title: Prevalence and aetiology of juvenile skeletal fluorosis in the south-west of the Hai district, Tanzania--a community-based prevalence and case-control study.
abstract: BACKGROUND
  Fluorosis is endemic throughout the East African Rift valley, including parts of Tanzania. The aim of the study was to identify all cases of deforming juvenile skeletal fluorosis (JSF) in a northern Tanzanian village and to document the extent of dental fluorosis (DF).
  
  
  METHODS
  Door-to-door prevalence survey of all residents of the village. Residents were assessed for the presence of DF and JSF. Those with JSF and randomly selected controls from the same age range were further assessed for possible JSF risk factors.
  
  
  RESULTS
  The village had a population of 1435. DF was endemic within the population, being present in 911 (75.5%; 95% CI, 73.0-77.9) of dentate individuals who were examined (n = 1207). JSF was present in 56 of 1263 people examined, giving a prevalence of 4.4% (95% CI, 3.3-5.6) and was more common in males. Low body mass index, drinking predominantly well water 3 years previously, not being weaned on bananas, the use of fluoride salts in cooking during childhood and drinking more cups of tea per day were independent predictors of JSF.
  
  
  CONCLUSIONS
  Juvenile skeletal fluorosis is a common and preventable public health problem. Providing clean, low-fluoride, piped water to affected communities is of obvious health benefit.
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK. hgjarvis77@hotmail.com
authors.forename: Helen G
authors.initials: HG
authors.lastname: Jarvis
authors.forename: Peta
authors.initials: P
authors.lastname: Heslop
authors.forename: John
authors.initials: J
authors.lastname: Kisima
authors.forename: William K
authors.initials: WK
authors.lastname: Gray
authors.forename: Godwin
authors.initials: G
authors.lastname: Ndossi
authors.forename: Anne
authors.initials: A
authors.lastname: Maguire
authors.forename: Richard W
authors.initials: RW
authors.lastname: Walker
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001847:Bone Diseases / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D060766:Drinking Water / Q000009:adverse effects / Q000032:analysis; D005260:Female; D005459:Fluorides / Q000009:adverse effects*; D009050:Fluorosis, Dental / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D012720:Severity of Illness Index; D013636:Tanzania / Q000453:epidemiology; D013662:Tea / Q000009:adverse effects; D014881:Water Supply / Q000032:analysis; D055815:Young Adult
chemical_list: D060766:Drinking Water; D013662:Tea; D005459:Fluorides