Abstract:
Introduction: Tumours of the maxillofacial region with an origin that is closely related to tooth formation are called odontogenic tumours. Both odontogenic and non odontogenic tumours can have malignant variants. In Tanzania, oral malignant tumours constitute 50.53% of neoplastic oral facial cases. At the inception most of the tumours occurring in the maxillofacial region are painless.
Aim of the study: To determine the factors associated with late reporting for health care among patients having oral maxillofacial tumours or tumour-like lesions attending Muhimbili National Hospital.
Materials and Methods: A descriptive cross sectional study was conducted, which involved 151 patients with either tumour like lesions or tumours of the oral and maxillofacial region. The study was conducted at the oral maxillofacial firm of Muhimbili National Hospital and oral maxillofacial department of the Muhimbili University of Health and Allied Sciences. Information was gathered using a structured questionnaire translated in Swahili language. Data was analysed using SPSS version 20. Ethical clearance was obtained from the Ethical committee of Muhimbili University.
Results: Study findings revealed that 55.6% of the patients lived near to health facilities which had no oral health services. Ameloblastoma was the tumour that was seen with the highest (21.9%) frequency followed by squamous cell carcinoma (14.6%) and ossifying fibroma (6.6%). Patients with ameloblastoma showed more delay in reporting to a health facility as compared to patients with squamous cell carcinoma. After referral from the primary health facility, (23) patients reported to the referral centre after one monthfrom the date of referral. Among these 8 (34.9%) reported after one year or more after referral. Lack of perception of the lesion as being a problem, costs involved for transportation and treatment, lack of pain, attending to traditional healers and the use of herbal medicines were found to be the reasons for the delay in reporting for health care among patients with oral maxillofacial tumours. Vast majority (98%) of the patients seen have never had any dental check-ups.
Conclusion: The patients with oral and maxillofacial tumours showed a delayed reporting to primary health facilities and consequently to the referral centre. The average time for reporting to the referral centre was rather long (69 weeks). The main reasons cited for the delay in reporting for health care by this group of patients is the low level of awareness (did not perceive the lesion being a problem), cost involved for transportation, treatment and purchase of drugs and absence of pain from the lesion.
Recommendations: There is need for education to the communities on the importance of early reporting whenever they suspect a lesion in the oral and maxillofacial region. Continuing education should be provided to the practicing oral and general health personnel who are working in the regions. There is a need for a more extensive study involving more regions and referral centres in the country.
