Abstract
Background Iodine deficiency is a public health problem. The universal salt iodization (USI) program is the main, simple, and cost-effective intervention strategy to control iodine deficiency. The study examined the iodine status in school-aged children in Ashanti region, Ghana, using thyroid volumes along with urinary iodine concentrations, the methods recommended by the WHO/ICCIDD for monitoring the sustained impact of USI programs. Methods This cross-sectional study was conducted among school-aged children (6–12 years) from randomly selected schools in the central and northern part of the Ashanti region, Kumasi Metropolis, and Ejura-Sekyedumase Municipality, respectively. A total of 852 children were enrolled in the study. Thyroid volume and urinary iodine concentrations of the children were determined using the standardized methods recommended by WHO/ICCIDD. Anthropometric measurements were also evaluated. Results The mean values of thyroid volume in female and male school-aged children were 3.53 ± 0.09 and 3.32 ± 0.07, respectively. The thyroid size was significantly associated with age (P < 0.0001), weight (P < 0.0001), height (P < 0.0001), BMI (P < 0.05), and BSA (P < 0.0001) by Pearson's correlation in both males and females. The P50 (median) thyroid volumes of school children investigated in this study were generally larger compared to the WHO/ICCIDD reference data by age and body surface area. The median value of urinary iodine concentration was 201.85 μg/L, which showed significant sex difference (P value <0.0001). Excessive iodine nutrition (≥300 μg/L) was observed among 34.4% of male children and 27.6% of female children. Also, 12.8% of the male and 19.5% of the female children had UIC below requirement (<100 μg/L). The criteria of thyroid volume per age yielded a goitre prevalence of 2.2%. In contrast, the criteria of thyroid volume by body surface area yielded a goitre prevalence of 0.9%. Conclusion The study clearly indicated that adequate iodine nutrition exists generally among the school children. However, insufficient and excessive iodine intakes still persist among some of the children. The establishment of local reference values for thyroid volume that might be applicable to precisely define goitre prevalence in the Ghanaian context is highly recommended.
Highlights
Iodine is an essential micronutrient element which is crucial for thyroid function, normal growth, and development [1]
Minute changes in iodine intake are sufficient to reset the thyroid system at different blood thyroid stimulating hormone (TSH) levels [2]. us, iodine deficiency from diets and goitrogen intake can result in a variety of health problems collectively known as Iodine Deficiency Disorders (IDDs). ese IDDs include goitre, mental retardation, and cretinism as well as infants and young children death [3]
The International Council for the Control of Iodine Deficiency Disorders (ICCIDD) in an iodine nutrition progress survey reported that Africa is housing about 58 million, the greatest number of iodine-deficient children [7]
Summary
Iodine deficiency is a public health problem. e universal salt iodization (USI) program is the main, simple, and cost-effective intervention strategy to control iodine deficiency. e study examined the iodine status in school-aged children in Ashanti region, Ghana, using thyroid volumes along with urinary iodine concentrations, the methods recommended by the WHO/ICCIDD for monitoring the sustained impact of USI programs. E study examined the iodine status in school-aged children in Ashanti region, Ghana, using thyroid volumes along with urinary iodine concentrations, the methods recommended by the WHO/ICCIDD for monitoring the sustained impact of USI programs. Yroid volume and urinary iodine concentrations of the children were determined using the standardized methods recommended by WHO/ ICCIDD. E mean values of thyroid volume in female and male school-aged children were 3.53 ± 0.09 and 3.32 ± 0.07, respectively. E P50 (median) thyroid volumes of school children investigated in this study were generally larger compared to the WHO/ICCIDD reference data by age and body surface area. E criteria of thyroid volume per age yielded a goitre prevalence of 2.2%. The criteria of thyroid volume by body surface area yielded a goitre prevalence of 0.9%. Insufficient and excessive iodine intakes still persist among some of the children. e establishment of local reference values for thyroid volume that might be applicable to precisely define goitre prevalence in the Ghanaian context is highly recommended
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