An analysis of iodine deficiency disorder and eradication strategies in the high atlas mountains of morocco

National data on iodine status in Israel are lacking. Reliance on iodine-depleted desalinated water, the absence of a salt iodization program, and reports of increased use of thyroid medication in Israel suggest that the population's iodine intake is likely inadequate. The aims of this study were therefore to determine the iodine status of Israeli school-age children (SAC) and pregnant women (PW) in a nationally representative sample obtained by a novel approach of using pre-discard urinalysis samples collected from a centralized national laboratory. Spot urine samples from 1023 SAC and 1074 PW, representing all regions and major sectors in Israel, were collected during 2016 at the Maccabi Healthcare Services central laboratory. Urinary iodine concentration (UIC) was measured, and the results were analyzed by trimester, sex, region, and sector. SAC were iodine deficient, with a median (interquartile range [IQR]) UIC of 83 μg/L (52-127 μg/L); 62% of SAC UICs were below the World Health Organization adequacy range for SAC (100-199 μg/L). PW were also iodine deficient, with a median (IQR) UIC of 61 μg/L (36-97 μg/L); 85% of PW UICs were below the adequacy range for PW (150-249 μg/L). For both SAC and PW, the median UIC was below the World Health Organization's adequacy range across all sectors, sexes, and districts. Among SAC, the median (IQR) UIC was lower among females (75 μg/L; 48-119 μg/L) than males (92 μg/L; 59-133 μg/L; p < 0.05). Median UIC values of PW correlated significantly with the median UIC for SAC by sub-district (R2 = 0.3, p < 0.05). Urine sampling via a centralized national laboratory was efficient and cost-saving. Iodine deficiency in Israeli SAC and PW is a serious public-health concern. A national program of salt iodization and iodine supplementation of PW should be urgently considered.

Iodine deficiency in pregnancy may impair foetal neurological development. The UK population is generally thought to be iodine sufficient; however, recent studies have questioned this assumption. Our study aimed to explore the prevalence of iodine deficiency in a cohort of pregnant mothers from South-West England. Urine samples were obtained from 308 women participating in a study of breech presentation in late pregnancy. They had no known thyroid disease and a singleton pregnancy at 36-38 weeks' gestation. Samples were analysed for urinary iodine concentrations (UIC). Baseline data included age, parity, smoking status, ethnicity, body mass index (BMI) at booking, prenatal vitamin use and a dietary questionnaire. There was no difference in median UIC between women with (n = 156) or without (n = 152) a breech presentation (P = 0·3), so subsequent analyses were carried out as a combined group. Participants had a mean (SD) age 31(5) years, median (IQR) BMI 24·4 (22·0, 28·3) kg/m2 ; 42% were primiparous, 10% smoked during pregnancy, and 35% took iodine-containing vitamins. Ninety-six per cent were Caucasian. Median (IQR) UIC was 88·0 (54·3, 157·5) μg/l, which is consistent with iodine deficiency by WHO criteria. A total of 224/308 (73%) of women had UIC values <150 μg/l. Increasing milk intake was associated with higher UIC (P = 0·02). There was no difference in median (IQR) UIC between those women who took iodine-containing vitamins (n = 108) and those who did not (n = 200): 88 (54, 168) vs 88 (54, 150) μg/l, P = 0·7. Iodine deficiency in pregnancy is common in South-West England. Measures to develop optimum prevention and treatment strategies are urgently needed.

Iodine: It's Important in Patients that Require Parenteral Nutrition

Objective To explore the iodine status of pregnant women after 17 years of salt iodization in rural areas of Shijiazhuang City. Methods Probability proportionate to size sampling was employed in which 30 towns were selected from the 211 towns in the rural areas of Shijiazhuang City. In each town selected, 40 pregnant women were randomly selected to collect their spot urine samples, edible salt samples and drinking water samples from their households to measure iodine content. The iodine content of salt was determined quantitatively using a titration method (GB/T 13025.7-2012). The urinary iodine content was determined using the method of ammonium persulfate digestion arsenic cerium catalytic spectrophotometry (WS/T 107-2006). The iodine content in drinking water was determined by the method of standard test for drinking water. Results A total of 1 200 salt samples was collected from the pregnant women's households in 30 towns, with the overall median iodine content being 27.2 mg/kg. The median salt iodine content in 30 towns varied from 23.4 to 32.6 mg/kg. A total of 478 water samples were collected, with a median of 5.3 μg/L. The median urinary iodine content (UIC) of 1 200 pregnant women in 30 towns was 146.4 μg/L. The median UIC in the first (≤13 weeks), second (14 ~ 26 weeks) and third (≥27 weeks) trimesters was 166.3, 145.1 and 133.5 μg/L, respectively. The median UIC in the first trimester was significantly higher than that in the third trimester (Mann-Whitney Test, U = 18 265, P 0.05). Conclusion Under the current universal salt iodization, the pregnant women's iodine intake could almost meet their requirement in the rural areas of Shijiazhuang City, however, mild iodine deficiency has existed in the third trimester. Alternative measures of iodine supplement could be implemented. Key words: Iodine deficiency; Salts; Iodine nutrition; Pregnant women; Survey

Background: Insufficient and excessive iodine intake during pregnancy can lead to serious health problems. In Tanzania, information available on iodine status during pregnancy is minimal. The aim of this study was to assess the iodine status and its association with socio-demographic factors in pregnant women in the Mbeya region, Tanzania. Method: A cross sectional survey involving 420 pregnant women (n=420) registered in Reproductive and Child Health Clinics was conducted. Data were collected via interviews and laboratory analysis of urinary iodine concentration (UIC). Results: Median UIC was 279.4μg/L (+/-26.1) to 1915μg/L. Insufficient iodine intake (UIC below 150μg/L) was observed in 17.14% of participants, sufficient intake in 24.29% and 58.57% had intakes above the recommended level (&gt;250μg/L). Pregnant women who consume fish had an increased risk of insufficient iodine [Adjusted OR7= 2.60 (95%CI 1.31-5.15)] while the risk was lower for those who attended primary education compared to non-formal education [Adjusted OR= 0.29 (95%CI 0.08-0.99)]. Pregnant women resident in Mbarali district aged between 35-49 years were associated with an increased risk of UIC above recommended level [Adjusted OR=4.09 (95%CI 1.85-9.010] and [Adjusted OR=2.51 (95%CI 0.99-6.330] respectively . Conclusion: This study demonstrated a significant relationship between geographical factors (residence in the Mbarali district) and excess median urine iodine concentration, in addition, this study also found an association between consumption of freshwater fish and insufficient mean urine iodine concentration as indicated by the World Health Organization recommendation. Therefore, educational programs on iodine intake are needed as attending primary education was found to be a protective factor for insufficient median urine iodine concentration.

Background: Insufficient and excessive iodine intake during pregnancy can lead to serious health problems. In Tanzania, information available on iodine status during pregnancy is minimal. The aim of this study was to assess the iodine status and its association with socio-demographic factors in pregnant women in the Mbeya region, Tanzania. Method: A cross sectional survey involving 420 pregnant women (n=420) registered in Reproductive and Child Health Clinics was conducted. Data were collected via interviews and laboratory analysis of urinary iodine concentration (UIC). Results: Median UIC was 279.4μg/L (+/-26.1) to 1915μg/L. Insufficient iodine intake (UIC below 150μg/L) was observed in 17.14% of participants, sufficient intake in 24.29% and 58.57% had intakes above the recommended level (&gt;250μg/L). Pregnant women who consume fish had an increased risk of insufficient iodine [Adjusted OR7= 2.60 (95%CI 1.31-5.15)] while the risk was lower for those who attended primary education compared to non-formal education [Adjusted OR= 0.29 (95%CI 0.08-0.99)]. Pregnant women resident in Mbarali district aged between 35-49 years were associated with an increased risk of UIC above recommended level [Adjusted OR=4.09 (95%CI 1.85-9.010] and [Adjusted OR=2.51 (95%CI 0.99-6.330] respectively . Conclusion: This study demonstrated a significant relationship between geographical factors (residence in the Mbarali district) and excess median urine iodine concentration, in addition, this study also found an association between consumption of freshwater fish and insufficient mean urine iodine concentration as indicated by the World Health Organization recommendation. Therefore, educational programs on iodine intake are needed as attending primary education was found to be a protective factor for insufficient median urine iodine concentration.

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 &lt;20 µg/L, classified as severely iodine deficient were 22.8%; 46.5% had UIC between 20 to &lt;50 µg/L, classified as moderately iodine deficient, and 27.2 % had UIC in the mild deficiency range of 50 to &lt;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.

Iodine status of Queensland children and the associations with diet and thyroid function

The present study aimed at assessing the population prevalence of goiter and iodine deficiency in school children of 6-12 yr living in urban slums of Bhubaneswer, the capital city of Orissa. A cross-sectional study was performed using the 30-cluster sampling methodology and surveillance methods for iodine deficiency as recommended by WHO/ICCIDD/UNICEF. The total goitre rate (n=1248), urinary iodine concentration (UIC) (n=411) and iodine content of edible salt (n=368) were measured. The goitre prevalence was 23.6% (grade 1=18.9%, grade 2=4.7%) with no significant gender variation. Goitre prevalence was significantly higher in children of 10-12 yr (P=0.012) and scheduled caste and tribe (P=0.003). Median urinary iodine concentration was 50.0 microg/l with 85.7% of children having values less than 100 microg/l, indicating as biochemical iodine deficiency. Median UIC was inversely in association with gradations of goitre. Children of 10-12 yr and scheduled caste/tribe communities had significantly higher median UIC (P=0.001) than their counterpart peers. About 51% of children were consuming salt having stipulated iodine content of 15 ppm. The study indicates moderate iodine deficiency in the population, despite a mandatory salt iodization programme in Orissa that has been in force since 1989. There is a need to improve the situation through enforcing monitoring of salt iodization to ensure quality and increasing the level of awareness about the iodized salt for sustainable prevention and control of iodine deficiency.

<h3>Background</h3> Iodine deficiency can have adverse health effects in all age groups affecting growth, development and cognitive functions as well as the incidence of goitre. Worldwide, the most important dietary...

Background: Globally, iodine deficiency has been drastically reduced since the introduction of salt iodization programs; nonetheless, many populations remain at-risk for iodine deficiency. This study aimed to assess the iodine status among women of reproductive age in Uzbekistan and to identify factors associated with iodine deficiency, including the availability of adequately iodized salt at the household level.Methods: A cross-sectional household survey was conducted to produce region-specific estimates of the household coverage with adequately iodized salt and iodine status among women for each of the 14 regions in Uzbekistan. Other information, such as socioeconomic status, lactation and pregnancy, residence, age, and consumption of iodine supplements, was also collected.Results: Overall, 36% of 3413 households had adequately iodized salt (iodine concentration >15 ppm [parts per million (mg I/kg salt)]), 20% had inadequately iodized salt (5–14 ppm), and 44% had salt without detectable iodine (<5 ppm). Adequate iodization was found in 33.2% of the 2626 salt samples taken from retail packages labeled as “iodized,” 36.5% of the 96 samples taken from retail packages without mention of iodization, and 50.5% of the 674 samples without the original packaging (p < 0.001). The median urinary iodine concentration (UIC) of 140.9 μg/L (95% confidence interval [CI 132.4–150.7]) in nonpregnant nonlactating women indicated adequate iodine status, while for nonpregnant lactating and pregnant women, the median UIC of 112.9 μg/L [CI 99.3–128.4] and 117.3 μg/L [CI 101.8–139.9], respectively, indicated borderline adequacy. Significant differences in UIC (p < 0.001) were found between nonpregnant nonlactating women living in households with adequately iodized salt (UIC 208.9 μg/L), inadequately iodized salt (UIC 139.1 μg/L), and noniodized salt (UIC 89.9 μg/L).Conclusions: Coverage with adequately iodized salt is low in Uzbekistan, and women in households with poorly iodized salt have substantially worse iodine status; claims on packaging about salt iodization do not reflect salt iodine content. This highlights the importance and effectiveness of salt iodization and the need to strengthen this program in Uzbekistan.

This study, which covered all the ten provinces of Zambia, aimed at assessing the Iodine Deficiency prevalence, and access to adequately iodised salt in the country. It was carried out in 2011 and entailed determining the urinary iodine concentration (UIC) among 1, 283 school children from 30 selected schools and the amount of iodine in 875 salt samples collected from the households of the children. The iodine concentration was also determined in salt samples collected from 365 salt traders near the selected schools. Each of the salt traders was requested to complete a questionnaire. In addition, a questionnaire was administered to 75 teachers from the selected schools. The Urinary Iodine Concentration (UIC) was assayed by the Sandell-Kolthoff reaction, after digesting the urine with Ammonium Persulfate at 100oC. The iodine concentration in the salt was determined using the quantitative titrimetric method. The data for the UIC and salt iodine plus data from questionnaires were analysed using Excel and Statistical Package for Social Sciences version 15 (SPSS 15). The median urinary iodine concentration (MUIC) was 248.5μg/l and the Interquartile Range (IQR) was 145 – 380 μg/L. These results indicated that Iodine Deficiency was not of public health concern among children in Zambia at the time of this study. However, the proportion of households with access to adequately iodised salt (15-40 ppm iodine) was 53%, which is below the recommended target of 90% or more household coverage. Results from questionnaires indicated that the challenges faced by the Zambian Government in attaining Universal Salt Iodisation (USI) include: (i) lack of sustainability of local salt iodisation in local salt producing areas, (ii) weak enforcement of the law on salt iodisation, (iii) poor packaging and storage of salt by traders and households, (iv) limited knowledge of the link between lack of iodine in salt and iodine deficiency, and (v) relatively high cost of imported iodised salt in local salt producing areas. Keywords: Iodized, Salt, Iodine Deficiency, Universal Salt Iodisation, Zambia

PurposeIodine deficiency has several adverse effects on human growth and development and it is categorized collectively as iodine deficiency disorders (IDDs). Recent estimations showed that 29.8 per cent of school-age children have insufficient iodine intake. Salt iodization is widely accepted as the best method for increasing iodine intake. In 1995, Morocco adopted the universal salt iodization strategy to reduce iodine deficiency and consequently prevent and control IDDs. This study aims to determine the benefit of this strategy on schoolchildren and adolescent by assessing iodine intake and evaluating iodine deficiency.Design/methodology/approachThis transversal study was conducted on 131 children and adolescents. Iodine intake was assessed using a food frequency questionnaire. Iodine status was evaluated on 24-h urine samples and the creatinine excretion was used to validate completeness of urine collection.FindingsThe medians of urinary iodine excretion and concentration were 77 µg/day and 96 µg/L, respectively. Overall, 72.5 per cent are deficient, so mild and moderate iodine deficiencies were reported in 58 per cent and 14.5 per cent, respectively, and no child exhibited severe deficiency. A significant difference was reported between iodine deficiency and, sex and age; iodine deficiency was more pronounced in boys and children under eight years. In this study, iodine status in deficient children does not change with the consumption pattern of dairy products and eggs, and results showed no significant association (p > 0.05). However, fish consumption was significantly associated to urinary iodine concentration = 100 µg/L (p = 0.044). Average UIC in school-aged children is still inadequate and consumption of foods high in iodine remains very insufficient. Therefore, additional efforts must focus on nutritional education of Moroccan school-aged children.Originality/valueIn the author’s knowledge, this is the first study evaluating schoolchildren iodine status by 24-h iodine collection; the study reported association of iodine deficiency with dietary habit concerning sources of food rich on iodine.

To review the iodine status of women as assessed through National Health and Nutrition Examination Surveys from 1971 to 2002. National normative estimates of iodine status of the civilian, non-institutionalized population in the United States of America. Women of reproductive age and pregnant women. In the United States of America, iodine began to be added to the diet in the 1920s. An excessive iodine intake was documented by the first National Health and Nutrition Examination Survey (NHANES I) in the 1970s which reported a median urinary iodine (UI) concentration of 320 microg l-1. In the NHANES III survey, conducted between 1988 and 1994, the median UI concentration had decreased to 145 microg l-1, while 14.9% of women aged 15-44 years and 6.9% of pregnant women had a UI concentration 50 microg l-1. The concentrations of serum T4 and thyroid-stimulating hormone of women with a low UI concentration did not, however, indicate an iodine deficiency. Further studies of the association between iodine excretion and biochemical and physiological changes should be undertaken to better understand women's needs for iodine and to develop criteria to monitor them in pregnancy. Because of the potential harm caused by iodine deficiency during pregnancy, we support the use of iodine supplements for all pregnancies while these data are being collected.

Direct iodine supplementation of infants versus supplementation of their breastfeeding mothers: a double-blind, randomised, placebo-controlled trial