Background Chronic Human Immunodeficiency Virus (HIV) infection is associated with reduced saliva flow rate due to infiltration of HIV and proliferation of CD8 lymphocytes in salivary glands. It is unclear whether HIV infection and antiretroviral therapy (ART) increase caries risk. This study aimed to determine the prevalence and factors associated with dental caries in HIV infected adults attending the Mulago Immune Suppression Syndrome (ISS) clinic in Uganda. Methods A cross-sectional study was conducted among HIV infected persons. Dental examinations were performed by two calibrated dentists using the WHO Radke’s caries classification criteria and reported using the decayed (D), missing (M), filled (F), teeth (DMFT) index. The prevalence and factors associated with dental caries was examined through linear regression analyses. Results Overall, 748 participants (females = 491, 65.6%) with a mean age of 39 ± 9.4 years were included in the final analysis; of whom 83.7% had caries (DMFT> 0), with a significantly ( p < 0.05) higher prevalence among females 86.6% than males 78.2%. The mean DMFT was 5.9 ± 5.5, with statistically significant differences based on gender (males 4.9 ± 4.8 and females 6.3 ± 5.9, p < 0.05) and duration on ART (< 2 years 4.8 ± 4.4, > 2 years but < 5 years 5.7 ± 5.5, > 5 years 6.6 ± 6.0 p < 0.05). The majority (67.2%) of participants reported brushing their teeth twice or more a day, and sugar intake was not associated with dental caries. Conclusion Caries prevalence is high among HIV infected adults under care. Duration of ART was associated with increased risk and severity of caries. Therefore, we recommend integration of dental care in HIV treatment programs.

BackgroundStudents at Makerere University College of Health Sciences (MakCHS) are introduced to ethics and professionalism using the inter-professional education (IPE) model. Ethics and professionalism should be running themes throughout succeeding years of study during which students are expected to develop qualities and skills for future inter-professional practice (IPP). We performed a situation analysis of IPE and IPP among students and teaching health professionals at MakCHS to guide development of a relevant training curriculum of ethics and professionalism.MethodsA cross sectional study with quantitative and qualitative methods which included questionnaires, focus group discussions and key informant interviews.ResultsWe interviewed 236 undergraduate students (148, 63 % male) and 32 teaching health professionals (25, 78 % male). Two hundred fifteen (91 %) students indicated they had joint learning activities with students of other professions and 166 (70 %) stated there was benefit in having an IPE model training curriculum. Most students (140, 59 %) strongly agreed that learning with other students will make them more effective members of the health team. Whereas the respondents reported inter professionalism as being well articulated in their course curricula, more than half said IPE is only implemented in the pre-clinical years of study. They noted that IPE and IPP concepts were not well programmed, health professionals engaged in teaching had poor attitudes towards IPE and IPP, there were limited numbers of skilled health care workers to implement IPP and there was poor communication between students and teaching health professionals. Majority of teaching health professionals noted challenges in implementation of IPE such as poor coordination and large student population and major factors influencing ethics and professionalism in healthcare such as limited government support, low pay for the health care workers, disrespect and lack of appreciation of the health workers by the public.ConclusionsOur findings demonstrate that IPE, IPP, ethics and professionalism are not emphasized in the clinical years of study at MakCHS. We recommend increased sensitization on the concepts of IPE and IPP plus enhanced mentorship for both students and teaching health professionals. Innovative strategies of implementation of IPE and IPP for training in ethics and professionalism must be introduced.

IntroductionMasters Students are major stakeholders in undergraduate medical education but their contribution has not been documented in Uganda. The aim of the study was to explore and document views and experiences of undergraduate students regarding the role of masters students as educators in four Ugandan medical schools.MethodsThis was a cross-sectional descriptive study using qualitative data collection methods. Eight Focus Group Discussions were conducted among eighty one selected preclinical and clinical students in the consortium of four Ugandan medical schools: Mbarara University of Science and Technology, Makerere College of Health Sciences, Gulu University and Kampala International University, Western Campus. Data analysis was done using thematic analysis. Participants’ privacy and confidentiality were respected and participant identifiers were not included in data analysis.ResultsUndergraduate students from all the medical schools viewed the involvement of master's students as very important. Frequent contact between masters and undergraduate students was reported as an important factor in undergraduate students’ motivation and learning. Despite the useful contribution, master’ students face numerous challenges like heavy workload and conflicting priorities.ConclusionAccording to undergraduate students in Ugandan medical schools, involvement of master's students in the teaching and learning of undergraduate students is both useful and challenging to masters and undergraduate students. Masters students provide peer mentorship to the undergraduate students. The senior educators are still needed to do their work and also to support the master's students in their teaching role.

Background Cut scores for students’ assessments have always been arbitrarily determined in many institutions. Some institutions have adopted reliable methods of determining cut scores, such as the Angoff method. However, use of this method requires many experts, making it difficult to implement in resource-limited settings. The possibility of involving postgraduate students in implementing the Angoff method of setting cut scores could be the solution to this problem. Objectives To explore the knowledge and practices of faculty regarding standard setting and the feasibility of using postgraduate students when implementing the Angoff method. Methods This was an exploratory operations research study in which data were collected during focus group discussions. Students were trained to use the Angoff method, i.e. a previous examination, in which the pass mark was 50%, was used to evaluate the method. Results Initial findings showed that faculty in the consortia of schools did not know what standard setting and the Angoff method entailed and had never used this approach. The postgraduate students involved in implementing the Angoff method of setting cut scores were excited and interested in engaging in the exercise; the pass mark they arrived at was 61.21%. Conclusion The study demonstrated that it is feasible to use the Angoff method of determining pass marks, even in resource-limited settings. This can be made possible by involving postgraduate students in the absence of enough faculty experts.

Objectives: Uganda is a low-income country faced with a number of challenges in health service delivery, including oral health services. Despite reports of an increased prevalence of oral diseases, they are afforded less priority, amidst competing priorities of infectious and other non-communicable diseases. Oral health-care services are offered free-of-charge in public health facilities. The majority of the Ugandan population live in rural areas. This would imply that public dental services should be more widely distributed in rural areas to meet the needs of the majority population. This study, therefore, aimed to determine the geographic distribution of public dental services relative to poverty and ruralization of the Ugandan population. Materials and Methods: All 112 districts in Uganda were to be surveyed for this study using an ecological design that incorporated the Ugandan population with socio-demographics obtained from the latest Uganda National Housing and Population Census and poverty data from the national Poverty Status Report 2014. The data from the districts were on the availability of public dental services and the physical location of these dental facilities. Overall, 182 public facilities were included in the study. The geographic location of public dental clinics was established using open-data sources. The data on ruralization were aggregated at the district level and that on poverty at the subregion level. Spatial analysis was done using geographic information science software, Quantum Geographic Information System. Results: The total Ugandan population was 34 million. Overall, 19.7% of the population was poor with the highest proportion located in the North and East of Uganda. Urban-rural characteristics varied across the country. Information on the 182 public dental clinics was collected from 97 of the 112 Ugandan districts. Among the 97 districts, 15% had no public clinic and were located in the poorest Ugandan regions. Among the 40 districts containing over 90% of the rural population, 20% had none, and 55% only had one dental clinic. In general, service availability reduced as the proportion of the rural and poor population increased. Conclusion: The spatial analysis presents an avenue to inform and guide the decision making and planning process by identifying geographic areas with access gaps relative to population socio-demographic characteristics. This study revealed that public dental services were least available for the poorest and rural populations, and yet they are already vulnerable to other access barriers. It is recommended that efforts should be made by health planners and policymakers to avert the health inequalities presented by inequitable access.