Low folate status and indoor pollution are risk factors for endemic optic neuropathy in Tanzania.


Hodson, KE; Bowman, RJ; Mafwiri, M; Wood, M; Mhoro, V; Cox, SE; (2011) Low folate status and indoor pollution are risk factors for endemic optic neuropathy in Tanzania. The British journal of ophthalmology, 95 (10). pp. 1361-4. ISSN 0007-1161 DOI: https://doi.org/10.1136/bjo.2010.197608

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Abstract

AIMS: Bilateral optic neuropathy in Dar-es-Salaam, Tanzania was first reported as an epidemic in 1988. Now argued to be endemic in 2010, the aetiology remains unclear. The authors investigated the hypothesis that low folate and vitamin B₁₂ status are associated with optic neuropathy, and also sought to investigate whether mercury, commonly used drugs, dietary factors and indoor pollution may also be risk factors.<br/> METHODS: 57 cases and 102 controls were recruited from two tertiary referral centres in Dar-es-Salaam. Data were collected on demographic characteristics, diet, medication history and HIV status. Folate and vitamin B₁₂ (holo-transcobalamin) were measured in stored serum samples. Exposure to mercury was assessed from concentrations in random urine samples.<br/> RESULTS: Cooking indoors more than twice per week (OR 54.48 (95% CI 9.30 to 319.10)) and indoor use of charcoal or firewood (OR 21.20 (95% CI 2.51 to 179.36)) increased the risk of optic neuropathy. Risk was reduced in those with a higher folate status (highest versus lowest quartile OR=0.11 (95% CI 0.02 to 0.51)) and higher protein intakes (OR=0.84 (95% CI 0.72 to 0.96). No association was found with mercury exposure or any common drug or food commodity.<br/> CONCLUSION: This study presents the first direct evidence of low folate status and indoor pollution in the aetiology of endemic bilateral optic neuropathy in Tanzania.<br/>

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 21733919
Web of Science ID: 295078000005
URI: http://researchonline.lshtm.ac.uk/id/eprint/524

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