Deciduos Canine Toothbud Extractions (DCBE) Experience Amongst Pastoralist Kenyan Communities

INTRODUCTION: DCBE is practiced by several rural communities in Kenya, mainly as a belief for the cure of to certain infant morbidity. OBJECTIVES: To compare the knowledge, attitude and practice of DCBE in three separate rural communities. METHODS: A Pilot study was undertaken to determine the occurrence of DCBE amongst pastoralist Maasai and Samburu communities in Kenya, in order to deter the practice. Structured questionnaires interviews of traditional birth attendants and mothers in the Maasai (Kadjiado-Elangata Wuas (n=23), Magadi-Ol Tepesi (n=25)) and Samburu -Wamba(n=99) communities were done to determine their knowledge, attitude and practice towards DCBE. RESULTS: Majority amongst the individuals interviewed were aware of the practice within the their communities (Kadjiado (95.7% (95% CI= 78.5-99.9)), Magadi (100%(95% CI=86.3-100)) Samburu (100%(95% CI=96.3-100)). 141 individuals responded on the question on whether their children had undergone the procedure of DCBE :- Kadjiado( 72.7%(95% CI=49.8-89.3)), Magadi ( 68%(95% CI=46.5-85.1)) and Samburu (23.4%(95% CI=14.5-31.7)). Out of 55 responses, diarrhea was the most commonly mentioned medical condition leading to extraction :-Kadjiado (66.7%(95%CI=38.4-88.2)), Magadi ( 82.4%(95% CI=56.6-96.2)) and Samburu (100 %(95% CI=85.2-100. Of 56 individuals 31 reported complications following DCBE(fever from septicemia and postoperative excessive bleeding) :- Kadjiado ( 50%(95% CI=24.6-73.3)), Magadi ( 47.1%(95% CI=24.6-73.3)) and Samburu ( 62.5%(40.6-81.2)). Of 146 individuals 36 advocated stoppage of the practice :- Kadjiado ( 72.7%(49.7-89.3)), Magadi (64(95% CI=42.5-82.0)) and Samburu ( 4.%(95% CI=1.11-10.2)). Children without accessible health care were more likely to have DCBE.(Binary logistic regression(41 individuals ) OR=3.8(95% CI=(0.97-15.0))p=0.055). CONCLUSIONS: The knowledge and attitude to DCBE are similar in the three communities except that the practice is less in Samburu, despite the low advocacy for stoppage. Since the main predictor for DCBE was lack of health facilities appropriate provision of health care to these communities can provide an effective intervention to the practice.