Iodine Content Of Salt Research Articles

Study of the Iodine Content in Table Salt of Kitchen during the Period of Conservation

Study of the Iodine Content in Table Salt of Kitchen during the Period of Conservation

Socio-demographic characteristics and Iodine status of the school-going children of Suryodaya Municipality, Ilam

Iodine deficiency disorder (IDD) is a major micronutrient deficiency problem in Nepal. This study was conducted with objective to measure the Urinary iodine excretion (UIE) and attempts were made to relate urinary iodine with salt use and other sociodemographic variables of household of primary school children of Suryodaya municipality of Ilam district of Nepal. A community based cross section study was conducted in two schools of study area selected randomly (lottery method). A total of 202 school children of 6-12 years were recruited for the study to collect urine and salt samples for urine iodine content (UIC) and salt iodine content (SIC) measurement respectively and detail information of study population was achieved from their household. UIC was measured by ammonium persulphate digestion microplate (APDM) method and SIC was estimated by rapid test kit (RTK). Data were expressed in frequency, mean±SD and median (IQR) according to the nature of data. Chi-square test, Mann-Whitney U test and Kruskal-Wallis test were used to test the significance considering p≤0.05 at 95% confidence interval. It was found that Median UIC of the study population was 152.14 µg/L. Overall; it was found that 30.7% children had urine iodine level less than the normal WHO levels. The availability of adequately iodized salt was 93.1% as measured by RTK. There was statically significant association between consumed salt iodine content and urine iodine excretion level (P < 0.05).

Availability of Adequately Iodized Dietary Salt and Associated Factors in a Town of Southeast Ethiopia: A Community-Based Cross-Sectional Survey.

Background Iodine deficiency is the world's major cause of preventable intellectual impairment, and nearly 2 billion people are at risk of iodine deficiency worldwide. Prevention and control of iodine deficiency disorders primarily aim at ensuring the intake of adequate iodine to maintain normal thyroid function. In our study area, studies regarding the coverage of adequately iodized salt at household level are meager. Hence, this study aimed to assess the magnitude of adequately iodized dietary salt at a household level in Kore Town, Southeast Ethiopia. Methods A community-based cross-sectional study was conducted in the Kore town from August 1 to 30, 2019. A total of 394 households were selected for this study using a simple random sampling technique. The level of salt iodine content was determined using the rapid field test kit. Then, iodine contents of dietary salt were reported as <15 parts per million and ≥15 parts per million. Data regarding sociodemographic factors, knowledge of respondents about iodized salt, and iodized salt handling practices were collected through a face-to-face interview. The binary logistic regression model was used to assess the association between independent factors and the outcome variable. Statistical significance was declared at p < 0.05. Result Out of all the households, 223 (56.6%) had adequately iodized salt. Not exposing iodized salt to sunlight (AOR = 2.35, 95% CI: 1.1, 5.2), storing the salt at a dry or cold place [(AOR = 4.77, 95% CI: 1.39, 16.45) and (AOR = 8.23, 95% CI: 1.44, 47.19), respectively], and having good knowledge about iodized salt (AOR = 1.88, 95% CI: 1.18, 3.01) were significantly associated with the presence of adequately iodized salt at the household level. Conclusion Availability of adequately iodized salt in the study area was far below the World Health Organization recommendation. Information regarding the importance and proper handling of iodized dietary salt should be communicated to the householders.

Prevalence of iodine deficiency among pregnant women in Gwembe and Sinazongwe districts of Southern Province, Zambia: a cross-sectional study

BackgroundMaternal iodine deficiency is one of the common causes of morbidity and mortality during pregnancy. Maternal iodine deficiency during pregnancy is associated with a number of adverse outcomes such as abortion, stillbirth, congenital anomalies, perinatal mortality and irreversible mental retardation. A study conducted in Zambia among pregnant women in 2013 on the prevalence of iodine deficiency showed that iodine deficiency was not a public health concern. The previous study used Urine Iodine concentration (UIC) as a marker of iodine deficiency among the pregnant women. Our study was conducted to assess the prevalence of iodine deficiency among pregnant women in Gwembe and Sinazongwe districts of Southern Province, Zambia, using urine iodine concentration and goitre presence by manual palpation.MethodsWe carried out a community based, cross sectional study in rural areas of Gwembe and Sinazongwe districts between April 2016 to March 2018. Data were collected from 412 pregnant women by a multistage cluster sampling technique. The presence of a goitre was examined by manual palpation and urinary iodine concentration was determined by the Ultra Violet Method using PerkinElmer Labda UV Spectrometer equipment made in Jena Germany (Model 107,745). As part of the existing baseline data, we used results of a 2013 countrywide study (n = 489) for household salt iodine content which showed a greater than 40 ppm at 76.2%, between 15 and 40 ppm at 19.21% and less than 15 ppm at 4.59%. Statistical analysis was done using Stata version 14.0. The outputs of analysis are presented as median and Interquartile range (IQR) as the urine data were not normally distributed. Further, the categorical and independent variables were presented as proportions (percentages) to describe the distribution and trends in the target sample population.ResultsThe median Urine Iodine concentration (UIC) of the pregnant women was 150 μg/L (Interquartile Range (IQR): 100–200 μg/L). Based on the UIC, There were 49% pregnant women who had inadequate iodine intake with urine iodine concentration of less than 150 μg/L, 34.0% had UIC of 150–249 μg/L indicating adequate iodine intake, 13.0% with UIC of 250–499 μg/L indicating more than adequate iodine intake, and 5.0% with UIC of above 500 μg/L indicating excessive iodine intake. To determine whether the women had access to iodized salt, we used baseline data from 2013 Zambia national survey for iodine concentration in household salt samples as being an average of 40 ppm, which also showed that 95.41% households consumed adequately iodized salt (≥15 ppm). The prevalence of goitre in our study was very low at 0.02% among the pregnant women of all ages who participated in the study (18–49 years).ConclusionIodine deficiency was still not a public health concern among the pregnant women of Gwembe and Sinazongwe districts of Southern Province in Zambia. Goitre prevalence has remained very low in this study area. The UIC and goitre observations were consistent with the Zambia National Food and Nutrition Commission findings in 2013 report. However, our study showed more pregnant women with insufficient than adequate iodine status indicating the risk of developing IDD is still high in this region. It also reinforces the argument that strengthening of the existing salt iodization program is needed in order to make a homogenous iodated salt available to the communities. The National Food and Nutrition Commission of Zambia needs to find innovative ways of sensitizing people about the adverse effects of IDDs and how these could be prevented. It is recommended that iodine supplementation be introduced as part of the package of Antenatal clinic care for all pregnant women.

Association of iodine-related knowledge, attitudes and behaviours with urinary iodine excretion in pregnant women with mild iodine deficiency.

Subsequent to the implementation of the universal salt iodisation policy, China has all but eliminated the iodine deficiency disorders. However, pregnant women are still experiencing mild iodine deficiency. The present study explored factors that could relate to mild iodine deficiency in pregnant women. In total, 2400 pregnant women were enrolled using a multistage, stratified, random sampling method in Shanghai. Data were collected via a standardised questionnaire. The urine samples and household cooking salt samples were collected for the detection of urinary iodine and salt iodine concentrations. The median urinary iodine concentration (MUIC) was 148.0μg L-1 for all participants, and 155.0μg L-1 , 151.0μg L-1 and 139.6μg L-1 in the first, second and third trimesters. The MUIC in the third trimester was significantly lower than that of the first trimester (P<0.05). The usage rates of iodised salt and qualified-iodised salt were 71.5% and 59.4%, respectively. Iodine-related knowledge score composition ratio was significantly different between the high and low UIC groups (P<0.05). Participants' MUIC increased significantly with the increases in iodine-related knowledge score (P<0.001). The third trimester was a significant risk factor for high UIC, whereas high iodine-related knowledge score, actively learning dietary knowledge and having a habit of consuming iodine-rich food were significant protective factors for high UIC (P<0.05). Iodine level is adequate among pregnant women in Shanghai during the first and the second trimesters, although it is is insufficient in the third trimester. Good iodine-related knowledge, attitudes and behaviours are important for pregnant women with respect to maintaining adequate urinary iodine.

Iodine nutrition and prevalence of sonographic thyroid findings in adults in the Heilongjiang Province, China.

BackgroundThyroid disease and thyroid nodules are common clinical problems. Iodine nutrition plays an important role in thyroid disease evolution. Here, we aimed to estimate the iodine nutritional status and prevalence of thyroid disease in the adults of the Heilongjiang Province in northeast China.MethodsWe performed a cross-sectional ultrasound (US)-based survey on volunteers aged 20–70 years from 30 regions of the Heilongjiang Province. The participants were recruited using the probability proportional to size (PPS) method, and consent for US screening was obtained from them. The survey was performed by trained technicians using the same US equipment with a 6–15 MHz linear transducer (MyLab 30 cv, Italy) and was hosted in public community locations such as local hospitals and outpatient departments. Information on basic demographic characteristics, such as urinary iodine and iodine intake were collected. The age- and sex-adjusted prevalence of thyroid disease was determined through direct standardization and reported using the province’s population in 2016 as reference.ResultsFrom December 12, 2017, to March 10, 2019, 3,754 participants with a mean age of 48.65 (±12.39) years participated in the study. Of them, 3,643 had reliable urinary iodine data. The median urinary iodine and salt iodine concentrations within the normal range were 163.30 µg/L and 24.30 mg/kg, respectively. The age- and sex-adjusted prevalence of thyroid disease was 52.91%. Diffuse thyroid disease (DTD), focal thyroid lesions (FTL), and coexistence of both diseases were prevalent in 8.68%, 36.58%, and 7.65% of the participants, respectively. The prevalence of the five categories according to US-based survey features in the ACR TI-RADS (i.e., TR1, TR2, TR3, TR4, and TR5) was 7.71%, 14.53%, 3.44%, 14.82%, and 3.51%, and the prevalence of nodules that needed fine-needle aspiration was 2.55%.ConclusionsIn Heilongjiang Province, adults aged 20–70 years belong to the optimal iodine status. Further, the salt iodine levels are in the normal range. Thyroid diseases are highly prevalent in this age group; however, the intervention rate is low. We provided population-based estimates of the prevalence of thyroid disease and the iodine status in adults of Heilongjiang Province. These findings are useful to support effective intervention planning for thyroid disease.

Iodine Nutrition and the Prevalence Status of Thyroid Nodules in the Population: a Cross-sectional Survey in Heilongjiang Province, China.

The aim of this study was to determine the iodine nutritional status and the epidemiological characteristics of thyroid nodules (TNs) in the adult population of Heilongjiang Province. From December 2017 to December 2018, a total of 3661 adults aged 20-70years were selected through probability proportional to size (PPS) sampling for a cross-sectional survey. During the field epidemiological investigation, each participant received a questionnaire survey and thyroid ultrasonography examination. The iodine concentrations in casual urine specimens and household edible salt were measured. The household coverage of iodized salt was 86.56%. The median urinary iodine concentration (MUIC) in the adult population in Heilongjiang Province was 161.57μg/L (25th-75th percentile: 100.35-245.15μg/L). The prevalence of TNs was 36.88%, and the prevalence in females was significantly higher than that in males (41.25% vs 32.50%, χ2 = 11.841, P < 0.01). The prevalence of TNs increased with age (χ2trend = 49.80, P < 0.001). The prevalence of multiple TNs increased with age (χ2trend = 48.709, P < 0.001). There was no significant difference in the MUIC between healthy control group and those with TNs (Z = - 1.386, P = 0.166). The female, age (40-49 age group, 50-59 age group, 60-70 age group), BMI (obesity, overweight), history of hypertension, history of diabetes, and smoking history were all independent risk factors that affected the occurrence of TNs. The iodine nutritional status of the adult population in Heilongjiang Province was adequate. The prevalence of TNs was higher in middle-aged and elderly women, so these individuals should be the focus of the prevention and treatment of thyroid nodule disease.

Iodine deficiency disorders in a South Indian district: still a public health problem?

Background: Iodine deficiency disorders (IDD) constitute the single largest cause of preventable brain damage worldwide leading to learning disabilities and psychomotor impairment. Nearly 266 million school children worldwide have insufficient iodine intake. IDD was found to be a public health problem in 47 countries. Since the information on current prevalence of goiter in Kolar was not available, the present study was undertaken.Methods: A cross-sectional study was conducted among school children aged 6-12 years in Kolar taluk. A total of 2700 children were selected for goiter examination by multistage random cluster sampling technique. A total of 270 children were tested for the median urinary concentration and 540 salt samples were tested from the households of the study population.Results: The total goiter rate was 5.66% among primary school children aged 6-12 years with a significant difference between ages. As the age increased the goiter prevalence also increased. The median urinary iodine excretion level was found to be 105 mcg/l and 92.788.7% salt samples had &gt;15 ppm iodine content.Conclusions: Present study shows mild goiter prevalence in primary school children in Kolar district and an adequate iodine content of salt in urine.

Development of USI-Kit for Evaluation of Iodine Content in Iodized Salt

Iodine deficiency has been considered as a serious public health problem for the past decades. Universal salt iodization program is introduced and implemented to address such problem. To encourage this program in an effective and sustainable way, it is essential to regularly monitor whether salt is adequately iodized at various points along the supply chain. The traditional iodometric titration method has problems related to accessibility, cost, and time. Colorimetric test kits have been used extensively to measure coverage of iodized salt in household surveys due to its expediency and affordability. In Thailand, “I-KIT” is the most widely used. The visualization of intensive color, however, is inconvenient for untrained-user in determining the adequacy of iodine content. Thus, an improvement to make testing more precise and affordable is still required. In this respect, a new test kit namely USI-Kit was developed to assess iodine quality and semi-quantity in edible salt. The kit was tested to evaluate its performance, by comparing the result with the I-KIT and with the spectrophotometric method. Compared with I-Kit, the USI-Kit exerted the relative accuracy, sensitivity, specificity, false positive rate, false negative rate and Kappa coefficient value of 74.0, 76.3, 72.6, 27.4, 23.7 and 0.47, respectively. Compared to the spectrophotometric method, USI-Kit exerted the relative accuracy, sensitivity, specificity, false positive rate, false negative rate and Kappa coefficient value of 85.4, 80.1, 89.3, 10.7, 19.9 and 0.70, respectively. The finding suggested that a newly developed iodine test kit holds promise to be used in field inspection of iodine content in salt.

Iodine Status and Discretionary Choices Consumption Among Primary School Children, Kinondoni Tanzania.

BackgroundTanzania is one of the countries where excessive iodine intake has been reported, to intervene, the identification of possible causes is required. This study aimed to assess iodine status and determine the critical contributors to excessive iodine intakes in schoolchildren aged 8–14 years.Materials and MethodsA total of 288 school children were randomly selected in this school-based cross-sectional study in Kinondoni municipality, Tanzania. Household salt samples were analyzed using iodine rapid field test kit while that was collected from retailers/wholesalers by iodometric titration. Spot urine samples were collected and analyzed for iodine levels using a modified microplate method following the Sandell‐Kolthoff reaction. A lifestyle questionnaire was administered to schoolchildren to assess their eating frequency of discretionary foods and salts.ResultsThe mean salt iodine content was 53.94 ± 13.02, and over 90% of household salt was iodized. Median urinary iodine concentration (UIC) was 401 µg/L indicating excessive iodine intake, and one-third of the children had UIC >500 µg/L. Nearly all school children consume discretionary choices as snacks or part of a meal. Potato chips and fried cassava were the top two discretionary choices consumed with discretionary salt use (67.3%). Potato chips (adjusted odds ratio [AOR=9.04, 95% CI: 3.61–22.63]), fried cassava (AOR=11.08, 95% CI: 3.45–35.54) and groundnuts consumption for 4–7 days/week (AOR = 0.30 95% CI: 0.09–1.0) were significantly associated with iodine intake.Conclusion and RecommendationThe evidence of excessive iodine intakes observed in previous studies and in this study should alert the policymakers to consider adjustment of the amount of iodine added to salt along with the obligation of reducing discretionary foods and salt intake.

Mild-to-moderate iodine deficiency in a sample of pregnant women and salt iodine concentration from Zhejiang province, China.

Since 2011, Zhejiang province has eliminated iodine deficiency disorders (IDD) in its populations. Following this achievement, a new revised iodine concentration in iodised salt was implemented in Zhejiang in 2012. However, the re-emergence of iodine deficiency has been reported in pregnant women. Therefore, the aim of this study was to assess household salt iodine concentration and iodine status of pregnant women in Zhejiang province, China. We conducted a cross-sectional study between April 2018 and August 2018 in Quzhou, Zhejiang province. Pregnant women aged ≥ 18years who did not have a history of thyroid disease were recruited into the study. They were asked to complete socio-demographic questionnaires including a food frequency questionnaire (FFQ). In addition, a spot urine sample and a household table salt sample were also provided by each participant. A total of 625 pregnant women agreed to participate. The overall median urinary iodine concentration (UIC) was 130µg/L, indicating mild-to-moderate iodine deficiency in pregnant women. The coverage of iodised salt was 85.2%, and of these, the rate of adequately iodised salt was 98.1%. In conclusion, our results confirmed the re-emergence of iodine deficiency in pregnant women as reported by other studies conducted in Zhejiang province. Therefore, urgent public health actions are needed to improve iodine status of pregnant women in order to prevent the adverse consequences of IDD on the neurodevelopment of foetus.

Iodine Content of Salt in Retail Shops and Retailers’ Knowledge on Iodized Salt in Wa East District, Upper West Region, Ghana

Background. There are laws to enforce the universal iodization of salt to check the consequences of iodine deficiency in Ghana. These laws are to ensure that there are production and sales of iodized salt in the country. Yet, the availability of iodized salt in the county's households is still not encouraging, with data indicating that 93.8% of children have urine iodine &lt;100 μg/dl. Hence, the study investigated the iodine content of salt in retail shops and knowledge of iodized salt among retailers in the Wa East District. The study will help the informed decision on strengthening and enforcing laws to achieve the universal salt iodization and the consumption of adequate iodized salt.Method. The study was a descriptive cross-sectional survey. We used a questionnaire to collect quantitative data from participants and a rapid field test kits to determine the iodine content of salt. STATA version 14.2 was used to analyse data. Chi-squared and logistic regression models were used to examine the association between the dependent and independent variables and consideredpvalue &lt;0.05 as statistically significant.Findings. The retailers’ primary source of information about iodized salt was health workers (46.2%), with the majority (52.8%) of them having low knowledge of iodized salt. Notwithstanding the high knowledge of iodized salt, as high as 53.8% of the salts do not have adequate iodine (&lt;15 ppm). Retailer’s sex (p=0.014), educational level (p=0.006), primary source of information about iodized salt (p=0.012), texture of salt being sold (p=0.023), and mode of displaying salt in the shop (p=0.003) were associated with knowledge of iodised salt. Again, retailer’s educational level (p=0.036), knowledge of iodized salt (p=0.034), texture of salt being sold (p=0.021), and method of displaying the salt being sold (p=0.004) were associated with an iodine content of the salt in the shop.Conclusions. Though policies have been implemented to promote production and consumption of iodized salt, the iodine content of salt in retail shops in the Wa East are not encouraging. We recommend the establishment of checkpoints along the production and distribution chain to ensure salt with adequate iodine reaches the consumer. Again, traders of iodized salt should have regular training on ways to preserve salt to maintain its iodine content.

Prevalence and risk factors of thyroid structural abnormalities among adults in Heilongjiang Province, China

Background and Objectives: The prevalence of adult thyroid structural abnormalities has increased significantly worldwide. However, no study has examined the thyroid structure and urine iodine levels of adults in Heilongjiang Province in the last decade. Therefore, this study aims to investigate the rate and risk factors of thyroid structural abnormalities among the residents of this province. Methods and Study Design: A probability proportional sampling method was used, and a total of 3,645 individuals in Heilongjiang Province were included. The subjects was asked to complete a thyroid ultrasound and fill out a questionnaire. Furthermore, urine iodine levels and salt iodine content were determined, and multivariate logistic regression was used to identify the independent risk factors for thyroid diseases. Results: The prevalence of thyroid structural abnormalities in Heilongjiang Province was 56.0%. Univariate analysis showed that there were significant differences between the structural abnormalities group and the normal thyroid group in terms of sex, age, body mass index, hypertension, diabetes, smoking, alcohol consumption, frequency of seafood consumption and pickled food consumption, employment status, and urine iodine level (p ＜ 0.05). Multivariate analysis showed that the following were independent risk factors of thyroid disease: female, increased age, hypertension, diabetes, cigarette smoking frequent seafood consumption, employment, and urine iodine levels. Conclusions: The prevalence of thyroid structural abnormalities in adults in Heilongjiang Province was relatively high. Therefore, to help prevent the occurrence of thyroid disease in adults in Heilongjiang Province, the risk factors of thyroid structural abnormalities should be better understood.

Household Coverage with Adequately Iodized Salt and Iodine Status of Nonpregnant and Pregnant Women in Uzbekistan

Background: Globally, iodine deficiency has been drastically reduced since the introduction of salt iodization programs; nonetheless, many populations remain at-risk for iodine deficiency. This study aimed to assess the iodine status among women of reproductive age in Uzbekistan and to identify factors associated with iodine deficiency, including the availability of adequately iodized salt at the household level.Methods: A cross-sectional household survey was conducted to produce region-specific estimates of the household coverage with adequately iodized salt and iodine status among women for each of the 14 regions in Uzbekistan. Other information, such as socioeconomic status, lactation and pregnancy, residence, age, and consumption of iodine supplements, was also collected.Results: Overall, 36% of 3413 households had adequately iodized salt (iodine concentration >15 ppm [parts per million (mg I/kg salt)]), 20% had inadequately iodized salt (5–14 ppm), and 44% had salt without detectable iodine (<5 ppm). Adequate iodization was found in 33.2% of the 2626 salt samples taken from retail packages labeled as “iodized,” 36.5% of the 96 samples taken from retail packages without mention of iodization, and 50.5% of the 674 samples without the original packaging (p < 0.001). The median urinary iodine concentration (UIC) of 140.9 μg/L (95% confidence interval [CI 132.4–150.7]) in nonpregnant nonlactating women indicated adequate iodine status, while for nonpregnant lactating and pregnant women, the median UIC of 112.9 μg/L [CI 99.3–128.4] and 117.3 μg/L [CI 101.8–139.9], respectively, indicated borderline adequacy. Significant differences in UIC (p < 0.001) were found between nonpregnant nonlactating women living in households with adequately iodized salt (UIC 208.9 μg/L), inadequately iodized salt (UIC 139.1 μg/L), and noniodized salt (UIC 89.9 μg/L).Conclusions: Coverage with adequately iodized salt is low in Uzbekistan, and women in households with poorly iodized salt have substantially worse iodine status; claims on packaging about salt iodization do not reflect salt iodine content. This highlights the importance and effectiveness of salt iodization and the need to strengthen this program in Uzbekistan.

Stable Iodine Nutrition During Two Decades of Continuous Universal Salt Iodisation in Sri Lanka

Universal salt iodisation (USI) was introduced in Sri Lanka in 1995. Since then, four national iodine surveys have assessed the iodine nutrition status of the population. We retrospectively reviewed median urine iodine concentration (mUIC) and goitre prevalence in 16,910 schoolchildren (6–12 years) in all nine provinces of Sri Lanka, the mUIC of pregnant women, drinking-water iodine level, and the percentage of households consuming adequately (15 mg/kg) iodised salt (household salt iodine, HHIS). The mUIC of schoolchildren increased from 145.3 µg/L (interquartile range (IQR) = 84.6–240.4) in 2000 to 232.5 µg/L (IQR = 159.3–315.8) in 2016, but stayed within recommended levels. Some regional variability in mUIC was observed (178.8 and 297.3 µg/L in 2016). There was positive association between mUIC in schoolchildren and water iodine concentration. Goitre prevalence to palpation was a significantly reduced from 18.6% to 2.1% (p < 0.05). In pregnant women, median UIC increased in each trimester (102.3 (61.7–147.1); 217.5 (115.6–313.0); 273.1 (228.9–337.6) µg/L (p = 0.000)). We conclude that the introduction and maintenance of a continuous and consistent USI programme has been a success in Sri Lanka. In order to sustain the programme, it is important to retain monitoring of iodine status while tracking salt-consumption patterns to adjust the recommended iodine content of edible salt.

Assessment of the iodine nutritional status among Chinese school-aged children.

ObjectiveThe remarkable success of iodine deficiency disorders (IDD) elimination in China has been achieved through a mandatory universal salt iodization (USI) program. The study aims to estimate the relationship between urinary iodine concentration (UIC) and iodine content in edible salt to assess the current iodine nutritional status of school aged children.MethodsA total of 5565 students from 26 of 39 districts/counties in Chongqing participated in the study, UIC and iodine content in table salt were measured. Thyroid volumes of 3311 students were examined by ultrasound and goiter prevalence was calculated.ResultsThe overall median UIC of students was 222 μg/L (IQR: 150-313 μg/L). Median UIC was significantly different among groups with non-iodized salt (iodine content <5 mg/kg), inadequately iodized salt (between 5 and 21 mg/kg), adequately iodized (between 21 and 39 mg/kg) and excessively iodized (>39 mg/kg) salt (P < 0.01). The total goiter rate was 1.9% (60/3111) and 6.0% (186/3111) according to Chinese national and WHO reference values, respectively. Thyroid volume and goiter prevalence were not different within the three iodine nutritional status groups (insufficient, adequate and excessive, P > 0.05).ConclusionsThe efficient implementation of current USI program is able to reduce the goiter prevalence in Chongqing as a low incidence of goiter in school aged children is observed in this study. The widened UIC range of 100–299 μg/L indicating sufficient iodine intake is considered safe with a slim chance of causing goiter or thyroid dysfunction. Further researches were needed to evaluate the applicability of WHO reference in goiter diagnose in Chongqing or identifying more accurate criteria of normal thyroid volume of local students in the future.

Iodine Deficiency as Assessed by Neonatal TSH in a Sample of Mother-and-Newborn Pairs in Jiangsu Province, China.

China has eliminated iodine deficiency disorders since 2011 via the implementation of universal salt iodisation. Following this, a new revised salt iodisation policy was introduced to reduce iodine content in table salt. Since maternal iodine deficiency can lead to cognitive impairment and cretinism in infants, the aim of our study was to assess if the iodine status of pregnant women and neonates was affected by the introduction of new salt iodisation policy. The medical records of the pregnant women and their neonates in the Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China, between January 2018 and May 2018 were reviewed and obtained. Our study included 374 mother-and-newborn pairs. Mean age of the participants was 28 ± 4years. TSH, FT3 and FT4 of the participants remained within the reference range. The prevalence of thyroid dysfunction was 4.3%. The overall mean neonatal TSH, birth weight and prevalence of low birth weight (LBW) was 2.56 ± 1.59 mIU/L, 3348 ± 465g and 2.4%, respectively. The prevalence of neonatal TSH values > 5 mIU/L was 8.3%, which suggested the emergence of mild iodine deficiency (i.e. 3.0-19.9%) in our province. In conclusion, although our study reported an improvement of iodine status to mild iodine deficiency in 2017, our pregnant women remained to be iodine deficient. We recommended an ongoing monitoring of iodine status and advocate for the routine iodine supplementation together with iodised salt in Chinese pregnant women.

Iodine Content of Salt Use after Years of Universal Iodization Policy and Knowledge on Iodized Salt among Households in the Sissala East Municipality in Upper West Region of Ghana

Background. Iodine deficiency is a global public health concern as it leads to inadequate production of thyroid hormone in the body, causing too many destructive consequences on the roles and functions of different human organs and muscles including brain growth and can manifest into many damaging effects such as intestinal cerebral impedance, cancer of intestine, breast disorders, and physical deformities like goitre and cretinism to one’s body. Despite all these negative effects, there are several important public health programs including universal salt iodization (USI) to improve on households’ iodine intake, notwithstanding this, countless families are still eating foods containing less iodine or no iodine at all. Hence, this study examined the intake of iodized salt after years of universal salt iodization and the knowledge on iodized salt among households in the Sissala East Municipality. Method. A descriptive cross-sectional study was adopted to collect data for the study. Data were collected from women in charge of household meal preparation using a semistructured questionnaire and rapid field iodine test kits. The Statistical Package for Social Sciences (SPSS) version 20 was used for the data analysis and presented in tables and graphs. p value &lt;0.05 was considered as statistically significant. Findings. Only 41.4% of the households have good knowledge on benefits of iodized salt and dangers associated with iodine deficiency. It was realized that the health workers (46.6%) and television were the main sources of information on iodized salt. Household salt usage with adequate (&gt;15 ppm) levels of iodine was 44.0%; however 85.9% of the salts were stored in covered containers. The study showed significant associations between knowledge on iodized salt and educational level (p≤0.001), occupation (p=0.043), religion (p=0.027), and ethnic lineage (p=0.046). Also, the use of iodized salt showed associations with the educational level (p≤0.001), occupation (p=0.003), religion (p=0.042), and knowledge on iodized salt (p≤0.001). Conclusions. Only about 4 in 10 households were consuming salt with adequate iodine, and this coverage is very low compared with the 90% or more coverage recommended by WHO/UNICEF/ICCIDD. Having secondary and tertiary education and having good knowledge of iodized salt has a great influence on the use of iodized salt; however, with this low level of knowledge of importance of iodized salt among women responsible for house food preparations, there is the need for health professionals to intensify education and promotion on iodized salt in the area and to monitor and verify iodine content of salts produced and sold in the market all times, as the source of the salt might have contributed to the low levels of iodine in the household salt.

High variability of iodine in iodized salt and urine from rural households in Sidama zone, Southern Ethiopia: A cross-sectional study

Iodine is essential for the synthesis of thyroid hormones which regulate the metabolic processes of most cells and play important roles in human growth and development. Iodine deficiency has long been one of the most common nutritional problems in the world. Ethiopia, particularly the study population (Sidama) has a history of severe iodine deficiency. The purpose of the study was to assess urinary iodine concentration, level of goiter in mothers and school-age children and household salt iodine concentration in households 10 months after launch of the national salt iodization program. A cross-sectional study was conducted on a randomly selected sample of women and schoolchildren. Goiter was assessed by palpation. Concentrations of iodine in salt, urine and water were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). The study included 193 mothers and 76 children. The median (IQR) urinary iodine concentration (UIC) was 143 (84, 202) μg/L in the mothers and 187 (102, 278) μg/L in the children. Mothers’ UIC ranged from 17 to 767.2 μg/L and children’s UIC ranged from 19 to 739 μg/L. Goiter prevalence was high in both mothers (76%) and children (79%). The median household salt iodine concentration (SIC) was 8.1 (4.3, 13.4) ppm (mg/kg) with a range of 0 to 42 ppm. None of the water samples contained iodine above the detection limit of 1 μg/L. Despite the launch of the salt iodization program in Ethiopia, 94% of the study participants were not aware that they used iodized salt and 88% did not know the benefits of iodized salt. The major source of iodine for this population was iodized salt; however, the salt at household level contained minimal but variable amounts of iodine. Low concentration of iodine in salt may be further compounded by storage, handling and cooking techniques. The high variability of salt iodine concentration (SIC) was also reflected in the UIC of the mothers and children.

The evolution, progress, and future direction of Nepal's universal salt iodization program

Nepal is located in what was once known as the Himalayan Goitre Belt and once had one of the highest prevalence's of iodine deficiency disorders in the world. However, through a well‐executed universal salt iodization program implemented over the past 25 years, it has achieved optimal iodine intake for its population, effectively eliminating the adverse consequences of iodine deficiency disorders. A comprehensive review of policy and legislation, surveys, and program reports was undertaken to examine the key elements contributing to the success of this program. The paper reviews the origins and maturation of salt iodization in Nepal, as well as trends in the coverage of iodized salt, the iodine content in salt, and population iodine status over the past two decades. The paper describes critical components of the program including advocacy efforts, trade issues with India, the role of the Salt Trading Corporation, monitoring, and periodic program reviews. The paper discusses the recent findings from the 2016 national micronutrient survey demonstrating the success of the salt iodization program and describes emerging challenges facing the program in the future.