Melaku Zenebe, Assefa Getachew, Enqusilassie Fikre, Bjorvatn Kjell, Tekle-Haimanot Redda
Columbia University, ICAP in Ethiopia, Addis Ababa, Ethiopia.
Ethiop Med J. 2012 Oct;50(4):307-13.
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.
The aim of this study is assess the magnitude of the problem at the community level.
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.
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.
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.
地方性骨氟病是一种慢性氟中毒形式,因通过饮用水摄入过量氟化物所致。在包括埃塞俄比亚在内的几个发展中国家的部分地区,这是一个重要的公共卫生问题。
本研究旨在评估社区层面该问题的严重程度。
本基于社区的横断面研究在翁吉 - 绍阿糖业公司(WSSE)开展。研究开始时对WSSE的成年人口进行了基线普查。使用根据普查结果编制的抽样框,通过简单随机抽样共选取了578名受试者。对于每位研究参与者,收集了社会人口学特征、可能的风险因素等信息,并采用标准X射线技术拍摄前臂正位和侧位X线片。
骨氟病的总体患病率为65.7%,男性患病率与女性患病率之比为79.3%对53%。与骨氟病相关因素的粗分析表明,男性比女性、体力劳动者比其他人群患病风险显著更高(粗比值比分别为3.39,95%可信区间 = 2.31 - 4.95;比值比为3.22,95%可信区间 = 2.20 - 4.72)。在逻辑回归分析中,只有性别、年龄和居住营地与骨氟病仍显著相关。在对其他因素进行调整后,男性患病风险更高(约为女性的2.5倍),55岁及以上的老年人患病风险比15 - 24岁的年轻人高约20倍。
本研究中放射性骨氟病(SKF)患病率极高的发现凸显了地方性SKF作为公共卫生问题的重要性。因此,需要迅速采取措施为社区提供安全饮用水,以预防致残性骨氟病的发生。