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. 2023 Dec 22;11(6):e2200342.
doi: 10.9745/GHSP-D-22-00342. Print 2023 Dec 22.

Prevalence of Skeletal Fluorosis in Northern Tanzania: A Follow-Up Study

Anna Foat  1 , Claire Stevens  2 , Grace George  2 , John Massawe  3 , Ally Mhina  3 , William K Gray  4 , Blandina T Mmbaga  5 , Deogratias S Rwakatema  5 , Paul Sallis  6 , Helen Jarvis  7 , Irene Haule  3 , Daniel Benedict  8 , Richard Walker  4   7
Affiliations

Prevalence of Skeletal Fluorosis in Northern Tanzania: A Follow-Up Study

Anna Foat et al. Glob Health Sci Pract. .

Abstract

Objectives: Skeletal fluorosis is a metabolic bone disease caused by excessive exposure to fluoride, predominantly through contamination of drinking water. This study aimed to identify all cases of skeletal fluorosis in Tindigani village situated in Northern Tanzania. This was done following changes in drinking water sources after a previous prevalence study in 2009 in this population.

Methods: In a door-to-door cross-sectional study of Tindigani village, a sample of residents was assessed for skeletal fluorosis and dental fluorosis. Diagnosis of skeletal fluorosis was based on pre-defined angles of deformity of the lower limbs. Dental fluorosis was diagnosed and graded using the Thylstrup and Fejerskov Index. Samples from current drinking water sources underwent fluoride analysis.

Results: Tindigani village had a population of 1,944 individuals. Of the 1,532 individuals who were screened, 45 had skeletal fluorosis, giving a prevalence of 3.3% (95% CI=2.4, 4.3). Dental fluorosis was present in 82.5% of those examined (95% CI=79.8, 85.3). Dental fluorosis was present in all individuals with skeletal fluorosis and at higher grades than in the rest of the population. Drinking water samples were collected from 28 sources. These included piped, surface, well, and borehole water sources. Fluoride concentrations ranged from 0.45-38.59 mg/L of fluoride.

Conclusions: Skeletal fluorosis is an ongoing but preventable health problem in the current population. The delivery of sustainable low fluoride piped water to this community would be of clear health benefit. This has been addressed at a local level.

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Figures

FIGURE 1
FIGURE 1
Flow Chart to Show Identified Cases of Skeletal Fluorosis, Tindigani, Tanzania
FIGURE 2
FIGURE 2
Percentage per TFI Grade Split by Presence of Skeletal Fluorosis, Tindigani, Tanzania Abbreviations: SF, skeletal fluorosis; TFI, Thylstrup and Fejerskov Index.
FIGURE 3
FIGURE 3
Change in Fluoride Concentration of Different Drinking Water Sources Between 2009 and 2018, Tindigani, Tanzania
See this image and copyright information in PMC

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