title: Dietary Fluoride Intake and Associated Skeletal and Dental Fluorosis in School Age Children in Rural Ethiopian Rift Valley.
abstract: An observational study was conducted to determine dietary fluoride intake, diet, and prevalence of dental and skeletal fluorosis of school age children in three fluorosis endemic districts of the Ethiopian Rift Valley having similar concentrations of fluoride (F) in drinking water (~5 mg F/L). The duplicate plate method was used to collect foods consumed by children over 24 h from 20 households in each community (n = 60) and the foods, along with water and beverages, were analyzed for fluoride (F) content. Prevalence of dental and skeletal fluorosis was determined using presence of clinical symptoms in children (n = 220). Daily dietary fluoride intake was at or above tolerable upper intake level (UL) of 10 mg F/day and the dietary sources (water, prepared food and beverages) all contributed to the daily fluoride burden. Urinary fluoride in children from Fentale and Adamitulu was almost twice (>5 mg/L) the concentration found in urine from children from Alaba, where rain water harvesting was most common. Severe and moderate dental fluorosis was found in Alaba and Adamitulu, the highest severity and prevalence being in the latter district where staple foods were lowest in calcium. Children in all three areas showed evidence of both skeletal and non-skeletal fluorosis. Our data support the hypothesis that intake of calcium rich foods in addition to using rain water for household consumption and preparation of food, may help in reducing risk of fluorosis in Ethiopia, but prospective studies are needed.
authors.affiliation: Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia. awekekeb@gmail.com.
authors.forename: Aweke
authors.initials: A
authors.lastname: Kebede
authors.affiliation: Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia. negussie.retta@gmail.com.
authors.forename: Negussie
authors.initials: N
authors.lastname: Retta
authors.affiliation: ENGINE/Save the Children, P.O. Box 387, Addis Ababa, Ethiopia. cherinet.abuye@savethechildren.org.
authors.forename: Cherinet
authors.initials: C
authors.lastname: Abuye
authors.affiliation: College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada. susan.whiting@usask.ca.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Whiting
authors.affiliation: Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia. kmelkitu@yahoo.com.
authors.forename: Melkitu
authors.initials: M
authors.lastname: Kassaw
authors.affiliation: Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia. Nubiya21@gmail.com.
authors.forename: Tesfaye
authors.initials: T
authors.lastname: Zeru
authors.affiliation: Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia. masresha88@gmail.com.
authors.forename: Masresha
authors.initials: M
authors.lastname: Tessema
authors.affiliation: National Institute of Nutrition and Seafood Research (NIFES), P.O. Box 185, Bergen N-5002, Norway. Marian.Kjellevold@nifes.no.
authors.forename: Marian
authors.initials: M
authors.lastname: Kjellevold
mesh_terms: D001847:Bone Diseases / Q000453:epidemiology / Q000209:etiology; D002118:Calcium / Q000378:metabolism; D002648:Child; D004032:Diet; D004777:Environment; D005002:Ethiopia / Q000453:epidemiology; D005458:Fluoride Poisoning / Q000453:epidemiology* / Q000209:etiology*; D005459:Fluorides / Q000032:analysis / Q000633:toxicity* / Q000652:urine; D009050:Fluorosis, Dental / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012424:Rural Population; D014867:Water / Q000737:chemistry*; D014881:Water Supply
chemical_list: D014867:Water; D005459:Fluorides; D002118:Calcium
keywords: Ethiopian Rift Valley; calcium; dental fluorosis; dietary fluoride; skeletal fluorosis