People's Knowledge and Practice of Salt Iodization, as Well as the Assessment of Iodine Content in Salt in the Cumilla Region of Bangladesh

Aim: To evaluate the household iodine content and knowledge, attitude, and behavior regarding salt iodization among the residents of Cumilla, Bangladesh. Subjects and Methods: We conducted a cross-sectional survey of 700 inhabitants in Cumilla's urban and rural areas to determine the iodine concentration of salt they consume. The participants were asked about what they know about iodine deficiency and salt iodization as well as how their salt was packaged and stored. Among them, 338 people provided a sample of salt to be tested of its iodine content by the titrimetric method. Results: 46.57% of people knew that iodization was the best way to prevent iodine deficiency while 35.14% considered salt iodization during purchasing. Most people stored salt in plastic boxes (89.7%) and closed containers (84.14%).Among all participants, only 37.14% of people were aware of the iodine requirement during pregnancy. In urban regions, the median iodine content was 36.76 ppm (OR=0.658, 95% CI, 0.469-0.925), while in rural areas, the median iodine content was 40.92 ppm (OR=1.188, 95% CI, 1.022-1.380). Iodine levels were less than 15 ppm (minimum limit) in 6.8% of samples and greater than 40 ppm (maximum limit) in 56.5%. Only 36.7% of the salt samples contained adequate iodine. Conclusion: An effective and consistent approach for controlling iodine concentration in distributed salt is required at Cumilla, Bangladesh.

Iodine Fractions in Soil and Their Determination

Iodine is an essential micronutrient for most living beings, including humans. Despite efforts through various iodine deficiency disorders elimination programs, such as salt iodization, this problem still persists. Sub-clinical deficiencies have often an endemic character, and they are characteristic to certain areas, where iodine is low or inaccessible in the geochemical environment. Thus, the monitoring of iodine speciation and fractionation—especially in soil, drinking water, and food—is needed. Therefore, the aim of this work is to review the iodine distribution in most common soil fractions which relate to its bioavailability; and briefly summarize the available methods for their identification in the environmental matrices as well.

Iodine deficiency in pregnant women and newborns in the Saratov region: current state of the problem

Introduction. Iodine deficiency remains an urgent challenge for the Russian Federation. Pregnant women should receive prophylactic potassium iodide supplements at a dose of 200–250 mcg per day. To monitor the severity of iodine deficiency in the regions and the efficacy of prenatal iodine prophylaxis, it is prudent to use the neonatal hyperthyrotropinemia rate for newborns (thyroidstimulating hormone level is higher than 5 μIU/L) based on the results of congenital hypothyroidism screening.Objective. To assess the changes in the severity of iodine deficiency and the efficacy of iodine prophylaxis in pregnant women and newborns in the Saratov region based on the incidence of neonatal hyperthyrotropinemia over the past 25 years.Materials and methods. The incidence of neonatal hyperthyrotropinemia in newborns in the Saratov region for the period of 1996–2000 and 2015–2020 was analysed. In total, 229,625 children were examined.Results and discussion. In 1996–2000, neonatal hyperthyrotropinemia was detected in 37.4% of newborns, which was evidence of the presence of moderate iodine deficiency in the region. In 2015–2020, the incidence of neonatal hyperthyrotropinemia decreased by 5.42 times to 6.9% (p < 0.0001) against the background of group iodine prophylaxis in pregnant women, but remained higher than the World Health Organization targets for iodine-rich regions (<3%) suggesting the preservation of mild iodine deficiency in pregnant women and newborns in the Saratov region.Conclusions. Despite the obligatory doctor’s prescription of prenatal group iodine prophylaxis, there is still iodine insufficiency in pregnant women and newborns in the Saratov region, which requires further improvement of the regional iodine deficiency eradication action system in the risk groups. However, significant advances in the fight against iodine deficiency in the nutrition of the Russian population can only be achieved after the adoption of the federal law on universal salt iodization.

Study of Urinary Iodine Level Assessment and its Relation to Thyroid Function during Pregnancy

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.

Study on Association between Height, Weight, Iodine Supplementation and Thyroid Volume

The policy of Universal Salt Iodization (USI) could reduce population’s thyroid volume (TVOL) in iodine deficiency areas. Conversely, the improved growth and developmental status of children might increase the TVOL accordingly. Whether the decreased TVOL by USI conceals the increase effect of height and weight on TVOL is unclear. The aim of this study was to analyse the association between height, weight, iodine supplementation and TVOL. Five national Iodine Deficiency Disorder surveys were matched into four pairs according to the purpose of analysis. County-level data of both detected by paired surveys were incorporated, 1: 1 random pairing method was used to match counties or individuals. The difference of TVOL between different height, weight, different iodine supplementation measures groups and the association between TVOL and them were studied. The mean height and weight of children aged 8-10 years increased from 129.9cm and 26.9kg in 2002 to 136.2cm and 32.1kg in 2019; while the median TVOL decreased from 3.10ml to 2.61ml. Iodine supplementation measures can affect TVOL; after exclude iodine effects, the median TVOL was increased with the height and weight. On the other side, after excluding the influence of height and weight, the median TVOL remained decreased. Only age, weight and salt iodine were significant associated with TVOL in multiple linear models. Development of height and weight in children is the evidence of improved nutrition. The decreased TVOL caused by iodized salt measures conceals the increase effect of height and weight on TVOL. Age, weight, and salt iodine affect TVOL significantly.

Pro-Oxidative Effect of KIO3 and Protective Effect of Melatonin in the Thyroid—Comparison to Other Tissues

Not only iodine deficiency, but also its excess may contribute to thyroid cancer. Potassium iodate (KIO3), which is broadly used in the salt iodization program, can increase oxidative damage to membrane lipids (lipid peroxidation, LPO) under experimental conditions, with the strongest damaging effect at KIO3 concentration of ~10 mM (corresponding to physiological iodine concentration in the thyroid). Melatonin is an effective antioxidant, which protects against KIO3-induced LPO in the thyroid. This study aimed to compare the protective effects of melatonin, used in the highest achievable in vitro concentration, against KIO3-induced oxidative damage to membrane lipids in various porcine tissues (thyroid, ovary, liver, kidney, brain, spleen, and small intestine). Homogenates were incubated in the presence of KIO3 (20; 15; 10; 7.5; 5.0; 0.0 mM) without/with melatonin (5 mM). The malondialdehyde + 4-hydroxyalkenals (MDA + 4-HDA) concentration (LPO index) was measured spectrophotometrically. KIO3 increased the LPO in all examined tissues; in the thyroid, the damaging effect of KIO3 (10; and 7.5 mM) was lower than in other tissues and was not observed for the lowest concentration of 5 mM. Melatonin reduced LPO induced by KIO3 (10, 7.5, and 5 mM) in all tissues, and in the thyroid it was also protective against as high a concentration of KIO3 as 15 mM; the LPO level resulting from KIO3 + melatonin treatment was lower in the thyroid than in other tissues. In conclusion, the thyroid is less sensitive tothe pro-oxidative effects of KIO3 compared to other tissues. The strongest protective effect of melatonin was observed in the thyroid, but beneficial effects were significant also in other tissues. Melatonin should be considered to avoid the potential damaging effects of iodine compounds applied in iodine prophylaxis.

Prevalence of Iodine Insufficiency Is High Among Pregnant and Lactating Women in Northern Bangladesh Three Decades After Initiating Mandatory Salt Iodization

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.

Hyperthyroidism Prevalence in China After Universal Salt Iodization

BackgroundUniversal salt iodization (USI) was implemented in mainland China in 1996. The prevalence of hyperthyroidism and its risk factors now require examination.MethodsData were acquired from a nationwide Thyroid, Iodine, and Diabetes Epidemiological survey (TIDE 2015–2017) of 78,470 subjects from 31 provinces. Iodine status, and thyroid hormones and antibodies were measured. ResultsAfter two decades of USI, the prevalence of overt hyperthyroidism (OH), Graves’ disease (GD), severe subclinical hyperthyroidism (severe SCH), and mild subclinical hyperthyroidism (mild SCH) in mainland China was 0.78%, 0.53%, 0.22%, and 0.22%, respectively. OH and GD prevalence were higher in women than in men (OH: 1.16% vs. 0.64%, P&lt;0.001; GD: 0.65% vs. 0.37%, P&lt;0.001).Prevalence was significantly decreased after 60 years-of-age compared with 30–39 years-of-age (OH:0.61% vs. 0.81%, P&lt;0.001; GD: 0.38% vs. 0.57%, P&lt;0.001).Excessive iodine(EI) and deficient iodine(DI) were both related to increased prevalence of OH (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.68–2.59; OR1.35, 95%CI 1.07–1.72, respectively); however, only deficient iodine was associated with increased prevalence of GD (OR1.67, 95%CI 1.30–2.15). Increased thyroid peroxidase antibody and thyroglobulin antibody levels were significantly associated with prevalence of OH and GD, but not severe SCH and mild SCH. Although hyperthyroidism was more prevalent in women, the association disappeared after adjusting for other factors such as antibody levels.ConclusionOH and GD prevalences in mainland China are stable after two decades of USI. Iodine deficiency, elevated thyroid antibody levels, and middle age are the main risk factors for OH and GD. The severe SCH population, rather than the mild SCH population, shows similar characteristics to the OH population.

Pregnant Women Are Iodine Deficient While Adequate Iodine Status Among School-Aged Children in Sarawak, Malaysia

Background: A mandatory universal salt iodization (USI) has been implemented in Sarawak since 2008. Objectives: The aim of this study is to assess the current iodine status among school-aged children (SAC) and pregnant women (PW) after 10 years of USI implementation in Sarawak. Methods: This cross-sectional survey among school-aged children and pregnant women was conducted between July and October 2018 in Sarawak. The multistage proportionate to population size sampling technique was used to select 30 schools and 30 maternal and child health care clinics. A total of 1200 children aged 8 to 10 years and 750 first-trimester pregnant women were randomly selected to participate in the study. Iodine excretion level in urine was determined according to the World Health Organization classification. Results: A total of 988 children and 677 PW participated in the study with a response rate of 82.3% and 90.2%, respectively. The overall median UIC level among the children was 126.0 μg/L (interquartile range [IQR], 71.0-200.9 μg/L) and classified as adequate iodine status. The median UIC among PW was 123.9 μg/L (IQR, 56.5-192.1μg/L) indicating inadequate iodine status. Conclusion: The present findings indicate that despite adequate iodine status in children, the majority of PW still showed inadequate iodine status. Thus, comprehensive monitoring of the iodine deficiency disorder problem among PW is warranted.

A CROSS SECTIONAL SURVEY OF IODIZED SALT CONSUMPTION AND ASSESSMENT OF COMMUNITY KNOWLEDGE AT HOUSEHOLD LEVEL IN TRIBAL AREA OF NORTH INDIA.

Background & Aim: Iodine deciency is prevalent but preventable cause of mental retardation, globally. In India, an estimated 167 million people are at risk of developing IDDs. Despite of the universal salt iodization in India, only 71 % of the households were consuming this by 2009.The present survey was conducted to estimate the uptake of adequately iodized salt in the tribal district of Himachal Pradesh. Material and Methods: A cross sectional survey was conducted in tribal Distt. Kinaaur of H.P. A total of 10 clusters were taken for survey and 18 -20 households per cluster were chosen randomly. The unit of study taken was a household. Results: A total of 196 households in Kinnaur were surveyed for iodized salt coverage, using MBI salt Iodine detection kit. The household coverage of adequately iodized salt in current survey was found to be 75%.. Conclusion: The district Kinnaur had transformed its phase from iodine decient to iodine sufcient. Majority of the respondents followed faulty storage practices and were not aware of right storage and cooking practices. More than half of respondents were unaware of importance of iodine / iodized salt and its role in normal growth and prevention of diseases.