Abstract
BackgroundThe distribution of goiter among children and its risk factors are not well investigated in Ethiopia. Therefore, this systematic review and meta-analysis was designed to determine the pooled prevalence of goiter and its associated factors among children in Ethiopia.MethodsElectronic web-based searches of PubMed, Google Scholar, EMBASE, and the World Health Organization’s Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) were conducted to find primary studies. Relevant data were extracted and descriptive summaries of the studies were presented in tables. The I2 statistic was used to assess heterogeneity across studies. Funnel plot asymmetry and Egger’s tests were used to check for publication bias. A random effects model was used to estimate the pooled prevalence of goiter. Odds ratios (OR) with 95% Confidence Intervals (CI) were also used to determine the association of identified variables with goiter. All statistical analyses were conducted using Stata version 14 software.ResultsOur search identified 982 studies, of which, 19 articles were eligible for inclusion in the final meta-analysis. The pooled estimate of goiter among children in Ethiopia was 40.50% (95% CI: 33.6–47.40). The regional distribution of goiter ranged from 44.22 (95% CI: 17.44–71) in Southern Nations Nationalities and Peoples’ Region, to 32.79% (95% CI: 19.86–45.73) in Benishangul Gumez region. The prevalence of goiter among female children (44.34%) was higher than among male (32.88%) children. Goiter prevalence was also significantly higher among children who consumed vegetables three or more times per week OR = 1.3 (95% CI: 1.02–1.66); those who had family history of goiter, OR = 2.38 (95% CI: 1.9–2.99); and those whose family stored salt near to fires, OR = 1.4 l (95% CI: 1.1–1.79).ConclusionThe prevalence of goiter among children in Ethiopia was high, and endemic according to the WHO criteria. Our findings suggest the need for interventions to improve salt iodization, and for improved health education on appropriate salt storage. In addition, more research may be needed to improve our understanding of foods that increase the risk of goiter among children.
Highlights
The distribution of goiter among children and its risk factors are not well investigated in Ethiopia
National salt iodization programs are considered a simple, cost-effective means of preventing Iodine Deficiency Disorders (IDD), as salt iodization is relatively easy to implement, and salt is steadily consumed by populations year round; and because countries usually have only a few large salt manufacturers who need to be incorporated into national programs [7, 9]
We found a high prevalence of goiter among children, with an overall pooled prevalence of 40.5%
Summary
The distribution of goiter among children and its risk factors are not well investigated in Ethiopia. National salt iodization programs are considered a simple, cost-effective means of preventing IDDs, as salt iodization is relatively easy to implement, and salt is steadily consumed by populations year round; and because countries usually have only a few large salt manufacturers who need to be incorporated into national programs [7, 9]. Such universal iodization programs have been extremely successful and are considered a global health success story and a model of public/private partnerships for promoting health [2]. Iodine deficiency can reappear if salt iodization is interrupted as a result of demobilization of the public health authorities or the lack of interest of the salt industry [10]
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