Epidemiology of skeletal fluorosis in Wonji Shoa Sugar Estate, Wonji, Ethiopia: a community based survey.
BACKGROUND
Endemic skeletal fluorosis is a form of chronic fluoride intoxication resulting from ingestion of excessive quantities of fluoride through drinking water. It is an important public health problem in parts of several developing countries including Ethiopia.


OBJECTIVE
The aim of this study is assess the magnitude of the problem at the community level.


METHODS
This community based, cross-sectional study was undertaken in Wonji-Shoa Sugar Estate. (WSSE). A base line census of the adult population of WSSE was carried out at the beginning of the study. A total of 578 subjects were selected by simple random sampling using a sampling frame which was prepared from the census results. For each study participant, information on socio-demographic characteristics, possible risk factors gathered and X-ray of the forearm PA and Lateral were taken using standard x-ray techniques.


RESULTS
The overall prevalence of skeletal fluorosis is 65.7%, with male to female prevalence ratio of 79.3% vs. 53%. The crude analysis of factors associated with skeletal fluorosis shows that, males than females and manual workers than others had significantly higher risk (Crude OR = 3.39, 95% CI = 2.31-4.95 and OR = 3.22, 95% CI = 2.20-4.72 respectively). On logistic regression, only sex, age and camp of residence remained significantly associated with skeletal fluorosis. Adjusted for other factors, males were more likely (about 2.5 times to be at risk than females and older people of age 55 years and above had about 20 times higher risk than young adults of age 15-24.


CONCLUSIONS
The finding of very high prevalence of radiological skeletal fluorosis (SKF) in this study highlights the importance of endemic SKF as a public health problem. Therefore, prompt measures are required to provide the community with safe drinking water to prevent development of crippling skeletal fluorosis.
Columbia University, ICAP in Ethiopia, Addis Ababa, Ethiopia. zy2115@columbia.edu
Zenebe
Z
Melaku
Getachew
G
Assefa
Fikre
F
Enqusilassie
Kjell
K
Bjorvatn
Redda
R
Tekle-Haimanot
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001847:Bone Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005457:Fluoridation / Q000009:adverse effects*; D005459:Fluorides / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
D005459:Fluorides