Background Existing studies in central areas of Eritrea showed high prevalence of dental caries, however, there is gap of knowledge regarding the burden in the rural areas. This study aimed to evaluate the prevalence of dental caries and its associated factors as well as knowledge, attitude and practice of students in Nakfa town, a rural and remote regions of Eritrea.

Methods This study is school based cross sectional study conducted among 401 Junior and high-school students in three schools in Nakfa town. The study used multistage sampling method where finally Students were randomly selected. Self-administered closed end questionnaire with 28 questions were used to collect the data. Dental examination was done by two 5 year experienced and certified dental therapists. All data analysis was done using SPSS version 26.

Results Overall prevalence of dental caries was 65.3% with mean DMFT index and mean significant index (SiC) of 2.03(SD±2.3) and 4.57(SD±1.9), respectively. Mean DMFT index was higher among the older age group (19-23 age group) and those who use traditional stick method of tooth cleaning. Our study also found that higher consumption of porridge was associated with higher prevalence of dental caries as well as higher mean DMFT index. Multivariate analysis showed that age group of 19-23 had 80% higher DMFT index than those 12-14 age category (AIRR= 1.8, 95% CI: 1.1-3). Furthermore, participants who use traditional method of cleaning tooth had 40% higher DMFT than those who use tooth brush with paste (AIRR= 1.40, 95% CI: 1.06-1.8). This study showed taht most of the participants had sufficient knowledge and positive attitude, 61.3% and 73.8% respectively, however, only 8.7% had adequate oral hygiene practice.

Conclusion The prevalence of dental caries was high in Junior and high school students in Nakfa town. High consumption of porridge is associated with high prevalence and high mean DMFT. This study also found that older age group and usage of traditional stick method of teeth cleaning is associated with higher DMFT. The overall level of knowledge and attitude of participants towards oral health was good whereas practice was suboptimal.

The authors have declared no competing interest.

This study did not receive any funding

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Ethical Approval and Official Permission Before starting the survey, ethical approval was obtained from the Ministry of health of Eritrea (Eritrean ministry of health research ethics and protocol review committee) and the directorate of education in Nakfa sub zone and official permission was obtained from the authorities (Principal/Director) of the schools included in the study. All the study procedures followed the recommendations of the Helsinki Convention.

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