Dental fluorosis in Tanzania Great Rift Valley in relation to fluoride levels in water and in ‘Magadi’ (Trona)

Background: The concentration of fluoride in ground drinking water greater than the world health organization standard value imposes a serious health, social and economic problem in developing countries. In the Ethiopian Rift Valley where deep wells are the major source of drinking water, high fluoride level is expected. Though many epidemiological studies on fluoride concentration and its adverse effects have been conducted in the region, the result is highly scattered and needs systematically summarized for better utilization. Objective: This research is aimed at estimating the pooled level of fluoride concentration in ground drinking water and the prevalence of dental fluorosis among Ethiopian rift valley residences. Methods: Cochrane library, MEDLINE/PubMed and Google scholar databases were searched for studies reporting the mean concentration of fluoride in ground water and prevalence of dental fluorosis in Ethiopian Rift valley. Search terms were identified by extracting key terms from reviews and selected relevant papers and review medical subject headings for relevant terms. Results: The mean fluoride level in ground water and the prevalence of dental fluorosis were pooled from eleven and nine primary studies conducted in Ethiopian Rift Valley respectively. The pooled mean level of fluoride in ground water therefore was 6.03 mg/l (95% CI; 4.72–7.72, p < 0.001) and the pooled prevalence of dental fluorosis among residents in Ethiopian rift valley was 32% (95% CI: 25, 39%, p<0.001), 29% (95% CI: 22, 36%, p<0.001) and 24% (95% CI: 17, 32%, p<0.001 for mild, moderate and sever dental fluorosis respectively. The overall prevalence of dental fluorosis is 28% (95% CI: 24, 32%, p<0.001). Conclusions: Though, the concentration level varies across different part of the rift valley region, still the level of fluoride in ground drinking water is greater than the WHO standard value (1.5mg/l). Relatively high-level pooled prevalence of dental fluorosis was also seen in Ethiopian rift valley. Therefore, further studies covering the temperature, exposure time and other intake path ways with large sample size is recommended. Interventional projects should be implemented to decrease the concentration of fluoride in the ground drinking water source. Key words: Dental fluorosis, Fluoride, Concentration, Rift Valley, Ethiopia

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“…for mild, 75% for moderate and 41.4% for sever fluorosis (31) which is significantly greater than this review result.…”

Section: Pooled Prevalence Of Dental Fluorosiscontrasting

confidence: 74%

Fluoride Concentration in Ground Water and Prevalence of Dental Fluorosis in Ethiopian Rift Valley: Systematic Review and Meta-Analysis

Enyew

Beyene

Abebe

et al. 2019

Preprint

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“…Globally, the prevalence of dental fluorosis in permanent teeth has been found to range from 4% reported for 12‐year‐old Lithuanians living in low water F areas (0.2 ppm) to 100% among 10‐ and 15‐year‐old Kenyan children living in 2 ppm water F areas . The range of dental fluorosis prevalence found in 8‐year‐olds in the current study (from 5.1% in the urban lower F area to 82.3% in the rural higher F area) falls within this global range, but the fluorosis prevalence in the rural higher F areas was higher than the 12.9% reported for 12‐ to 15‐year‐old Nigerian and lower than the 96.3% reported for 12‐ to 18‐year‐old Tanzanian children, respectively, living in ≥1.5 ppm F water areas. The relationship between drinking water F concentration and dental fluorosis has been studied around the world, and a number of reports have discussed the African context .…”

Section: Discussionsupporting

confidence: 41%

Prevalence and extent of enamel defects in the permanent teeth of 8‐year‐old Nigerian children

Ibiyemi

Zohoori

Valentine

et al. 2017

Comm Dent Oral Epid

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Objectives: Enamel formation is a vulnerable developmental process, susceptible to environmental influences such as excessive systemic fluoride (F) exposure and infant/childhood disease. This study determined prevalence and extent of developmental enamel defects (DDE) and dental fluorosis in 8-year-old Nigerians and explored associations with key predictors.Methods: A sample of 322 healthy 8-year-olds (155 males, 167 females) from primary schools in lower and higher water F areas of (i) rural and (ii) urban parts of Oyo State in south-west Nigeria (n = 4 areas) (in which the mean (SD) F concentration of community water supplies ranged from 0.07 (0.02) to 2.13 (0.64) mg F/L) were dentally examined using modified DDE (mDDE) and Thylstrup and Fejerskov (TF) indices. Drinking waters, cooking waters and toothpaste samples were analysed for F concentration using a F ion-selective electrode (F-ISE). Information on infant/ childhood diseases, infant feeding and tooth cleaning practices was obtained from parents/legal guardians. Data were analysed using ANOVA, chi-square tests, Spearman correlation and binary logistic regression as appropriate.Results: Mean (SD) F concentration of actual drinking and actual cooking waters consumed by participants was 0.25 (0.20) and 0.24 (0.14) mg F/L respectively in the urban higher F area; 1.11 (1.00) and 1.16 (1.02) mg F/L, respectively in the rural higher F area (P < .05). Overall, mouth prevalence of DDE in the permanent dentition was 61.2% with a mean (SD) of 2.4 (2.2) index teeth affected. Dental fluorosis mouth prevalence was 29.8% with a mean of 2.1 (3.7) teeth affected. Prevalence and extent of DDE and dental fluorosis were greater in higher F than lower water F areas (P < .001). A weak positive correlation was seen between extent of dental fluorosis and drinking water F concentration (q = 0.28). The absence of infant/childhood disease was associated with a lower risk of DDE being present (P = .001),with an odds ratio of 0.43 (95% CI = 0.26, 0.71). Gender was a statistically significant (P = .014) predictor for dental fluorosis with females having a higher risk OR 1.94 (95% CI = 1.14, 3.28) of dental fluorosis than males.Conclusions: In these Nigerian 8-year-olds (n = 322), mouth prevalence of DDE was 61.2% (mean (SD) teeth affected = 2.4 (2.2)), and a key positive predictor was a history of infant/childhood disease. With 29.8% of these children exhibiting dental fluorosis (mean (SD) teeth affected = 2.1(3.7)), drinking water F concentration was

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“…Mild dental fluorosis can be encountered at concentrations of 0.9-1.2 mg/L (IPCS 2002). In agreement with this, some studies have shown that Arusha and Kilimanjaro are among the regions with the highest prevalence of dental fluorosis in Tanzania (Vuhahula et al 2009). …”

Section: Water-soluble Ionic Speciesmentioning

confidence: 77%

Water quality assessment in the Pangani River basin, Tanzania: natural and anthropogenic influences on the concentrations of nutrients and inorganic ions

Hellar-Kihampa

Wael

Lugwisha

et al. 2013

International Journal of River Basin Management

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The ongoing rapid expansions of human activities and population dynamics have a potential impact on the environmental quality of the Pangani River basin, one of the largest water resources in Tanzania, including possible loadings of different kinds of micro-contaminants. However, the specific extent of the impacts is not well investigated. In this work, we assessed the environmental quality of the basin, based on the seasonal characterization of physicochemical water and sediment parameters, dissolved inorganic ions and nutrient loads. The contributions of geochemical processes and land-use practices were evaluated by multivariate correlations and principal component analysis (PCA). Hierarchical cluster analysis was used to classify similar water quality stations and identify the most and least enriched ones. Surface waters were slightly alkaline, characterized by low total dissolved solids (48 -652 mg/L). Extremely low oxygen concentration (2.0 mg/L) was also a cause of concern at one station. The Na + and HCO − 3 ions provided the dominant cation and anion, respectively. The PCA identified the weathering of carbonate-and Na + -bearing rocks, gypsum dissolution and atmospheric deposition of sea salt as the major factors controlling the ionic composition, contributing more than 60% of the spatial variance. The concentration profiles of the chemical species showed a generally low level of anthropogenic inputs, except at a few locations where nitrate and nitrite were significantly enriched above the limits of safe exposure, with patterns indicating influences of farming and livestock-keeping. A seasonal difference was observed, with lower ion concentrations during the rainy season, likely due to the dilution effect of increased water discharge. This study provides new insights into the environmental quality of the basin and indicates the need for continuous monitoring and assessment of the chemical species in the area.

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Dental fluorosis in Tanzania Great Rift Valley in relation to fluoride levels in water and in ‘Magadi’ (Trona)

Cited by 33 publications

References 6 publications

Fluoride Concentration in Ground Water and Prevalence of Dental Fluorosis in Ethiopian Rift Valley: Systematic Review and Meta-Analysis

Fluoride Concentration in Ground Water and Prevalence of Dental Fluorosis in Ethiopian Rift Valley: Systematic Review and Meta-Analysis

Prevalence and extent of enamel defects in the permanent teeth of 8‐year‐old Nigerian children

Water quality assessment in the Pangani River basin, Tanzania: natural and anthropogenic influences on the concentrations of nutrients and inorganic ions

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