Proportion of good oral hygiene and mean value oral hygiene index among children with cerebral palsy in Africa and Asia: a systematic review and meta-analysis.

Background: Children with cerebral palsy face various challenges, including oral hygiene, which is crucial for their overall well-being and quality of life. However, limited research investigates oral hygiene among children with cerebral palsy. This systematic review and meta-analysis aim to assess the proportion of good oral hygiene and mean value oral hygiene index among children with cerebral palsy in Africa and Asia.

Methods: This review included full articles conducted among children with cerebral palsy in Africa and Asia, assessing the proportion of oral hygiene and/or the mean oral hygiene index. PubMed, Scopus, Embase, Hinari, citation searching, and grey literature were retrieved to identify eligible articles through Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The registration number in Prospero is CRD42024540182. Data were extracted by standardized JBI data extraction format for personal hygiene and the mean value of oral hygiene index. Then exported to STATA 14 for further analysis. I and Egger's tests were employed to estimate the heterogeneity and publication bias respectively. Subgroup analysis based on country, study design, year of publication, and the sample size was also examined.

Results: The random-effects model analysis revealed that the pooled proportion of good oral hygiene among children with cerebral palsy in Asia and Africa was 21.8% (95% CI: 14.2-29.4). Additionally, the analysis showed that the pooled mean value of the oral hygiene index among children with cerebral palsy in Asia and Africa was 1.9 (95% CI: 0.8-2.9). The study conducted separate analyses on the proportion of good oral hygiene in Africa and Asia, showing that the estimated proportion was 33.3% (95% CI: 15.1-51.4) for Africa and 11.7% (95% CI: 7.6-15.9) for Asia. Additionally, the study categorized the proportion of good oral hygiene based on the study design, revealing that 22.9% (95% CI: 10.4-35.4) for case-control studies and 21.5% (95% CI: 12.6-30.4) for cross-sectional studies. Furthermore, the analysis considered the difference in publication year, the proportions of good oral hygiene were found to be 23.2% (95% CI: 10.1-36.3) for publications before ≤ 2015 and 20.3% (95% CI: 11.4-29.3) for publications after > 2015. Lastly, the study examined the proportion of good oral hygiene based on sample size, 28.3% (95% CI: 11.0-45.6) for sample sizes ≤ 70 and 15.8% (95% CI: 9.3-22.2) for sample sizes > 70.

Conclusions: This review suggested that the proportion of good oral hygiene among children with cerebral palsy appears insufficient in Asia and Africa. With just one-fifth exhibiting good oral hygiene, it is advisable to strengthen interventions and support programs in both regions to enhance oral hygiene in this vulnerable population. Further research better to focus on identifying potential factors and conducting qualitative investigations to comprehend the perspectives of children and caregivers on oral hygiene within these regions.