013 was randomly selected and stratified by age group (⩽5 years, 6-21 years and >21 years). We estimated the treatment received with 95% confidence intervals in each age group, and differences between age groups were assessed using Fisher's exact test.
  
  
  RESULTS
  Nearly all patients (97.6%) underwent tooth extraction, and this did not vary significantly by age group (P = 0.558). In addition to dental caries, most patients also had chronic pulpitis (74.9%).
  
  
  CONCLUSIONS
  Caries prevention and care should be prioritized through a developed community program on oral health. We recommend introducing advanced training, equipment and materials for dental caries management other than tooth extraction, and increasing the number of qualified dentists.
authors.affiliation: Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda.
authors.forename: C
authors.initials: C
authors.lastname: Mukashyaka
authors.affiliation: Ministry of Health, Butaro District Hospital, Burera, Rwanda.
authors.forename: B
authors.initials: B
authors.lastname: Uzabakiriho
authors.affiliation: Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda.
authors.forename: C L
authors.initials: CL
authors.lastname: Amoroso
authors.affiliation: Ministry of Health, Butaro District Hospital, Burera, Rwanda.
authors.forename: T
authors.initials: T
authors.lastname: Mpunga
authors.affiliation: Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda.
authors.forename: J
authors.initials: J
authors.lastname: Odhiambo
authors.affiliation: Ministry of Health, Butaro District Hospital, Burera, Rwanda.
authors.forename: P
authors.initials: P
authors.lastname: Mukashema
authors.affiliation: Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Seymour
authors.affiliation: Ministry of Health, Butaro District Hospital, Burera, Rwanda.
authors.forename: J de D
authors.initials: Jde D
authors.lastname: Sindayigaya
authors.affiliation: Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda ; Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: B L
authors.initials: BL
authors.lastname: Hedt-Gauthier
keywords: Africa; cellulitis; dental care; pulpitis; tooth extraction