scholarly journals Impact evaluation of efforts to eliminate iodine deficiency disorders in Nigeria

2003 ◽  
Vol 6 (2) ◽  
pp. 169-173 ◽  
Author(s):  
John Egbuta ◽  
Frank Onyezili ◽  
Koen Vanormelingen

AbstractObjective:The objective of the present review is to assess the impact of universal salt iodisation in Nigeria during the last five years, with reference to some of the sentinel sites studied previously during a 1995 multi-centre study.Design, setting and subjects:The method of goitre classification by palpation was employed using the new internationally accepted method in which the classification is simply graded as 0, 1 or 2. The multistage random sampling method was used and states and local government areas were already selected by virtue of their known status for iodine deficiency disorders (IDD). Schools were randomly chosen in each local government area and children aged 8–12 years in each school were determined. A percentage of the children was then included in the study to give a sample size greater than the minimum number allotted to the school. A total of 2372 schoolchildren (1420 males and 952 females) in 11 local government areas were examined; urine samples were collected from 537 children and analysed for urinary excretion of iodine. The method known as the Sandell–Kolthoff reaction was adopted, in which the iodide in the urine samples catalyses the reduction of ceric ammonium sulphate (yellow colour) to the cerous form (colourless) in the presence of arsenious acid. The degree of reduction in colour intensity of the yellow ceric ammonium sulphate is proportional to the iodine content in the urine sample.Results:The results from this study show that the median urinary iodine excretion for this sampled population in Nigeria, drawn mostly from IDD-endemic areas, is 14.65 μg dl−1 with a mean value of 13.39 μg dl−1.Conclusion:This finding would suggest that Nigeria, in general terms, has achieved the goal of universal salt iodisation and should now focus its attention on constant monitoring in order to sustain this iodisation level.

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.


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.


2009 ◽  
Vol 1 (4) ◽  
pp. 140-169 ◽  
Author(s):  
Erica Field ◽  
Omar Robles ◽  
Maximo Torero

Cognitive damage from iodine deficiency disorders (IDD) has important implications for economic growth through its effect on human capital. To gauge the magnitude of this influence, we evaluate the impact on schooling of reductions in IDD from intensive iodine supplementation in Tanzania. Our findings suggest a large effect of in utero iodine on cognition and human capital: treated children attain an estimated 0.35–0.56 years of additional schooling relative to siblings and older and younger peers. Furthermore, the effect appears to be substantially larger for girls, consistent with laboratory evidence indicating greater cognitive sensitivity of female fetuses to maternal thyroid deprivation. (JEL I12, I21, J16, O15)


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.


1995 ◽  
Vol 133 (2) ◽  
pp. 216-217 ◽  
Author(s):  
TA Mityukova ◽  
LN Astakhova ◽  
LD Asenchyk ◽  
MM Orlov ◽  
L VanMiddlesworth

Mityukova TA, Astakhova LN, Asenchyk LD, Orlov MM, VanMiddlesworth L. Urinary iodine excretion in Belarus children. Eur J Endocrinol 1995;133:216–7. ISSN 0804–4643. Casual urine samples were collected to determine iodine excretion of 1680 Belarus children during 1990–1994. The subjects, 8–16 years old, were from nine different regions of Belarus; 60% were from the Gomel oblast, which has been associated with relatively high levels of radioiodine fallout and increased incidence of thyroid cancer. Most of the median values indicate borderline/low iodine intake or mild iodine deficiency. Ranges were wide but 163 children excreted < 20 μgI/l urine and they should be considered severely deficient in iodine. L VanMiddlesworth, Dept. of Physiology and Biophysics, University of Tennessee, 894 Union Avenue, Memphis, TN 38163, USA


Author(s):  
Rahul Damor ◽  
Jatin Chhaya ◽  
Sukesha Gamit ◽  
Jayant Patel ◽  
J. K. Kosambiya

Background: Iodine is an essential micronutrient required for normal human growth and development as it is needed for the synthesis of thyroid hormones produced by thyroid glands. The sicknesses occurred due to deficiencies of iodine in the nutrition are termed iodine deficiency disorders. Urinary iodine concentration is the prime indicator of a person’s nutritional iodine status. So, the aim of this study was to assess the status of iodine deficiency based on median urinary iodine excretion.Methods: Community based cross sectional study was carried out among purposively selected primary schools of the Dang district. All students between the age group of 6 to 12 years who were present on the day of visit were included in the study. A total 387 urine samples were collected during the period of August 2015 to September 2016.Results: Based on median urinary iodine excretion, among total analysed samples, about 6.5% samples confirmed severe iodine deficiency, 22% samples showed moderate iodine deficiency and about 36% samples indicated mild iodine deficiency. About one third (31.3%) samples suggested optimum iodine intake. Only few samples (4.4%) revealed more than required iodine intake.Conclusions: About one third (31.3%) of the surveyed population had adequate iodine intake while majority (64.4%) of them had inadequate iodine intake. 


Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 172 ◽  
Author(s):  
Kristen Hynes ◽  
Judy Seal ◽  
Petr Otahal ◽  
Wendy Oddy ◽  
John Burgess

In Australia, pregnant women are advised to take an iodine supplement (I-supp) (150 µg/day) to reduce risks to the foetus associated with iodine deficiency (ID). To examine the impact of this recommendation on iodine status, and to identify factors that contribute to adequacy during gestation, supplement use and Urinary Iodine Concentration (UIC) was measured in 255 pregnant women (gestation range 6 to 41 weeks) in Tasmania. The median UIC (MUIC) of 133 µg/L (Inter-quartile range 82–233) was indicative of ID, being below the 150–249 µg/L range for adequacy during pregnancy. Women taking an iodine-containing-supplement (I-supp) had a significantly higher MUIC (155 µg/L) (n = 171) compared to the combined MUIC (112.5 µg/L) (n = 84) of those who had never (120 µg/L) (n = 61) or were no longer taking an I-supp (90 µg/L) (n = 23) (p = 0.017). Among women reporting I-supp use, the MUIC of those commencing the recommended 150 µg/day prior to conception was significantly higher than those starting supplementation following pregnancy confirmation: 196 (98–315) µg/L (n = 45) versus 137.5 (82.5–233.5) µg/L (n = 124), p = 0.032. Despite recommendations for iodine supplementation pregnant Tasmanian women remain at risk of ID. Commencing an I-supp of 150 µg/day prior to conception and continuing throughout pregnancy is required to ensure adequacy. Timely advice regarding the importance of adequate iodine nutrition, including supplementation is needed to reduce the risk of irreversible in utero neurocognitive damage to the foetus.


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