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Lucina Koyio, is currently a PhD student at our Department with a NUFFIC PhD fellowship. She gives an update (2010):

My research entitled 'primary health intervention for oro pharyngeal candidiasis in HIV infection' is based in Nairobi East district in Kenya. Like many sub-Saharan countries, the district with a high, 9.3%, HIV prevalence is staffed with primary health care (PHC) providers (nurses and clinical officers). They serve an estimated population of 1,2 million in health centers and dispensaries. To integrate oral care for HIV patients into the primary health care system, the PHC providers needed to be trained in recognition and management of the lesions since they rarely do an oral examination during consultations. A cross sectional survey in December 2009 which showed that the PHC providers were willing to include routine oral examination in general consultations preceded a one day training program. The training was administered in March 2010 with the help of supervisors from Radboud University Nijmegen, Department of Global Oral Health and the University of Nairobi. The formulated training program included a pre and post test written assessment and recognition of oral HIV lesions on photographs.

To evaluate the training program, we interviewed the PHC providers in the test group on barriers to routine oral examination during reminder visits in April and May 2010. We repeated the assessments in June 2010 in both the test and control groups. During the reminder visits, the PHC providers reported they could recognize oral HIV lesions with ease and that they routinely examined the mouth during consultations. The evaluation on the training program also includes ongoing records search on the number of patients who are diagnosed with oral HIV lesions. Additionally, a total of 720 monthly patient interviews in the test group and in the control group health facilities are ongoing.
As we prepare for the scheduled 3^rd evaluation of the training program in November 2010, we are also in the process of formulating a training program for community health workers which will be done in January 2011. We intend to assess the effect of community mobilization in increasing the number of patients with oral HIV lesions who are referred for HIV testing. We are currently formulating posters in oral HIV lesions (since none exists in Kenya) to sensitize the community on recognition of oral HIV lesions and referral of patients to the health facility. At the same time, we are also in consultation with the pathologist concerning laboratory tests for highly active anti-retroviral therapy (HAART) treated patients who develop oral HIV lesions.