High Iodine Deficiency among Pregnant Women in Periurban Ghana: A Hospital-Based Longitudinal Study

Background. Iodine deficiency causes maternal hypothyroidism which can lead to growth, cognitive, and psychomotor deficit in neonates, infants, and children. This study examined the iodine status of pregnant women in a periurban setting in Ghana. Methods. This longitudinal study recruited 125 pregnant women by purposeful convenience sampling from the antenatal clinic of the Sefwi Wiawso municipal hospital in Ghana. Urinary iodine concentration (UIC) was estimated by the ammonium persulfate method at an estimated gestational age (EGA) of 11, 20, and 32 weeks. Demographic information, iodized salt usage, and other clinical information were collected using a questionnaire. Results. The prevalence of iodine deficiency among the pregnant women was 47.2% at EGA 11 and 60.8% at both EGA of 20 and 32, whereas only 0.8% of participants not using iodized salt had iodine sufficiency at EGA 32. 18.4%, 20%, and 24% of participants using iodized salt had iodine sufficiency at EGA 11, 20, and 32, respectively. Conclusion. A high prevalence of iodine deficiency was observed among our study cohort.

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Indicators of Iodine Status in Pregnancy and Postpartum in a Group of Pregnant Women from Perimarine Area of Romania

ARS Medica Tomitana ◽

10.2478/arsm-2020-0013 ◽

2020 ◽

Vol 26 (2) ◽

pp. 63-69

Author(s):

Scrinic Olesea ◽

Delia Corina Elena ◽

Toma Geanina Mirela ◽

Circo Eduard

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Concentration ◽

Iodine Intake ◽

Iodized Salt ◽

Urinary Iodine Concentration ◽

Urinary Creatinine ◽

Iodine Status ◽

In Pregnancy

Abstract Objective: Assessment of iodine nutritional status in pregnant women in the perimarine area of Romania, a region without iodine deficiency. Adequate iodine intake is the main source for normal thyroid function, ensuring the need for maternal thyroid hormones during pregnancy, but also for the development and growth of children in the fetal and postpartum period. Material and method: Prospective study performed on 74 pregnant women in the first 2 trimesters of pregnancy, originating from the perimarin area. The following indicators of iodine status were analyzed: urinary iodine concentration (UIC), the ratio between urinary iodine concentration and urinary creatinine (UIC/UCr), the prevalence of maternal goiter and the value of neonatal TSH (thyroid stimulating hormone). Results: The mean gestational age was 11 weeks. The ways of iodine intake are: iodized salt - 59.4%, iodized salt and iodine supplements- 23%, only iodine supplements -10.8% and 6.8% consume only non-iodized salt. The median of UIC was 133.03 mcg/l considered insufficient iodine intake (normal in pregnancy UIC >150 mcg/l), but the adjustment of UIC to urinary creatinine reveals a median of 152.83 mcg/g, a value that reflects an adequate iodine intake. The prevalence of goiter was 25.6% characteristic for a moderate iodine deficiency. The prevalence of neonatal TSH >5 mIU/L was registered in 18.8% characteristic of mild iodine deficiency. Conclusions: Monitoring of the iodine nutritional status is recommended for the prevention of disorders due to iodine deficiency under the conditions of universal salt iodization. Perimarine areas considered sufficient in iodine may show variations in iodine status in subpopulations under certain physiological conditions, such as pregnancy. An indicator of iodine status of the population is UIC, but the UIC/UCr ratio may be a more optimal indicator for pregnant women, to avoid possible overestimated results of iodine deficiency in pregnancy.

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THE SITUATION OF URINARY IODINE CONCENTRATION (UIC) AMONG SCHOOL AGE CHILDREN, WOMEN AT REPRODUCTIVE AGE AND PREGNANT WOMEN IN INDONESIA: THE ANALYSIS OF RISKESDAS 2013

GIZI INDONESIA ◽

10.36457/gizindo.v39i1.207 ◽

2017 ◽

Vol 39 (1) ◽

pp. 49

Author(s):

Djoko Kartono ◽

Atmarita Atmarita ◽

Abas B Jahari ◽

Soekirman Soekirman ◽

Doddy Izwardy

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Concentration ◽

Iodized Salt ◽

Reproductive Age ◽

School Age Children ◽

Urinary Iodine Concentration ◽

Iodine Status ◽

Iodine Level

Iodine Deficiency Disorders (IDD) are the leading cause of goiter, cretinism, developmental delays and other health problems. Iodine deficiency is an important public health issue as it is a preventable cause of intellectual disability. While elimination of iodine deficiency is imperative, it should be noted that excessive intake of iodine can also lead to adverse health effects. This paper analyzed the iodine status using median urinary iodine concentration (MUIC) of school age children (SAC), women of reproductive age (WRA), and pregnant women (PW) who live in the same household from Riskesdas 2013. The total number of households included in the analysis was 13,811 households, from which 6,149 SAC (aged 6 – 12 years), 13,218 WRA (aged 15-49 years), and 578 PW (aged 15-49 years) were enumerated. The national MUIC of SAC, WRA and PWwas in the normal range indicated that the iodine status was adequate using WHO epidemiological criteria. Iodine status in some sub-populations indicated deficiency, however, in terms of geographic characteristics people who live in the urban has better iodine status compared to rural areas. Similarly, populations in richer economic quintiles had better iodine status. Only pregnant women in the 1st and 2nd quintile were deficient. Almost all regions in Indonesia showed the MUIC was in the normal adequate range, except NTT-NTB, Maluku-Papua, and East Java for pregnant women who tend to have lower MUIC (<150 µg/L). The status of iodized salt at the household was detected using both Rapid Test Kit/RTK as well as Titration. The result demonstrated a strong association between salt iodine level and iodine status. The MUIC for all three groups were lower when the iodine level in salt was lower, then increased when the levels of iodine content in salt increased. The iodine status of pregnant women consuming non-iodized salt was inadequate. The detrimental effect of iodine deficiency on the mental and physical development of children as well as on the women of reproductive age has been recognized. Indonesia still needs the salt iodization program to keep the iodine status in the normal range. In particular coverage with adequately iodized salt needs to be improved in order to improve the iodine status of pregnant women. For the prevention of Iodine disorders (insufficient), monitoring should be undertaken in regular basis to assess the MUIC, especially for pregnant women.

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Assessment of iodine status among school age children and pregnant women of Belarus in 2017–2018

Clinical and experimental thyroidology ◽

10.14341/ket9732 ◽

2018 ◽

Vol 14 (3) ◽

pp. 149-155

Author(s):

Tatiana V. Mokhort ◽

Sergei V. Petrenko ◽

Boris Y. Leushev ◽

Ekaterina V. Fedorenko ◽

Natalia D. Kolomiets ◽

...

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodine Concentration ◽

School Age Children ◽

Normative Values ◽

Urinary Iodine Concentration ◽

School Age ◽

Iodine Sufficiency

Background. Despite the measures taken by the Government of Belarus, the problem of iodine deficiency among the population remains actual. Aims. To determine iodine sufficiency in children and pregnant women living in Belarus. Materials and methods. The study included 873 schoolchildren aged 9–12 years of both sexes, of which 650 children were in regular schools, and the remaining children in boarding schools. A separate group consisted of 700 practically healthy pregnant women (during gestation from 16 to 36 weeks). Questioning, determination of urinary iodine concentration and thyroid volume with ultrasound was carried out. Results. Urine iodine median was 191 µg/L in the 873 children in 16 regions of Belarus. Thyroid volume corresponds to the normative values in children. According to the survey, 81% of households used iodized salt, constantly – 46%. Indicator of iodine sufficiency of 700 pregnant women (median urinary iodine concentration was 121 µg /l) is a non-optimal for this population group. Conclusions. Currently adequate iodine supplementation in school age children has been achieved. The prevalence of thyroid gland diseases caused by iodine deficiency in children decreased significantly. In pregnant women iodine supply is still insufficient.

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Adequately iodized salt is an important strategy to prevent iodine insufficiency in pregnant women living in Central Java, Indonesia

PLoS ONE ◽

10.1371/journal.pone.0242575 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242575

Author(s):

Ina Kusrini ◽

Jessica Farebrother ◽

Donny Kristanto Mulyantoro

Keyword(s):

Pregnant Women ◽

Thyroid Function ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Concentration ◽

Interquartile Range ◽

Iodized Salt ◽

Vulnerable Groups ◽

Urinary Iodine Excretion ◽

Urinary Iodine Concentration

Iodine is an essential micronutrient for cognitive development and growth. Optimal intakes are critical during pregnancy. We report the iodine status and thyroid function of pregnant women living in areas previously affected by severe iodine deficiency and in longstanding iodine sufficient areas in Java, Indonesia. This cross-sectional study was conducted in Magelang, Java, from July to November 2015, in four sub-districts; two previously affected by severe iodine deficiency (area 1) and two that were iodine-sufficient (area 2). Iodine intake was estimated using median urinary iodine concentration in spot samples and mean urinary iodine excretion in 3 x 24-hour samples, thyroid hormones (thyroid-stimulating hormone and free thyroxine) were measured in venous blood samples, and iodine content of household salt samples was estimated by titration. We recruited a total of 244 pregnant women, 123 in area 1 and 121 in area 2. Urinary iodine results suggested adequate habitual iodine intakes in both areas (median urinary iodine concentration in area 1: 222 μg/l (interquartile range 189, 276 μg/l), area 2: 264 μg/l (interquartile range 172, 284 μg/l), however, the risk of inadequate intakes increased with advancing trimester (Odds Ratio = 2.59 (95% CI 1.19–5.67) and 3.85 (95% CI 1.64–9.02) at second and third trimesters, respectively). Estimated prevalence of thyroid function disorders was generally low. Salt was iodized to approximately 40 ppm and foods rich in native iodine did not contribute significantly to dietary intakes. Adequately iodized salt continues to prevent iodine insufficiency in pregnant women living in areas previously affected by severe iodine deficiency in Java, Indonesia. Monitoring and surveillance, particularly in vulnerable groups, should be emphasized to ensure iodine sufficiency prevails.

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Subclinical Iodine Deficiency among Pregnant Women in Haramaya District, Eastern Ethiopia: A Community-Based Study

Journal of Nutrition and Metabolism ◽

10.1155/2014/878926 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 14

Author(s):

Haji Kedir ◽

Yemane Berhane ◽

Alemayehu Worku

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Dietary Habits ◽

Urinary Iodine ◽

Iodized Salt ◽

Urinary Iodine Concentration ◽

Community Based ◽

Eastern Ethiopia ◽

Iodine Deficiency In Pregnancy ◽

Haramaya District

Background.Iodine deficiency in pregnancy is a worldwide problem. This study aimed to assess prevalence and predictors of subclinical iodine deficiency among pregnant women in Haramaya district, eastern Ethiopia.Methods.A cross-sectional, community-based study was conducted on 435 pregnant women existing in ten randomly selected rural kebeles (kebele is the smallest administrative unit in Ethiopia). Data on the study subjects’ background characteristics, dietary habits, and gynecological/obstetric histories were collected via a structured questionnaire. UIC of <150 μg/L defined subclinical iodine deficiency. Data were analyzed by Stata 11. A multivariable logistic regression was used to identify the predictors of subclinical iodine deficiency.Results.The median urinary iodine concentration (MUIC) was 58.1 μg/L and 82.8% of the women who had subclinical iodine deficiency. The risk of subclinical iodine deficiency was reduced by the use of iodized salt (AOR = 0.13) and by intake of milk twice a month or more (AOR = 0.50), but it was increased by maternal illiteracy (AOR = 3.52).Conclusion.Iodine nutritional status of the pregnant women was poor. This shows that women and their children are exposed to iodine deficiency and its adverse effects. Thus, they need urgent supplementation with iodine and improved access to and intake of iodized salt and milk during pregnancy.

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Association of Iodine-Related Knowledge, Attitudes, and Behaviours with Urinary Iodine Excretion in Pregnant Women with Mild Iodine Deficiency

10.21203/rs.3.rs-44718/v1 ◽

2020 ◽

Author(s):

Zhengyuan Wang ◽

Yiwen Wu ◽

Zehuan Shi ◽

Jun Song ◽

Guoquan Wang ◽

...

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Significant Risk ◽

First Trimester ◽

Iodized Salt ◽

Urinary Iodine Excretion ◽

Urinary Iodine Concentration ◽

Third Trimester ◽

The Third

Abstract Background: China’s universal salt-iodization program has all but eliminated iodine deficiency disorders. Concern has shifted to mild iodine deficiency. Our study examined factors with the potential to predict mild iodine deficiency in pregnant women. Methods: A total of 2 400 pregnant women were enrolled using a multistage, stratified, random-sampling method. Data were collected through face-to-face interviews, a standardized questionnaire, an iodine-related knowledge questionnaire, urine samples, and household cooking salt samples. Results: The median urinary iodine concentration (MUIC) was 148.0 μg/L for all participants, and 155.0 μg/L, 151.0 μg/L, and 139.6 μg/L in the first, second, and third trimesters, respectively. The third trimester’s MUIC was significantly lower than that of the first trimester, and the usage rates of iodized salt and qualified-iodized salt were 71.5% and 59.4%, respectively. Iodine-related knowledge was significantly different between the high and low UIC groups. Participants’ MUIC increased significantly with increases in iodine-related knowledge. The third trimester was a significant risk factor for high UIC, whereas abundant iodine-related knowledge, study the dietary knowledge urgently, and consumption of iodine-rich food within 48 hours of a urine iodine test were significant protective factors for high UIC (P<0.05). Conclusions: Iodine levels are adequate among pregnant women in Shanghai during the first and second trimesters, but insufficient in the third trimester. The use of iodized cooking salt does not determine the iodine status of pregnant women. Abundant iodine-related knowledge is important for pregnant women in the third trimester to maintain adequate urinary iodine.

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Women Remain at Risk of Iodine Deficiency during Pregnancy: The Importance of Iodine Supplementation before Conception and Throughout Gestation

Nutrients ◽

10.3390/nu11010172 ◽

2019 ◽

Vol 11 (1) ◽

pp. 172 ◽

Cited By ~ 8

Author(s):

Kristen Hynes ◽

Judy Seal ◽

Petr Otahal ◽

Wendy Oddy ◽

John Burgess

Keyword(s):

At Risk ◽

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Concentration ◽

Urinary Iodine Concentration ◽

Iodine Nutrition ◽

Supplement Use ◽

Iodine Supplementation ◽

The Impact

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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Evaluation of Urinary Iodine Concentration for Predicting Iodine Deficiency in Sub-Saharan Africa: First Population Based Study From the Demographic and Health Surveys Data (P10-089-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.p10-089-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Djibril Ba ◽

Paddy Ssentongo ◽

Guodong Liu ◽

Ping Du ◽

Xiang Gao

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Concentration ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Urinary Iodine Concentration ◽

Factors Associated ◽

Sub Saharan

Abstract Objectives Approximately 2 billion individuals suffer from an insufficient iodine intake, and sub-Saharan Africa is particularly the most affected. We thus conducted a cross-sectional study to assess iodine deficiency status, among women of reproductive age 20–49 years in Tanzania and examine the factors associated with iodine deficiency. Methods The current analysis was based on 3057 women aged 20–49 y who participated the Tanzania Demographic and Health Surveys 2015–2016. Iodine status was assessed using urinary iodine concentration (UIC). Iodine deficiency was defined if UIC was less than 100ug/L. A stepwise multivariable logistic regression to identify the factors associated with iodine deficiency. Potential predicators included age, education level, married status, wealth index, having a prenatal doctor and prenatal nurse, currently pregnant, currently breastfeeding, place of residence, employment status, and history of terminated pregnancy. Results The median UIC among pregnant women (median: 129 μg/L; 25th and 75th percentile: 57.8–240), uneducated women (99.0 μg/L; 48.2–201 μg/L), and poor women (92 μg/L; 43.1 -191 μg/L) were below the recommended ranges (≥150 μg/L for pregnant women and ≥100 μg/L for non-pregnant women) by the World Health Organization. Multivariable logistic stepwise regression showed that women were more likely to be iodine deficient if they were pregnant (aOR 1.55 [95% CI 1.11, 2.15], currently breastfeeding (aOR 1.56 [95% CI 1.28, 1.92], poor (aOR 1.75 [95% CI 1.35, 2.26], uneducated (aOR 1.77 [95% CI 1.26, 2.48], and living in the rural area (aOR 1.79 [95% CI 1.37, 2.34]. Unexpectedly, currently employed women also had significantly higher odds of iodine deficient (aOR 1.41 [95% CI 1.10, 1.80], relative to those without employment. Conclusions There is disparity in UIC among of women of reproductive age 20–49 in Tanzania. Poverty and lack of education appeared to be the driving factors for iodine deficiency. High risk of iodine deficient among pregnant and breastfeeding women appeal for action to implement and enforce universal salt iodization among this vulnerable population in Tanzania. Funding Sources There was no external or internal funding to support this study.

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Pregnant Women's Iodine Status and Their Knowledge, Attitude, and Practice towards Iodized Salt in Esfarayen and Jajrom Cities in 2016-2017

Journal of Nutrition and Food Security ◽

10.18502/jnfs.v5i1.2313 ◽

2020 ◽

Author(s):

Zohreh Sadat Sangsefidi ◽

Zahra Sadat Sangsefidi ◽

Elham Sadat Sharifian ◽

Habibeh Sadat Shakeri

Keyword(s):

Pregnant Women ◽

Total Population ◽

Urinary Iodine ◽

Iodine Concentration ◽

Moderate Level ◽

Iodized Salt ◽

World Health ◽

Urinary Iodine Concentration ◽

Attitude And Practice ◽

Knowledge Attitude And Practice

Background: Evaluation of status of iodine during pregnancy is crucial. Therefore, this study was conducted to investigate it in pregnant women and to evaluate their knowledge, attitude, and practice toward consuming iodized salt. Methods: In a cross-sectional study, 150 pregnant women were selected by census method based on the inclusion criteria. The participants' status of iodine was measured by measuring their urinary iodine concentration. Furthermore, the women's knowledge, attitude, and practice were investigated regarding iodized salt intake by a valid questionnaire. Results: Median concentrations of the urinary iodine in total population and Esfarayen people 139.05 (92.0-216.5) and 131.19 (211.43-86.43) μg/l, respectively which were lower than the World Health Organization recommendations (150-249 μg/l), while it was within the recommended range in Jajrom people 176.12 (101.76-248.62) μg/l. Although most people in the total population and Esfarayen people had moderate level of knowledge, attitude, and practice, most mothers in Jajrom had good knowledge and attitude scores along with moderate scores of practices. A significant direct correlation was found between attitude level and urinary iodine concentration (P = 0.043, r = 0.17). Conclusions: In total population, the median urinary iodine concentration was lower than the recommended level. Furthermore, knowledge, attitude, and practice of most people were at the moderate level.

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Lack of dietary sources of iodine and the prevalence of iodine deficiency in rural women from Sidama zone, southern Ethiopia

African Journal of Food, Agriculture, Nutrition and Development ◽

10.18697/ajfand.60.12735 ◽

2013 ◽

Vol 13 (60) ◽

pp. 8401-8414

Author(s):

T Gebreegziabher ◽

◽

N Teyike ◽

A Mulugeta ◽

Y Abebe ◽

...

Keyword(s):

Dietary Intake ◽

Iodine Deficiency ◽

Rural Women ◽

Urinary Iodine ◽

Iodine Concentration ◽

Iodized Salt ◽

Southern Ethiopia ◽

Urinary Iodine Concentration ◽

Iodine Deficiency Disorders ◽

Dairy Consumption

Iodine deficiency has been reported to affect a large number of people in Ethiopia. Although significant progress against iodine deficiency disorders (IDD) has been reported worldwide, millions of people remain with insufficient iodine intake. Multiple factors may contribute to iodine deficiency. Hence, the objective of this study was to investigate iodine deficiency and dietary intake of iodine. A cross-sectional survey design was used to assess urinary iodine concentration (UIC), goiter and dietary intake of iodine in a sample of 202 non-pregnant women living in three rural communities of Sidama Zone, southern Ethiopia. Urinary iodine concentration was analyzed using the Sandell-Kolthoff reaction, goiter was assessed using palpation and dietary source of iodine was assessed using a food frequency questionnaire. Data were analyzed using selected descriptive and analytical statistical measures with SAS software. Mean (SD) age, mid upper arm circumference (MUAC) and body mass index [BMI -Wt(kg)/(Ht(m))2] were 30.8(7.9) y, 24.8(2.5) cm and 20 (2.2) respectively. Median UIC was 37.2 µg/L. Participants with UIC <20 µg/L, classified as severely iodine deficient were 22.8%; 46.5% had UIC between 20 to <50 µg/L, classified as moderately iodine deficient, and 27.2 % had UIC in the mild deficiency range of 50 to <100 µg/L. Only 3.5% of the women had UIC ≥ 100 μg/L. The total goiter rate was 15.9%, which was 1.5% visible and 14.4% palpable goiter. A majority of the participants consumed Enset (E. ventricosum), corn and kale frequently and meat was consumed rarely. None of the participants reported ever consuming iodized salt or ever having heard about use of iodized salt. Adjacent communities (Alamura, Tullo and Finchawa) showed significant differences in UIC, goiter rate and frequency of fish and dairy consumption. The findings of the present study revealed that iodine status of the population is a significant public health problem. Hence, there is a need to supply iodized salt in order to achieve the goal of elimination of iodine deficiency disorders in the community.

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