Performance evaluation of Iodine Deficiency Disorder control Program in Mandya District

Background: Considering the burden of Iodine Deficiency Disorders in our country, Government of India has an exclusive national health program to prevent it from becoming a major public health concern. To attain its objectives, National Iodine Deficiency Disorder Control Program (NIDDCP) undertakes routine evaluation of the Program all over the country. Aim & Objective: To determine the prevalence of Goitre, to estimate Iodine content in salt samples and Iodine excretion in urine samples of schoolchildren aged between 6 to 12 years in Mandya district. Settings and Design: A cross sectional institutions based survey was conducted among schoolchildren from the villages in selected clusters of Mandya district. Materials and Methods: Probability Proportional to Size sampling method was used to select 30 clusters. 90 children aged between 6 to 12 years from each cluster were screened. Salt Iodine content was ascertained by Iodometric titration method and urinary Iodine excretion was estimated by Sandell-Kolthoff method. Statistical analysis used: Frequency, proportions and mean were calculated and inferential statistics were used. Results: Prevalence of Goitre was 4.4%, with higher prevalence among girls. 49.8% salt specimens lack adequate iodine (<15ppm) at household level. Median UIE was 164 Micrograms /litre. Conclusions: As per the impact indicators, IDD is not a public health concern in Mandya district as of now.

Adequately Iodized Salt Utilization and Associated Factors among Households in Tach Armachio District, Northwest Ethiopia: A Community-Based Cross-Sectional Study

Background. For the synthesis of thyroid hormones, iodine is a crucial trace element. Iodine deficiency disorders affect all groups particularly: pregnant, young women and children. Iodine deficiency disorder has been recognized as a serious public health issue in Ethiopia. Therefore, this study planned to assess iodized salt utilization and associated factors at the household level. Methods. A community-based cross-sectional study was conducted from January 25 to February 24, 2019, in Tach Armachio district, Northwest Ethiopia. A single population proportion formula was used to calculate the sample size and a total of 555 households were sampled. A multistage sampling technique was conducted to select the household. An iodometric titration method was performed. A structured, pretested, and face-to-face interview questionnaire was used to collect data; then, it was entered in Epi Info 7 and exported to SPSS version 25 for analysis. Bivariable and multivariable analyses were done to identify predictor variables. A 95% confidence interval and adjusted odd ratio were reported. P values less than 0.05 were considered statistically significant in the multivariable analysis. Results. This study showed that iodized salt was adequately utilized by 61.1% (CI = 57%–65%) of households. Good knowledge of iodine deficiency disorder (AOR = 2.25, 95% CI = (1.44, 3.50)), keeping salt in the kitchen house away from fire (AOR = 5.09, 95% CI = (3.25, 7.98)), buying packed salt [AOR = 1.89, 95% CI = (1.12, 3.19)), keeping salt in a covered container (AOR = 2.18, 95% CI = (1.24, 3.81)), and exposing salt to sunlight (AOR = 0.39, 95% CI = (0.23, 0.65)) were significantly associated. Conclusion. In the district, adequately iodized salt utilization was low. Therefore, it is necessary to enforce the current law for merchants to sell iodized packed salt and teach the community how to handle it.

Iodine Deficiency Disorder and Knowledge about Benefit and Food Source of Iodine among Adolescent Girls in the North Shewa Zone of Amhara Region

Background. As the dietary iodine content depends on the iodine contents of the soil where the crop is harvested, in highland areas where the iodine content of topsoil was washed away due to erosion, iodized salt is the main source of iodine. This study assessed the magnitude of iodine deficiency disorder and knowledge about the benefit and food sources of iodine among adolescent girls in the highland areas of the North Shewa Zone, Amhara Region, central Ethiopia. Methods. An institutional cross-sectional study was conducted from October 5, 2018, to December 30, 2019. Through a multistage sampling technique, 625 adolescent school girls were selected from 9 schools. A pretested semistructured self-administered questionnaire was used for data collection. Anthropometric measures and thyroid gland physical examinations were performed by trained nurses. The collected data were entered into the computer through Epi Data 3.1 software, and analysis was performed using Anthro plus and SPSS software. Results. The total goiter rate was 317 (50.7%) with 95%CI of 46.9% to 54.6%. Grade-one and grade-two goiter accounts 226 (36.2%) and 91 (14.6%), respectively. About one-third, 428 (68.5%), had knowledge about locally available iodine source foods and 309 (72.2%) of them mentioned salt as a source of iodine. Over half, 216 (55.1%), of 392 (62.7%) participants who had knowledge about the benefit of iodine knew it prevents goiter. Diet diversity score of <5 food groups [AOR 1.487, 95%CI 1.061–2.083], stunting [AOR 1.876, 95%CI 1.079–3.257], menstruation [AOR 1.615, 95%CI 1.110–2.349], rural residence [AOR 1.412, 95%CI 1.005–1.984], and open salt storage container [AOR 2.001, 95%CI 1.044–3.833] were significantly associated with goiter. Conclusions. Total goiter rate of adolescent school girls is high in the area. Low diet diversity score, stunting, menstruation, rural residence, and using an open container for salt storage increased the risk of goiter. In addition to universal salt iodization, the emphasis has to be given on proper handling and utilization of iodized salts at the household level to avoid iodine deficiency disorder in adolescent girls.

Determination of Urinary Iodine Excretion to Assess Iodine Deficiency Disorder among Pregnant Women in District Hospital of Sindhupalchowk, Nepal

Pregnant women and infants are risk populations of iodine deficiency disorders (IDD). Therefore, this study was designed to explore the status of IDD among pregnant women through the analysis of urinary iodine excretion (UIE). A total of 94 pregnant women from Chautara Hospital Sindhupalchowk were included to analyze UIE through Sandell-Kolthoff Reaction. Although the general clinical status of women was satisfactory, the urinary iodine excretion revealed that still, 18.0 percent of pregnant women in Sindhupalchowk had insufficient iodine intake. This indicates that pregnant women are still at risk of iodine deficiency disorder, and they should be in the priority population for the IDD prevention program.

Effect of nutrition education on iodine deficiency disorder and iodized salt intake in south west Ethiopian women: a cluster randomized controlled trial

Background: Although iodine nutrition status is improving globally, the progress is not uniform throughout the world due to several factors. Among these, poor knowledge, negative attitude and improper practice of iodized salt are the main risk factors for poor iodine nutrition in Ethiopia.Objectives: This study was aimed to assess the effect of nutrition education intervention in improving the knowledge, attitude and practice (KAP) towards iodine deficiency disorder and iodized salt intake in southwest Ethiopia.Methods: A cluster randomized controlled trial was carried out among 652 women of reproductive age group in southwest Ethiopia. A total of 24 clusters were selected and randomized in to an intervention and control villages. Women in the intervention village received iodine nutrition related education for six months; while those in the control village did not receive any education. Baseline and endline data were collected from both groups. Generalized Estimating Equations (GEE) was used to determine the effect of intervention.Results: A total of 647 (99.2%) participants were successfully involved in the study. In the intervention group the median attendance was 10 out of 12 education sessions. There was significant change in mean KAP scores for intervention group (p < .001). In multivariable GEE model, after adjusting for other background characteristics, the knowledge score from the baseline increased by approximately nine points (β= 8.674, P<0.0001) and three points for both attitude ((β=3.193, P<0.0001) and practice (β=2.926, P<0.0001) after six months of intervention.Conclusions: Well designed and community-based iodine nutrition education is an effective strategy to improve the KAP of iodine deficiency disorder and iodized salt utilization.Trial registration: PACTR201809544276357 (Retrospectively registered on 14, Sept. 2018), http://www.pactr.org

Magnitude of iodine deficiency disorder and associated factors in Dawro zone, southwest Ethiopia; the hidden hunger: a cross-sectional study

Background: Iodine deficiency disorder (IDD) is continued to be a major public health problem in Ethiopia. The problem is worse but the data is scarce in some pocket areas of the country. This study was aimed to assess the magnitude of IDD and associated factors in southwest Ethiopia by using different biochemical and clinical indicators. Methods: Both community and school based cross- sectional study was conducted on school age children (6-12 years) from March 1 to 24, 2017. Simple random and systematic sampling techniques were applied to select districts and eligible children respectively. Household data was collected from children’s primary care takers by using structured questionnaire. A trained surgeon examined all children (n=652) for goiter. Urine sample was collected from 20% of children (n=130). Results: A total of 652 school children were participated in the study. Total goiter rate and median urinary iodine concentration (UIC) was 54.8 % and 96.12μg/l respectively. In multivariable logistic regression analyses student’s age was significantly (P<0 05) associated with both goiter and median UIC. However; sex of students and family income were significantly (P<0.001) associated with goiter and cassava consumption was significantly (P<0.001) associated with UIC. Conclusion: As indicated by the median UIC, there was mild iodine deficiency in this study community. However; chronic iodine deficiency was still a severe public health problem (high goiter prevalence). In addition, there was low concentration of iodine in the salt and increased cassava cultivation and consumption indicating the potential risk in the area. Therefore, it is necessary to intensify IDD elimination activities along with teaching communities on techniques of cassava processing for household consumption. Trial registration: PACTR201809544276357. Retrospectively registered on 14, Sept 2018.

Magnitude of iodine deficiency disorder and associated factors in Dawro zone, southwest Ethiopia; the hidden hunger: a cross-sectional study

Background: Iodine deficiency disorder (IDD) is continued to be a major public health problem in Ethiopia. The problem is worse but the data is scarce in some pocket areas of the country. This study was aimed to assess the magnitude of IDD and associated factors in southwest Ethiopia by using different biochemical and clinical indicators. Methods: Both community and school based cross- sectional study was conducted on school age children (6-12 years) from March 1 to 24, 2017. Simple random and systematic sampling techniques were applied to select districts and eligible children respectively. Household data was collected from children’s primary care takers by using structured questionnaire. A trained surgeon examined all children (n=652) for goiter. Urine sample was collected from 20% of children (n=130). Results: A total of 652 school children were participated in the study. Total goiter rate and median urinary iodine concentration (UIC) was 54.8 % and 96.12μg/l respectively. In multivariable logistic regression analyses student’s age was significantly (P<0 05) associated with both goiter and median UIC. However; sex of students and family income were significantly (P<0.001) associated with goiter and cassava consumption was significantly (P<0.001) associated with UIC. Conclusion: As indicated by the median UIC, there was mild iodine deficiency in this study community. However; chronic iodine deficiency was still a severe public health problem (high goiter prevalence). In addition, there was low concentration of iodine in the salt and increased cassava cultivation and consumption indicating the potential risk in the area. Therefore, it is necessary to intensify IDD elimination activities along with teaching communities on techniques of cassava processing for household consumption. Trial registration: PACTR201809544276357. Retrospectively registered on 14, Sept 2018.

Magnitude of iodine deficiency disorder and associated factors in Dawro zone, southwest Ethiopia: the hidden hunger

Background: Iodine deficiency disorder (IDD) is continued to be a major public health problem in Ethiopia. The problem is worse but the data is scarce in some pocket areas of the country. This study was aimed to assess the magnitude of IDD and associated factors in southwest Ethiopia by using different biochemical and clinical indicators. Methods: Both community and school based cross- sectional study was conducted on school age children (6-12 years) from March 1 to 24, 2017. Simple random and systematic sampling techniques were applied to select districts and eligible children respectively. Household data was collected from children’s primary care takers by using structured questionnaire. A trained surgeon examined all children (n=652) for goiter. Urine sample was collected from 20% of children (n=130). Results: A total of 652 school children were participated in the study. Total goiter rate and median urinary iodine concentration (UIC) was 54.8 % and 96.12μg/l respectively. In multivariable logistic regression analyses student’s age was significantly (P<0 05) associated with both goiter and median UIC. However; sex of students and family income were significantly (P<0.001) associated with goiter and cassava consumption was significantly (P<0.001) associated with UIC. Conclusion: As indicated by the median UIC, there was mild iodine deficiency in this study community. However; chronic iodine deficiency was still a severe public health problem (high goiter prevalence). In addition, there was low concentration of iodine in the salt and increased cassava cultivation and consumption indicating the potential risk in the area. Therefore, it is necessary to intensify IDD elimination activities along with teaching communities on techniques of cassava processing for household consumption. Trial registration: PACTR201809544276357. Retrospectively registered on 14, Sept 2018.