scholarly journals Assessment of the Sustainability of the Iodine-Deficiency Disorders Control Program in Lesotho

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.

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.


Author(s):  
Fuad I. Abbag ◽  
Saeed A. Abu-Eshy ◽  
Ahmed A. Mahfouz ◽  
Mohammed A. Alsaleem ◽  
Safar A. Alsaleem ◽  
...  

Objectives: To investigate the present occurrence of stunting and explore the role of iodine deficiency disorders (IDDs) as a predictor of stunting among primary school children in the Aseer Region. Methods: In a cross-sectional investigation on school children in the Aseer region, thyroid enlargement was evaluated clinically. Urine was collected to evaluate iodine content. Results: The present study involved 3046 school-age pupils. The study disclosed a total goiter rate of 24.0% (95% CI: 22.5–25.5%). The median urinary iodine content (UIC) was 17.0 µg/L. A prevalence of stunting (height for age z score of less than −2) of 7.8% (95% CI: 6.9–8.8%) was found. In a logistic regression model, pupils having clinical goiter (aOR = 1.739; 95% CI: 1.222–2.475) and students having UIC of less than 17 µg/L (aOR = 1.934; 95% CI: 1.457–2.571) were considerably related with stunting. In the receiver operating characteristic (ROC) curve, urinary iodine content to forecast stunting was good (AUC = 0.611, 95% CI: 0.594–0.629). The curve recognized the optimum cutoff point of urinary iodine content to be ≤19.0 µg/L. The sensitivity was 59.66% (95% CI: 53.1–66.0) and the specificity was 57.62% (95% CI: 55.8–59.5). Conclusion: The present study showed that stunting among school-aged children presents a mild public health problem. On the other hand, a severe iodine deficiency situation was revealed among school children in the Aseer region. Continuous monitoring of iodine status among school children is therefore necessary. Concerted interventions that blend nutrition-sensitive with nutrition-specific approaches are expected to influence decreasing stunting significantly.


Author(s):  
Vijaykumar P. Mane ◽  
Yuvaraj Banot Yenkanaik ◽  
Smita M. Nimbannavar ◽  
Anilkumar L. ◽  
Sharankumar Holyachi ◽  
...  

Background: Iodine deficiency disorders are recognized as major public health problem in India and the simplest, most effective and inexpensive preventive method is the consumption of Iodized salt. The objective of this study is to estimate the prevalence of goitre among children aged 6 to 12 years in rural areas of Koppal district, to determine various factors associated with goiter among children, to estimate the level of urinary iodine excretion among urine samples collected from children and to estimate the level of iodine content among salt samples collected in the study setting.Methods: A cross sectional study was conducted for a duration of 6 months from June 2018 to November 2018 in rural areas of Koppal district among 3047 school children aged 6 to 12 years selected by cluster sampling technique. Goiter was detected and graded using standard techniques and the collected salt and urine samples were sent to MRHRU, Sirwar, Raichur for analysis. Data was collected using pretested and semistructured questionnaire and was analyzed using WHO Epi info software version 3.5.4.Results: The prevalence of goitre among school children in Koppal district was 442 (14.5%) and it was found to be significantly associated with age and source of drinking water. Majority i.e., 65.96% of urine samples had iodine content less than 100 µg/l and majority i.e., 79.15% of salt samples had iodine content less than 15 PPM.Conclusions: Goiter is mild public health problem in Koppal district with majority of urine samples excreting iodine below optimum levels and majority of salt samples being inadequately iodized.


2000 ◽  
pp. 37-46 ◽  
Author(s):  
S Brahmbhatt ◽  
RM Brahmbhatt ◽  
SC Boyages

OBJECTIVES: (i) To assess the severity of iodine deficiency disorders (IDD), (ii) to determine the aetiology of IDD in Gujarat, (iii) to identify the best prevalence indicator of IDD, and (iv) to compare thyroid volume (TV) results with the WHO International reference. METHODS: Five hundred and thirty schoolchildren (6-15 years) were studied from two districts (Baroda and Dang) and data were collected on dietary habits and parameters such as height, weight, thyroid size by palpation and ultrasonography, urinary iodine (UI), and blood thyroid stimulating hormone (TSH). Drinking water was analyzed for iodine content and food articles for goitrogens. RESULTS: In Gujarat children median UI (interquartile range)=56 (30-96)microg/l, mean TSH=1.71 +/- 2.10mU/l, goiter by palpatio n = 30%, and median TV = 27.8 (23-35)ml. Females had lower median UI (48 (27-82) microg/l) and higher mean TSH levels (2.0 +/- 2.5mU/l) than males. Applying the WHO ultrasonography reference to Gujarat children resulted in an enlarged TV-for-body surface area in almost 100% of subjects. Ninety-nine percent of females and 95% of males had enlarged TV-for-age. Three to eight times larger TV were seen in all subjects as compared with European children. Dang children were severely malnourished. Flavonoids like vitexin, glucosyl vitexin and apigenin were detected in pearl millet. Apigenin was never identified in pearl millet. Dang district water was lacking in iodine content. CONCLUSIONS: IDD is a severe public health problem in Gujarat. Baroda district is a new pocket of IDD. High amounts of dietary flavonoids in Baroda and Dang districts, and lack of iodine in Dang water, account for IDD. TV measurement by ultrasound is the best prevalence indicator of IDD.


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.


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 ◽  
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


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.


Author(s):  
Sudarshan Kushwah ◽  
Akhil R. Nair ◽  
Jeevan Singh Meena ◽  
Shipra Verma ◽  
Harshima Sawlani ◽  
...  

Background: Iodine deficiency disorders (IDD) constitute the single largest cause of preventable neurological damage worldwide. Majority of consequences of IDD are invisible and irreversible but at the same time these are preventable. The study was conducted to assess the prevalence of goiter in school children aged 6-12 years, to estimate the urinary iodine excretion and to assess the level of iodine concentration in salt samples obtained from households of selected school children.Methods: Population proportionate to size sampling. Sample size was 90 primary school-going children of age 6-12 years in each selected village, total 2700 from 30 villages/wards in Betul district, Madhya Pradesh, India.Results: The prevalence of goiter among the 6-12 years children was found to be 32.06%. Females had higher prevalence compared to males. Of the 540 salt samples, 370 (68.4%) had iodine concentration ≥15 ppm at household level.Conclusions: IDD is a mild public health problem in Betul district.


Author(s):  
Dinesh P. Sharma ◽  
Amitkumar Maheshwari ◽  
Chandan Chakrabarti ◽  
Darshan J. Patel

Abstract Aim Iodine deficiency disorder (IDD) is the cause of preventable brain damage, mental retardation, and stunted growth and development in children. This study aimed to detect the prevalence of IDD in Kachchh district, Gujarat, by testing urinary iodine excretion levels and iodine intake of salts in school-going children. Methods A cross-sectional study was conducted and the level of iodine deficiency was assessed in 223 school children of both sexes, aged 6 to 12 years from four talukas, that is, subdivisions, of the Kachchh district by estimating urinary iodine using Sandell–Kolthoff reaction along with iodine content in edible salt samples by MBI kit (STK-Spot testing kit, MBI Kits International, Chennai, TN, India). Results The median urinary iodine level was found to be 194 μg/L, indicating no biochemical iodine deficiency in the region. In the study areas, 1% of the population showed a level of urinary iodine excretion < 50 μg/L. About 83% salt samples had iodine level more than 15 ppm and the iodine content in salt samples less than 15 ppm was only about 17%, indicating the salt samples at households contain iodine in adequate level. Conclusion There is a need of periodic surveys to assess the change in magnitude of IDD with respect to impact of iodized salt intervention.Furthermore, to strengthen National Iodine Deficiency Disorders Control Program, factors should be identified. There is also a need to prevent and reimpose the ban on the sale of noniodized salts in Gujarat.


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