Dental Caries Prevalence and Associated Factors Among Primary School Children in Kigali, Rwanda: A Cross-Sectional Study

Background: Dental caries represents a significant public health challenge in low- and middle-income countries, yet epidemiological data from sub-Saharan Africa remain scarce. Objective: To determine the prevalence of dental caries and identify associated risk factors among 5–11-year-old children attending public primary schools in Kimironko Sector, Kigali, Rwanda. Methods: This cross-sectional study employed stratified random sampling to recruit 325 children from three public primary schools (G.S. Kimironko I & II, E.P. Kibagabaga) between November 2024 and June 2025. Data collection comprised clinical oral examinations by calibrated dental examiners using WHO diagnostic criteria and parent-completed structured questionnaires assessing sociodemographic characteristics, dietary habits, oral hygiene practices, and parental knowledge. Chi-square tests examined bivariate associations, with statistical significance set at α=0.05. Results: Dental caries prevalence was 51.1% (95% CI: 45.7–56.5%), with significant inter-school variation. Significant associations emerged for residence (OR=1.75, 95% CI: 1.11–2.76, p=0.015), dental visit frequency (p=0.045), parental reminders to brush (OR=2.55, 95% CI: 1.35–4.81, p=0.003), parental tooth-checking behavior (p=0.002), and composite parental knowledge score (p=0.031). Fluoride treatment showed an inverse association that did not reach statistical significance (OR=0.42, 95% CI: 0.17–1.07, p=0.077). No significant associations were detected for age, gender, or dietary habits. Conclusions: Dental caries prevalence among Kimironko primary school children exceeds both national and regional estimates and was significantly associated with modifiable environmental and behavioral factors rather than demographic characteristics in bivariate analyses.  Our findings underscore the urgent need for school-based preventive interventions to reduce this substantial disease burden. Keywords: dental caries; child oral health; epidemiology; risk factors; fluoride; parental involvement; Rwanda; East Africa