Abstract
Introduction Two main strategies are currently recommended for the prevention and control of iodine deficiency in the world: implementation of universal salt iodisation programmes and permanent monitoring of iodine consumption by the population. Although iodine intake and coverage iodised salt have increased in the world population, iodine deficiency disorders (IDDs) may still be a public health problem in a few countries or communities. Objective To assess the impact of salt iodisation programmes on urinary iodine concentrations and goitre rates in the world population. Methodology. A systematic review based on the PRISMA method. We obtained articles from Scopus, Science Direct, MEDLINE databases, and other sources between March and April 2020, without limitation of dates. “Iodisation” AND “urinary iodine concentrations” AND “goitre” in English, Portuguese, and Spanish without filters and clinical trial, case-control, and cross-sectional studies were included in this review. Results Of 479 abstracts, twenty-three were eligible. Coverage on iodised salt was in the range of 16 to 98%, and 11 studies had been sufficient, whilst eight studies had adequate iodine concentration in salt and three excess. 81.8% of studies that had an adequate median of UIC had a good impact in their respective salt iodisation programmes. Conclusion After 18 years of salt iodisation programme implementation in the 13 countries, the majority achieved sustaining elimination of IDD whilst all had adequate median UIC; however, more detailed studies are still needed to confirm that all communities are equally protected of IDD.
Highlights
Two main strategies are currently recommended for the prevention and control of iodine deficiency in the world: implementation of universal salt iodisation programmes and permanent monitoring of iodine consumption by the population
Conclusions is review shows that urinary iodine concentration (UIC) levels have increased from 16.9% to 166% and total goitre prevalence rate (TGR) has reduced by 1.2% to 62.3% within 18 years in populations with Iodine deficiency (ID)
Salt iodisation programmes have had good impacts on health. e outcomes confirm that 18 years after the implementation of salt iodisation programmes in the 13 countries examined in the included reviews, most had achieved sustainable elimination of iodine deficiency disorders (IDDs) with an adequate UIC
Summary
Two main strategies are currently recommended for the prevention and control of iodine deficiency in the world: implementation of universal salt iodisation programmes and permanent monitoring of iodine consumption by the population. To assess the impact of salt iodisation programmes on urinary iodine concentrations and goitre rates in the world population. 81.8% of studies that had an adequate median of UIC had a good impact in their respective salt iodisation programmes. After 18 years of salt iodisation programme implementation in the 13 countries, the majority achieved sustaining elimination of IDD whilst all had adequate median UIC; more detailed studies are still needed to confirm that all communities are protected of IDD. International organisations suggest two strategies for the prevention and control of ID: implementation of a universal salt iodisation (USI) programme and monitoring iodine consumption by the population through urinary iodine concentration (UIC) assessment. High iodine intake reduces both thyroid volume and TGR, and both of these measures are reported to be more sensitive to long-term iodine intake assessment; they are good indicators [2, 3]
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