scholarly journals Iodine-deficiency disorders in the Aseer region, south-western Saudi Arabia: 20 years after the national survey and universal salt iodization

2015 ◽  
Vol 18 (14) ◽  
pp. 2523-2529 ◽  
Author(s):  
Fuad I Abbag ◽  
Saeed A Abu-Eshy ◽  
Ahmed A Mahfouz ◽  
Suliman A Al-Fifi ◽  
Hussein El-Wadie ◽  
...  

AbstractObjectiveTo study (i) the current prevalence of iodine-deficiency disorders among schoolchildren in south-western Saudi Arabia after universal salt iodization and (ii) the iodine content of table salts and water.DesignCross-sectional study on a stratified proportional allocation sample of children. Thyroid gland enlargement was assessed clinically and by ultrasound scanning. Urine, table salt and water samples were taken to measure iodine content.SettingsThe Aseer region, south-western Saudi Arabia.SubjectsSchoolchildren aged 8–10 years.ResultsThe study included 3046 schoolchildren. The total goitre rate amounted to 24·0 %. Prevalence of enlarged thyroid by ultrasound was 22·7 %. The median urinary iodine concentration of the study sample amounted to 17·0 µg/l. The iodine content of table salt ranged from 0 to 112 mg/kg; 22·5 % of the table salt samples were below the recommended iodine content (15 mg/kg) set by WHO. The total goitre rate increased significantly from 19·8 % among children using table salt with iodine content ≥15 mg/kg to reach 48·5 % among children using table salt with 0 mg iodine/kg. Analysis of water samples taken from schools showed that the majority of water samples (78·8 %) had an iodine content of 0 µg/l.ConclusionsThe study documented that 18 years after the national study, and after more than a decade of universal salt iodization in Saudi Arabia, the problem of iodine-deficiency disorders is still endemic in the Aseer region. Efforts should focus on fostering advocacy and communication and ensuring the availability of adequately iodized salt.

2007 ◽  
Vol 28 (3) ◽  
pp. 337-347 ◽  
Author(s):  
Masekonyela Linono Damane Sebotsa ◽  
André Dannhauser ◽  
Pieter L. Jooste ◽  
Gina Joubert

Background Evaluation of the sustainability of iodine-deficiency disorders control programs guarantees successful and sustained virtual elimination of iodine deficiency. The Lesotho universal salt iodization legislation was enacted in 2000 as an iodine-deficiency disorders control program and has never been evaluated. Objectives To assess the sustainability of the salt iodization program in Lesotho, 2 years after promulgation of the universal salt iodization legislation. Methods The proportion to population size method of sampling was used in 2002 to select 31 clusters in all ecological zones and districts of Lesotho. In each cluster, 30 women were selected to give urine and salt samples and 30 schoolchildren to give urine samples. The salt samples were analyzed by the iodometric titration method, and the ammonium persulfate method was used to analyze the urine samples. The chairperson of the iodine-deficiency disorders control program was interviewed on programmatic indicators of sustainability. SAS software was used for statistical analysis of the data. Results The urinary iodine concentrations of very few children (10.1% and 21.5%) and women (9.8% and 17.9%) were lower than 50 μg/L and 100 μg/L, respectively. At the household level, 86.9% of the households used adequately iodized salt. Only four indicators of sustainability have been attained by the salt iodization program in Lesotho. Conclusions Iodine-deficiency disorders have been eliminated as a public health problem in Lesotho, but this elimination is not sustainable. Effective regular monitoring of salt iodine content at all levels, with special attention to iodization of coarse salt, is recommended, together with periodic evaluation of the iodization program.


2014 ◽  
Vol 8 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Hassimi Sadou ◽  
Ibrahim G. Dandano ◽  
Mousbahou M. Alma ◽  
Hamani Daouda

Introduction: Since 1996, Niger has officially adopted the universal dietary salt iodization program (UDSI). Objective: It is a before‑after trial study conducted to determine the impact of UDSI program in Tiguey 16 years after. Subjects and methods: The study was centered on 371 volunteers whose thyroid gland was palpated and urinary iodine concentration (UIC) determined in 319 of them. Results: The total goitre rate (TGR) was 13.20% with 9.70% invisible but palpable goitre (G1) and 3.50% visible goitre (G2). In 1987, the TGR was 77.15%, with 25.25% G1 and 51.90 % G2. The median UIC was 166.00 μg/L, the 20th percentile 66.40 μg/L and the 80 percentile was 300 μg/L. 68.34 % of the volunteers had a UIC ≥ 100 μg/L, 2.51% <20 μg/L, 10.97% between 20 and 49 μg/L and 18.18% between 50 and 99 μg/L. In 1987, only 3.96% of the studied sample had a UIC ≥ 100 μg/L, 45 % had a UIC <20 μg/L, 35% between 20 and 49 μg/L and 16% from 50 to 99 μg/L. No significant relationship was found between UIC and age and gender or goitre prevalence and gender (P> 0.05). However, goitre prevalence increases significantly with age (p < 0.05). Conclusion: The implementation of the UDSI program in Niger decreased goitre prevalence and significantly improved the nutritional iodine status of the populations of Tiguey. However a slight endemic goitre and mild to moderate iodine deficiency persists.


1998 ◽  
Vol 19 (4) ◽  
pp. 347-352 ◽  
Author(s):  
Jinkou Zhao ◽  
Hua Wang ◽  
Jun Ge ◽  
Qinlan Zhang ◽  
Xiping Huan ◽  
...  

To assess the iodine-deficiency disorder status in nine counties of Jiangsu Province, China, where salt iodization was initiated in 1985, a special verification survey was conducted in 1997 by a provincial multisectoral team. Results obtained by regular monitoring of counties indicated that the goitre rate in schoolchildren had progressively decreased from 41.9% in 1983 to 3.9% in 1997, while the median urinary iodine concentrations of the population had remained above 100 μg/L since 1985. More than 90% of the edible salt supplied to households had been iodized at ≥ 20 mg I/kg during the previous five years. The data obtained by provincial verification confirmed the county findings of ≥ 90% adequate iodized salt in households, < 5% goitre rate in schoolchildren, and adequate urinary iodine excretions. The provincial team also considered the established mechanisms for salt iodization and supply and iodine information management potentially sustainable. The high variability of the iodine content of household salt indicates that improved quality assurance of iodized salt at production and continued monitoring of population iodine indicators are needed.


2009 ◽  
Vol 13 (3) ◽  
pp. 424-429 ◽  
Author(s):  
Subhash Yadav ◽  
Sushil Kumar Gupta ◽  
Madan M Godbole ◽  
Manoj Jain ◽  
Uttam Singh ◽  
...  

AbstractObjectiveThe aim of the present study was to determine the impact of universal salt iodization (USI) on the prevalence of iodine deficiency in the population of an area previously known to have severe iodine deficiency in India.DesignIn a cross-sectional survey, a total of 2860 subjects residing in fifty-three villages of four sub-districts of Gonda District were examined for goitre and urinary iodine concentration. Free thyroxine and thyroid-stimulating hormone levels were also measured. Salt samples from households were collected for estimation of iodine content.ResultsA reduction in goitre prevalence was observed from 69 % reported in 1982 to 27·7 % assessed in 2007. However, 34 % of villages still had very high endemicity of goitre (goitre prevalence >30 %). Twenty-three per cent of households consumed a negligible amount (<5 ppm) and 56 % of households consumed an insufficient amount (5–15 ppm) of iodine from salt.ConclusionsAlthough there was an overall improvement in iodine nutrition as revealed by decreased goitre prevalence and increased median urinary iodine levels, there were several pockets of severe deficiency that require a more targeted approach. Poor coverage, the use of unpackaged crystal salt with inadequate iodine and the washing of salt before use by 90 % of rural households are the major causes of persisting iodine-deficiency disorders. This demonstrates lapses in USI implementation, lack of monitoring and the need to identify hot spots. We advocate strengthening the USI programme with a mass education component, the supply of adequately iodized salt and the implementation of complementary strategies for vulnerable groups, particularly neonates and lactating mothers.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Magda Shoukry Mohamed ◽  
Merhan Samy Nasr ◽  
Salah Hussien El-Halawany ◽  
Ahmed Mohamed Abbas ◽  
Salma Said Hassan Tayeh

Abstract Background The global effort to prevent iodine deficiency disorders through iodine supplementation, such as universal salt iodization, has achieved impressive progress during the last few decades. However, iodine excess, due to extensive environmental iodine exposure in addition to poor monitoring, is currently a more frequent occurrence than iodine deficiency. Iodine excess is a precipitating environmental factor in the development of autoimmune thyroid disease. Aim of the study to evaluate the urinary iodine level as a marker of iodine status in pregnant women in 3rd trimester and assess its relation to thyroid functions. Patients and Methods This Cross Sectional Study was conducted on 100 subjects with their ages ranging from 18-35 years old, pregnant females, at the third trimester, selected from Obstetric Out- patient Clinic of Ain shams University Hospitals. Samples were collected from participants in cairo, during the Spring and Summer from March to August. Results in our study, there was a significant negative correlation between Urinary Iodine level and TSH as Iodine difficient group has the Highest TSH, and the Highest Thyroid Volume, as there was a significant negative correlation between Urinary Iodine level and Thyroid Volume. Conclusion TSH level and Thyroid Volume were global effort to prevent iodine deficiency disorders through iodine supplementation, such as universal salt iodization, has achieved impressive progress during the last few decades. However, iodine excess, due to extensive environmental iodine exposure in addition to significantly higher in Iodine difficient group than Excess iodine group, And FT4 level was lower in Iodine difficient group than excess iodine group.


2000 ◽  
pp. 727-731 ◽  
Author(s):  
M Zimmermann ◽  
A Saad ◽  
S Hess ◽  
T Torresani ◽  
N Chaouki

OBJECTIVES: In 1994, WHO/International Council for the Control of Iodine Deficiency Disorders recommended replacing the WHO 1960 four-grade goiter classification with a simplified two-grade system. The effect of this change in criteria on the estimation of goiter prevalence in field studies is unclear. In areas of mild iodine deficiency disorders (IDD) where goiters are small, ultrasound is preferable to palpation to estimate goiter prevalence. However, in areas of moderate to severe IDD, goiter screening by palpation may be an acceptable alternative to thyroid ultrasound. To address these two issues, we compared WHO 1960 and 1994 criteria with thyroid ultrasound for determination of goiter prevalence in areas of mild and severe IDD in Morocco. DESIGN: A cross-sectional study of 400 six- to 13-year-old children from two mountain villages (Ait M'hamed and Brikcha) in rural Morocco was carried out. METHODS: Urinary iodine concentration (UI), whole blood TSH and serum thyroxine were measured. Thyroid size was graded by inspection and palpation by two examiners using both WHO 1960 and 1994 criteria. Thyroid volume was determined by ultrasound. Variation between examiners and examination methods was assessed. Sensitivity and specificity of the two classification systems compared with ultrasound were calculated. RESULTS: Median UIs in Ait M'hamed and Brikcha were 183 and 24 microg/l respectively. In Ait M'hamed, using 1960 and 1994 criteria, goiter prevalence was 21 and 26% respectively, compared with 13% by ultrasound. In Brikcha, with 1960 and 1994 criteria, goiter prevalence was 64 and 67% respectively, compared with 64% by ultrasound. Agreement between observers was better with the 1994 criteria than with the 1960 criteria in Ait M'hamed (kappa=0.53 and 0.47 respectively), while in Brikcha observer agreement was similar with the two systems (kappa=0.67). Using either the 1994 or 1960 criteria, agreement with ultrasound was only moderate in Ait M'hamed (kappa=0.41-0.44), but good in Brikcha (kappa=0.55-0.64). Overall, compared with ultrasound, sensitivity increased 3-4% using 1994 criteria, while specificity decreased 4-5%. CONCLUSIONS: The WHO 1994 criteria are simpler to use than the 1960 criteria and provide increased sensitivity with only a small reduction in specificity. Agreement between observers is better with the 1994 criteria than with the 1960 criteria, particularly in areas of mild IDD. Like the 1960 criteria, the 1994 criteria overestimate goiter prevalence in areas of mild IDD, compared with ultrasound. However, the 1994 palpation criteria provide an accurate estimate of goiter prevalence in areas of severe IDD, and may be an acceptable and affordable alternative to thyroid ultrasound in these areas.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1037-1037
Author(s):  
Abu abdullah Mohammad Hanif ◽  
Md Mokbul Hossain ◽  
Mehedi Hasan ◽  
Abu Ahmed Shamim ◽  
Malay Kanti Mridha

Abstract Objectives Optimum Iodine status during pregnancy and lactation is crucial for normal fetal growth and child development. We assessed the urinary iodine concentration of pregnant and lactating women to determine their iodine status and measured salt iodine from their households. Methods We collected spot urine samples and corresponding household salt samples from 80 pregnant women (37 and 43 second and third-trimester women, respectively) and 49 lactating women (with children &lt;6 months). Urinary iodine was determined by manual digestion with ammonium persulfate followed by Sandell-Kolthoff Reaction using 96 multi-well plates and a micro-plate reader at 405 nm. The iodine content in salt was measured by iodometric titration method. Samples were analyzed at the icddr, b Immunology, Nutrition, and Toxicology Laboratory, Dhaka, Bangladesh. Results The median [IQR] UIC in the second-trimester women, third-trimester women, and lactating women was 90.6[41.9–171.5] mcg/L, 67.9[24.2–144.5] mcg/L, and 74.7[48.1–134.8] mcg/L, respectively. More than three-quarters of pregnant women (73% of the second-trimester women and 79% of the third-trimester women) and more than half of the lactating mothers (57%) were below the WHO recommended cut-offs. Only 42% of the household salts were adequately iodized. A moderate positive linear relationship was found between urinary and household salt iodine content (r = 0.51, P &lt; 0.0001). Conclusions Even with mandatory salt iodization policy in Bangladesh for about three decades, the iodine insufficiency among pregnant and lactating women is widespread and needs to be improved through ensuring the availability of adequately iodized salt or supplement. Funding Sources ETH Zurich, Switzerland.


2000 ◽  
Vol 12 (2) ◽  
pp. 79-84 ◽  
Author(s):  
C. Yamada ◽  
D. Oyunchimeg ◽  
P. Enkhtuya ◽  
A. Erdenbat ◽  
A. Buttumur ◽  
...  

In 1992, the Mongolian government conducted a nationwide palpation study of the thyroid glands, and the study showed an overall goiter rate of 30%. As a result of this, the Mongolian Government launched its Iodine Deficiency Disorders (IDD) Elimination Programme in 1996 and its primary strategy was salt iodization. In 1998 and 1999, we carried out programme monitoring studies in 11 provinces. The results showed: among schoolchildren, a goiter rate was 22.8% (n=6,535), median values of urinary iodine excretion ranged from 11 μg/l to 256 μg/l (n=1,930), and usage rates of iodized salt (>20 PPM iodine content) in their households ranged from 3% to 82%. We concluded that severe iodine deficiency in 1992 was improved from moderate to mild severity a few years later by salt iodization. However, stronger official commitments and community participation are needed to improve the programme so that iodized salt will be made more widely available. Asia Pac JPublic Health 2000;12(2): 79-84


2021 ◽  
pp. 10-17
Author(s):  
Stephen N. Onteri ◽  
Anselimo O. Makokha ◽  
Beatrice Nyanchama Kiage Mokua ◽  
Philip Ndemwa

Aims: Iodine plays a key role in thyroid hormone production and functioning. Inadequate iodine intake results in iodine deficiency (ID) which impairs the normal functioning of the thyroid. The deficiency is responsible for damage to brain development, growth retardation, cretinism, and thyroid dysfunction. Millions of people have been condemned to a life of few prospects and continued underdevelopment due to ID. The study was conducted to assess iodine status among primary school children in the Mt. Elgon region and the impact of salt iodization on this status. Study Design:  A school-based cross-sectional descriptive study to assess iodine status among primary school children was employed in the study. Study Area and Duration: The study was carried out in Kenya, Bungoma County, Mount Elgon Sub-County. The study period was between 27th November 2018 and 26th November 2019. Methodology: Healthy primary school children aged 6 to 12 years who met the inclusion criteria were included in the study. Spot urine samples were collected in schools, while water samples were collected from different water sources. Salt was collected from households (HH) and at distribution outlets. The Sandell Kolthoff reaction was used to analyse urine and water samples while salt was analysed using iodometric titration. Results: The median urinary iodine concentration (UIC) was 200.7 µg/l. Out of which 0.55% were severely deficient, 5.25% moderately deficient, 18.23% with a mild deficiency, 25.69% had adequate iodine levels, 22.38% had more than adequate, and 27.90% had excess iodine levels. Household and salt samples from different distribution outlets that conformed to set standards of iodization were 49.4% and 63.64%, respectively. Iodine was not detected in all the water samples collected. Conclusion: The study population was found to have adequate iodine based on the median UIC of 200.7 µg/l. However, there was a coexistence of both deficiency and excessive UIC and salt iodization within the population. No iodine was detected in the water samples in the region.


2013 ◽  
Vol 7 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Hassimi Sadou ◽  
Yaou Moussa ◽  
Mousbahou Malam Alma ◽  
Hamani Daouda

Introduction: Universal dietary salt iodization (UDSI) was implemented in Niger in 1996. However, since 2000 there was a slowdown in progress against iodine deficiency. Objective: The objective was to assess iodine nutritional status of infants and their lactating mothers living in Dosso, the state capital of a severe iodine deficiency region in Niger. Methods: The study was centered on 238 full-term infants and their mothers. Some of the data collected were: arm circumference (AC), head circumference (HC) of infant; familial thyroid disease history; the infant feeding method; age of the mother and child; parity, occupation and educational level of the mother. Results: In infants, the urinary iodine concentration (UIC) ranged from 20 to 1600 μg/l with a median of 220 μg/L and 17.23 % had iodine deficiency (UIC<l00μg/L). In mothers, the UIC was within 10 and 820 μg/L with a median of 68 μg/L and 69.75 % had iodine deficiency. No significant statistical correlation was found between infant UIC and their age, type of feeding and gender as well as educational level, occupational group, parity and age of their mothers (p>0.05). Spearman's correlation test indicated weak significant correlation between maternal and infant UIC (r = 0,167, p = 0, 01). Conclusion: Iodine status was suboptimal in 70% of mothers and 17% (mild to moderate) of breastfed infants, thus indicating an urgent need to provide iodine supplement for lactating women in Dosso.


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