Abstract
Iodine deficiency is still prevalent in parts of Pakistan, despite the introduction of a national Iodine Deficiency Disorder Control Programme in 1994. The purpose of this study was to gain an understanding of the knowledge, attitudes and practice regarding the use of iodised salt in a brick kiln community, and to use this information to design an intervention to increase its consumption. A cross-sectional survey was used to assess the use of iodised salt and focus group discussions explored the attitudes and barriers to its use. Thematically analysed transcripts informed the design of a 4-month intervention. Iodised salt sales and urine iodine concentration (UIC) were monitored to assess the effectiveness of the intervention. At baseline, 2.6% of households reported use of iodised salt and barriers included its higher cost and belief about a negative impact on reproduction. During the intervention, sales of salt labelled as iodised increased by 45%, however this was not reflected in an increase in UIC. This study highlighted the positive impact of education and awareness raising on iodised salt consumption in a hard to reach, marginalised community. However, issues regarding adequate iodisation by local producers and appropriate storage also need to be urgently addressed at a provincial level.
Highlights
Iodine deficiency is one of the most common, yet preventable causes of brain damage worldwide, and is of international public health concern, in developing countries [1,2]
Iodine is required for thyroid hormone synthesis, the consequences of inadequate iodine intake include a spectrum of adverse effects on physical and mental growth and development, collectively referred to as the Iodine Deficiency Disorders (IDD)
Three types of salt were routinely sold in their shops, Anwar Iodised salt, Shafaf salt and Simple salt
Summary
Iodine deficiency is one of the most common, yet preventable causes of brain damage worldwide, and is of international public health concern, in developing countries [1,2]. Iodine is required for thyroid hormone synthesis, the consequences of inadequate iodine intake include a spectrum of adverse effects on physical and mental growth and development, collectively referred to as the Iodine Deficiency Disorders (IDD). Monitoring iodine status at the population level is frequently included in nutrition surveys. Current estimates (2011), based on urinary iodine concentration (UIC) of school-aged children as a biomarker of recent iodine intake [3] indicate that, overall, 29.8% of the world’s population has an inadequate iodine intake. Inadequate iodine intake is greatest in parts of Europe, Africa and South East Asia
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