Factors Associated with Household Iodised Salt Use and Iodine Deficiency Among Nepalese School Children Aged 6-9 Years

Abstract

Iodine deficiency is one of the world’s leading causes of delay in cognitive growth of children, and remains a public health problem, particularly in low-income countries including Nepal. This current study used cross-sectional data to examine factors associated with iodine deficiency and household iodised salt among Nepalese children. The source of data was the 2016 Nepal National Micronutrient Status Survey (NNMSS). Household iodised salt and urinary iodine were examined (by using and multivariate statistical models that adjust for clustering and sampling weights) against a set of non-biological and eating habits factors of 1153 Nepalese children aged 6-9 years. The mean household salt iodine concentrations (in ppm) in the Eastern, Central, Western, Mid-Western and Far-Western were 1.15 ± 1.6, 9.6 ± 2.6, 43.5 ± 12.9, 69.1 ± 3.7 and 85.6 ± 3.9 respectively. The corresponding median iron status of the children (and interquartile range IQR) in μg/l were 299 (177.6-569.2), 387.8 (197-604.8), 357.7 (203.8-566.7), 239.2 (140.3-493.1) and 238.5 (114.1-397.5) respectively. The likelihood of iodine deficiency was significantly higher among children from the Mountain ecological zone compared with those from the Terai zone [adjusted odds ratio (AOR): 0.02; 95% confidence interval (CI): (1.03, 1.49)]. Children who consumed dark green leafy vegetables were significantly less predisposed to iodine deficiency compared with those who did not [AOR: 0.87; 95% CI: (0.77, 0.99)]. The likelihood of household iodised salt use was significantly lower among children from the Far-Western region compared with those from the Eastern region [AOR: 0.81; 95% CI: (0.68, 0.97)]. The use of iodised salt was significantly more likely among children from rich households compared with those from poor households [AOR: 1.19; 95% CI: (1.06, 1.33)]. The likelihood of iodised salt use was significantly higher among households where children consumed meat compared with those in which children did not consume meat [AOR: 1.07; 95% CI: (1.01, 1.15)]. Among the development regions, it is only the Mid-Western region where household iodine concentration among the children was less than 75%. Appropriate interventions should be put in place to improve this situation. Interventions to improve household iodised salt use should target should also target children from poor households and those from households where children did not consume meat.