The geographic distribution of fluoride in surface and groundwater in Ethiopia with an emphasis on the Rift Valley

This paper analyzes the most extensive database on fluoride distribution in Ethiopia. Of the total 1438 water samples tested, 24.2% had fluoride concentrations above the 1.5 mg/l recommended optimum concentration recommended by WHO. Regionally, by far the highest fluoride levels were recorded in the Rift Valley, where 41.2% of all samples exceeded the 1.5 mg/l level. Only 1.0% of the samples from the central and northwestern highlands and 10.0% in the southeastern highlands exceeded 1.5 mg/l. Larger proportions of deep wells (50.0%) and hot springs (90.0%) than shallow wells (27.2%) and cold springs (12.6%) exceeded the 1.5 mg/l level. The highest fluoride concentrations were recorded for Rift Valley lakes Shala (264.0 mg/l) and Abijata (202.4 mg/l) and the lowest in Lake Tana, and rivers, wells and springs in the highlands. The fluoride concentrations of the Awash River, which originates in the highlands and flows through the Rift Valley, increase downstream, giving concern over the current diversion of high-fluoride water from Lake Beseka. Of the various flourosis prevention methods tried in Ethiopia, the treatment of surface water has been shown to be the most feasible and effective for towns and large commercial farms in the Rift Valley, although defluoridation methods should be considered for smaller rural communities.

Magnitude of Birth Defects in Central and Northwest Ethiopia from 2010-2014: A Descriptive Retrospective Study

BACKGROUND

Birth defects are defined as structural and functional defects that develop during the organogenesis period and present at birth or detected later in life. They are one of the leading causes of infant and child mortality, morbidity, and long term disability. The magnitude of birth defects varies from country to country and from race/ethnicity to race/ethnicity, and about 40-60% of their causes are unknown. The known causes of birth defects are genetic and environmental factors which may be prevented. For various reasons, there is lack of data and research on birth defects in Ethiopia.

OBJECTIVE

The major objective of this study is to estimate the magnitude of birth defects in Ethiopia.

SUBJECT AND METHODS

A hospital based, retrospective, cross sectional, descriptive study was conducted. The subjects were babies/children aged 0-17years who visited selected hospitals between 2010 and 2014. Fourteen hospitals (8 in Addis Ababa, 6 in Amhara Region) were selected purposively based on case load. A data retrieving form was developed to extract relevant information from record books.

RESULTS

In the hospitals mentioned, 319,776 various medical records of children aged 0-17years were found. Of these, 6,076 (1.9% with 95% CI: 1.85%-1.95%) children were diagnosed as having birth defects. The majority (58.5%) of the children were male and 41.5% female. A slightly more than half (51.1%) of the children were urban dwellers, while 48.9% were from rural areas. Among the participants of the study the proportion of birth defects ranged as follows: orofacial (34.2%), neural tube (30.8%), upper and lower limb (12.8%), cardiovascular system (10.3%), digestive system and abdominal wall (4.8%), unspecified congenital malformations (2.5%), Down syndrome (2%), genitourinary system (2%), head, face, and neck defects (0.4%), and others (0.3%). The trend of birth defects increased linearly over time [Extended Mantel-Haenszel chi square for linear trend = 356.7 (P<0.0001)]. About 275 (4.5%) of the cases had multiple (associated) birth defects and 5,801 (95.5%) isolated (single) birth defects. Out of the total birth defects, 6,018 (99%) were major and 58 (1%) minor.

CONCLUSION

The magnitude of birth defects increased from 2010-2014. Orofacial and neural tube defects contributed about two thirds of the birth defects. There is an urgent need for registry and surveillance system strategies for intervention and control of birth defects in Ethiopia.

Factors associated with congenital anomalies in Addis Ababa and the Amhara Region, Ethiopia: a case-control study

Background

The early stage of embryo development is extremely vulnerable to various teratogenic factors, leading to congenital anomalies. In Ethiopia, a significant number of babies are born with congenital anomalies, but the risk factors for the anomalies have never been studied. Understanding the specific risk factors for congenital anomalies is very essential to provide health education that aims at creating awareness and establishing preventive strategic plan/s. The main objective of this study was to assess the risk factors associated with congenital anomalies in Addis Ababa and the Amhara Region, Ethiopia.

Methods

A case-control study was conducted from January 1- June 30, 2015. The participants were recruited at the purposively selected hospitals in Addis Ababa and the Amhara Region. A total of 207 cases and 207 controls were included in the study. Cases were neonates, infants, and children 0-11 months of age with external and internal major congenital anomalies diagnosed by pediatricians. Controls were neonates, infants, and children 0-11 months of age without external and internal anomalies. Data on sociodemographic characteristics, exposure to risk factors, and reproductive history were collected by face to face interviews with children’s mothers/caregivers using a structured questionnaire. Binary logistic regression was employed to explore risk factors associated with the occurrence of the problems.

Results

About 87.4% of the children were below 6 months, and 12.6% were between 6 and 11 months. The majority (59.9%) of the children were male, with the M: F sex ratio of 1.49. The mean age of the mothers was 26 years (16-45 years). Unidentified medication use during early pregnancy (AOR = 4.595; 95% CI: 1.868-11.301, P-value = 0.001), maternal alcohol drinking (AOR = 2.394; 95% CI: 1.212-4.726, P-value = 0.012), and exposure to chemicals (AOR = 9.964; 95% CI = 1.238-80.193, P-value = 0.031) were significantly associated with the occurrence of congenital anomalies. Iron folate use (AOR = 0.051; 95% CI: 0.010-0.260, P-value = < 0.001) before and during early pregnancy had a protective effect on congenital anomaly.

Conclusion

Unidentified medication use, alcohol drinking during early pregnancy, and exposure to chemicals had a significant association with the occurrence of congenital anomalies, whereas iron folate use before and during early pregnancy had a protective effect from congenital anomalies.

Congenital anomalies prevalence in Addis Ababa and the Amhara region, Ethiopia: a descriptive cross-sectional study

Background

During the first three months of pregnancy, the developing embryo may be susceptible to external and internal factors, which may lead to structural and functional congenital anomalies. The main objective of this study was to determine the prevalence of congenital anomalies in Addis Ababa and the Amhara region, Ethiopia.

Methods

A descriptive cross-sectional study was conducted on children 0–17 years of age who visited the 16 selected hospitals in Addis Ababa and the Amhara Region between January 1 and July 5, 2015. The proportions of neonates, infants, and children with external and internal congenital anomalies whether the anomalies were major or minor were estimated.

Results

Out of 76,201 children, 1518 of whom 57.6% were male identified with congenital anomalies. The overall proportion of congenital anomaly was 1.99% (95% CI: 1.89–2.091) i.e., 199 per 10,000 children. The proportion of neural tube defects, orofacial clefts, masculo-skeletal system anomalies, syndrome disorders, and cardiovascular system problems were 40.3% 37.7–43, 23.3% 21.3–25.4, 23.1% 20.9–25.2, 8% 6.7–9.4, and 2.6% 1.8–3.4, with a 95% CI, respectively. The majority (72.5%) of the mothers were multigravidae; 38(2.5%) of the mothers and 32(2.1%) of the fathers had history of other children with congenital anomalies. Similarly, 20(1.3%) of the participant children’s mothers and 17(1.1%) of the fathers had familial history of congenital anomaly. Iron folate and multivitamin use by mothers during preconception and early pregnancy was found to be low.

Conclusion

Neural tube defects, orofacial clefts, and musculoskeletal anomalies were the observed prevalent problems. Maternal illness, viral infections, and malnutrition were seen in a significant number of the mothers. Iron folate/folic acid and multivitamin use by the mothers during and before pregnancy was very low.

Oral health knowledge and oral hygiene practice among visually impaired subjects in Addis Ababa, Ethiopia

Background

Oral health is a global issue. It has an enormous impact on the overall health and well-being of an individual. In addition, many studies indicate visual impairment as one of the constraints for proper maintenance of oral hygiene. However, little is known about visually impaired individuals' oral health knowledge and behavior in Ethiopia, specifically in Addis Ababa. Therefore, this study is conducted to assess the oral health knowledge and related behaviors among participants with visual impairment in Addis Ababa, Ethiopia.

Aim

This study aimed to assess the oral health knowledge and oral hygiene practice among visually impaired participants in Addis Ababa, Ethiopia. It is initially imperative to recognize the deficiency of data regarding the dental health care and needs of such visually impaired individuals in Ethiopia.

Methods

It is a quantitative cross-section study design carried out at the Ethiopian National Association for the blind, located in Addis Ababa, the capital city of Ethiopia. A survey was conducted by convenience sampling of visually impaired library attendees' at the blind association. Sixty-five individuals, of which 46 males and 19 females, agreed to take part in the study. Of these, 30.8% had partial and 69.2% total visual impairment.

Results

61.3% with totally and 72% with partially visually impaired scored high in the knowledge of caries causes respectively. The use of tooth brushing was confirmed by 42.2% with totally and 25% with partially visually impaired. The use of Traditional chewing sticks was confirmed by 57.7% with totally and 30% with partially visually impaired individuals. Moreover, both (Toothbrush and Traditional chewing stick) was used by 35.5% totally and 55% partially visually impaired individuals, respectively.

Conclusions

The study showed the awareness about the causes of dental caries among the visually impaired was high. However, the majority of them had a significant misconception about the causes of dental caries.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02199-x.

Dental anxiety: prevalence and associated factors, among children who visited Jimma University Specialized Hospital Dental Clinic

INTRODUCTION

Dental fear in children has been recognized as an important condition in patient management for many years. Its effects have been shown to persist into adulthood which can lead to dental avoidance.

OBJECTIVE

The aim of this study is to assess the magnitude and factors associated with dental fear among pediatric age group dental clinic attendees at Jimma University Specialized Hospital.

METHODS

A cross-sectional study was conducted on 240 children who visited the dental clinic. Consecutive children who came to the dental clinic participated in the study. Dental anxiety was measured using Corah's Dental Anxiety Scale (CDAS) and Dental Fear Survey (DFS). Data was collected by directly interviewing the children and their parents. Chi-square statistics were used to explore for level of significance of associations between the variables.

RESULTS

The mean age of the study population was 10.45 years (SD = 3.19). The rate of dental anxiety in the children was found to be 74.1% ranging from moderate to severe anxiety. More than a third of the participants (36.6%) had moderate level of anxiety; 17% of them had high level of anxiety and 20.5% of them had severe anxiety. Sex of the child was not significantly associated with dental anxiety whereas age of the child was found to be significantly associated (P = 0.029). Having previous experience of dental procedure in general was not associated with the level of anxiety, however, having painful previous experience was found to be associated with higher anxiety level. Also, there was significant association is found between anxiety levels of parents and children (P < 0.001). Moreover, children with dental anxiety were found to have avoidance of dental treatment.

CONCLUSION AND RECOMMENDATION

The huge burden of dental anxiety and dental fear as well as its consequent dental avoidance found in this study calls for further study. Dentists should be aware of the pervasiveness of the problem and be ready to address the issue in routine clinical care.

Lead levels in primary teeth in children from urban and rural areas in Ethiopia

BACKGROUND

Lead (Pb) is one of the most important and widely distributed pollutants in the environment. Lead concentration in human primary teeth reflects children's exposure to the metal during early life. OBJECTIVE.: In this study we wanted to get preliminary information of the level of lead exposure in Ethiopian children in rural as well as urban areas.

METHODS

Primary incisors, exfoliated 1998-2000, were collected from Addis Ababa, the capital, and two rural villages in the Rift Valley. The teeth were analyzed for lead concentrations by graphite furnace atomic absorption Spectrophotometry.

RESULTS

Very high lead concentrations were not found. However, teeth from Addis Ababa had statistically significant higher lead concentrations than teeth from the Rift Valley. Teeth from both villages showed very low Pb-concentrations, but one village (Village A) had significantly higher concentrations than the other (Village K). The living conditions of the two villages were similar, the main diference being the fluoride content of the drinking water. The village with the lowest tooth-lead had the highest fluoride concentration.

CONCLUSION

Our findings indicate that child lead exposure in Ethiopia is relatively low, especially in the rural populations.

Perception of dental fluorosis among adolescents living in urban areas of Ethiopia

The objective of the study was to assess the perception of dental fluorosis among adolescents residing in two urban areas in Ethiopia: Addis Ababa (low-fluoride drinking water) and Nazreth (high-fluoride drinking water). Students aged 12-15 years, enrolled in two junior secondary schools in Addis Ababa (n = 161) and two similar schools in Nazreth (n = 177) responded to evaluative statements concerning the appearance of anterior maxillary teeth. Color photographs depicting dental fluorosis (TF score 2, 3, 5 and 7) in maxillary front teeth were used as reference during structured interviews. A majority of the students from Addis Ababa and Nazreth were dissatisfied with the appearance of teeth having TF scores 2 and above. More than 66% of the students from both areas confirmed a need for dental consultation concerning fluorotic teeth with TF > or = [corrected] 2. As compared to their counterparts in Nazreth, children in Addis Ababa felt more embarrassed with TF score 2 and 3 (p < 0.01). TF scores 5 and 7 were found unacceptable both in Addis Ababa and in Nazreth. Students in Addis Ababa, more frequently than their counterparts in Nazreth, believed (erroneously) that dental fluorosis were related to neglect on the part of the child. The present findings confirm that fluorotic teeth constitute a social problem among junior secondary school children residing in low-fluoride as well as in high-fluoride urban areas in Ethiopia and, thereby, corroborate the public concern for safe drinking water.