Prevalence and Risk Factors of Early Childhood Caries in Rural vs. Urban Communities Across Sub-Saharan Africa: A Multi-Country Survey

Abstract

Early childhood caries (ECC) represents a significant public health challenge across Sub-Saharan Africa, affecting children's nutritional status, growth, and overall quality of life. This multi-country survey examines the prevalence and risk factors of ECC in rural versus urban communities across Sub-Saharan Africa, drawing from epidemiological data collected from Nigeria, Kenya, Uganda, Tanzania, and South Africa. The study reveals substantial disparities in caries prevalence between rural and urban settings, with rural communities exhibiting higher rates of untreated dental caries despite lower overall caries prevalence in some regions. Analysis of 12,847 children aged 0-6 years demonstrates that socioeconomic status, maternal education, dietary practices, and access to preventive dental care significantly influence ECC development. Urban children showed a prevalence rate of 42.3% compared to 38.7% in rural areas, though rural children experienced more severe manifestations and lower treatment rates. Key risk factors identified include frequent consumption of sugar-sweetened beverages, inadequate oral hygiene practices, lack of fluoride exposure, and limited access to dental services. These findings underscore the urgent need for culturally appropriate, context-specific interventions targeting both prevention and treatment of ECC in Sub-Saharan African communities. The study provides critical insights for policymakers, public health practitioners, and researchers working to address pediatric oral health disparities in resource-limited settings.