Iodine Content Of Salt Research Articles

Urinary iodine level and its determinants in pregnant women of Shanghai, China.

It is known that iodine deficiency during pregnancy can interfere with normal fetal growth and development. However, iodine levels of pregnant women in Shanghai, China, and factors that could influence its levels remain unclear. A total of 916 pregnant women were selected from the Maternal and Child Care Service Centre of Minhang District in Shanghai. Morning urinary iodine (UI) and iodine content of salt from the participants' home were measured, and UI concentration was adjusted by creatinine concentrations. Serum tri-iodothyronine, thyroxin, free tri-iodothyronine, free thyroxine and thyroid-stimulating hormone were tested in the second trimester of pregnancy by time-resolved fluoroimmunoassay. The median levels of UI in pregnant women were 156.3, 176.9 and 175.1 μg/g creatinine in the first, second and third trimesters of pregnancy, respectively. The prevalence of UI deficiency (UI < 150 μg/g creatinine) was 48.3, 34.2 and 36.2% in the three trimesters of pregnancy, respectively. Factors that significantly influenced the UI levels include the following: iodine content of household salt; age; occupation; multivitamin supplement with iodine; seaweed intakes. Furthermore, UI and iodine content of salt were moderately correlated (r 0.406, P < 0.001). In addition, there was no significant association between UI and thyroid hormone levels. The present study showed a high prevalence of UI deficiency in pregnant women in Shanghai, especially during the first trimester of pregnancy. Both iodine content of household salt and multivitamin supplement with iodine are the main determinants of UI levels in Shanghai.

Survey of iodine nutritional status in 2011, Zhejiang, China.

Universal salt iodization (USI) was introduced in China in 1995, but whether the iodine status is optimal is questionable. This study was conducted to assess the iodine nutrition among Zhejiang population in coastal regions in China. A cross-sectional survey for iodine nutritional status was conducted with general population (n=10,350), including pregnant and lactating women (n=450 each) selected by stratified multistage sampling. Iodine content in drinking water, table salt and urine, were determined using arsenic-cerium catalytic spectrophotometry, the direct titration and the arsenic-cerium catalytic spectrophotometry, respectively, and daily iodine intake was estimated by 3 days of 24-hour recall method. The median iodine content in drinking water was 2.46 μg/L, Zhejiang belonged to the region of iodine deficiency in outer environment according to China standard. The median iodine content in table salt was 27.9 mg/kg, conforming to the standard requirements; the household coverage rate of qualified iodized salt reached 76.8%, which does not reach the standard requirement of WHO >90%. The dietary iodine intake of a reference individual averaged 379 μg/d, which indicated that the current iodine intake in diet was appropriate. In addition, the median urinary iodine concentration (UIC) was 162 μg/L in general population, and 130 μg/L in pregnant women, which didn't reach the standard requirements. The current dietary iodine intake in Zhejiang was generally sufficient and safe, but there is a risk of iodine deficiency among pregnant women and the population who do not consume iodized salt.

Breast Milk Iodine Concentration Correlated with Urinary Iodine Concentration of Infants from Southern Ethiopia

Breast milk from iodine‐sufficient mothers is considered an adequate source of iodine for the exclusively breastfed infant until the age of 6 months. A national policy requiring salt iodization was initiated in Ethiopia in 2011, but reports indicate high variability in salt iodine concentration (SIC) at the community level. Although the recommended household SIC should be 15‐40 ppm, salt from 102 rural households of lactating women in southern Ethiopia ranged from 0 to 39 ppm. Only about 20% of households had SIC &gt;15 ppm. Mean ± SD age of mothers was 23 ± 3.9 y. Maternal BMI was 21.3 ± 2.5 and MUAC was 23.1 ± 1.9 cm. Goiter was observed in 75 of the mothers. Breast milk and urine samples were collected from these mothers and urine samples were collected from their 6 day old infants. Breast milk iodine (BMIC) and urinary iodine (UIC) were analyzed by inductively coupled plasma mass spectrometry (ICP‐MS). Median (Interquartile range) BMIC was 1551 (495, 2487) µg/L. Median maternal UIC was 106 (71, 160), but 47 had UIC below 100 µg/L. Median infant UIC was 212 (109, 348) µg/L. UIC of the mother correlated with BMIC (r=0.26, p&lt; 0.007). BMIC and infant UIC were correlated (r=.34, p&lt;0.0001) as were UIC of mother and infant (r=.63, p &lt;0.0001). UIC of the mother and iodine of the household salt predicted 15% of the variation in BMIC while UIC of the mother and BMIC predicted 41% of the variability in UIC of the infant. Despite the fact that the study population was getting variable amounts of iodine from the recently implemented salt iodization program, BMIC at 6 days after delivery was high. (Supported by Néstle Foundation and Oklahoma Agricultural Experiment Station).

An assessment of association of thyroid volume with growth indicators and comparison of different thyroid volume indexes in school-aged children

To analyze the association between thyroid volume and physical growth of school-age children, and to compare volume indexes of individual thyroids for reference of selection of assessment indicators. All the students of the 12 classes of grades 3-5 at a primary school in Minhang district, Shanghai were rounded up with a multi-stage cluster sampling, for physical examinations to measure their height, weight, Body mass index (BMI) and body surface area (BSA), followed by B-ultrasonography to measure their thyroid volume. Data of the measurements were calculated to learn their height corrected volume index (HVI), weight and height corrected volume index (WHVI), BMI corrected volume (BMIV), and BSA corrected volume (BSAV) individually. Their urine and salt samples were collected to measure iodine concentration in urine and salt. Individual indexes were studied for their association with the growth and development indexes of children. Thyroid volume data were collected for 485 students, including 258 boys (53.2%) and 227 girls (46.8%). Their height, weight, BMI and BSA were found to be positively correlated with their age (P < 0.05). For children of the same age group, their thyroid volume was also positively correlated with their physical development indexes. Of all the thyroid indexes, the difference between BSAV physical development factors had no statistical association (with partial-correlation coefficients for age, gender, height, and weight being 0.07, 0.05, 0.01 and 0.02 respectively), and their thyroid volume, HVI, BMI and weight were correlated to age, height and weight. Thyroid volume was associated with age and weight. It was inappropriate to diagnose goiter with criteria of age, gender and thyroid volume. BSAV was recommended for its non-association with age, gender and weight and its stability.

Iodine Deficiency Disorders and Salt Iodisation - Public Health Implications

Iodine deficiency disorders represent the broad negative health and development consequences as a result of low iodine in the diet. Iodine deficiency is a public health problem in many countries around the world and the most common cause of preventable mental impairment worldwide. Pregnant women and young children present a group most susceptible to iodine deficiency. Salt iodization is a safe, efficient, cost-effective and sustainable strategy for improving the iodine intake by the population and the control of iodine deficiency disorders. During the past twenty five years universal salt iodization was introduced in many countries worldwide and now two thirds of world’s population is consuming iodized salt. Salt is a vehicle for iodization but high salt intake correlates with high blood pressure, the leading factor for global mortality, deaths from coronary heart diseases and stroke. Two dominating global public health problems with clear commonalities are hypertension leading to cardiovascular diseases (CVD) and IDD. They are both preventable and salt reduction does notcontradict to salt iodization. The concentration ofiodine in salt can easily be adjusted to meet policies aimed at reducing the consumptionof salt in order to prevent cardiovascular disease and to ensure adequate iodine intake of the population. The only groups at risk for low iodine intake when salt intake will be reduced are pregnant women and small children. In these cases careful monitoringof iodine status and eventually additional supplementation must be of high priority.

Iodine-deficiency disorders in the Aseer region, south-western Saudi Arabia: 20 years after the national survey and universal salt iodization.

To study (i) the current prevalence of iodine-deficiency disorders among schoolchildren in south-western Saudi Arabia after universal salt iodization and (ii) the iodine content of table salts and water. Cross-sectional study on a stratified proportional allocation sample of children. Thyroid gland enlargement was assessed clinically and by ultrasound scanning. Urine, table salt and water samples were taken to measure iodine content. Settings The Aseer region, south-western Saudi Arabia. Schoolchildren aged 8-10 years. The study included 3046 schoolchildren. The total goitre rate amounted to 24·0 %. Prevalence of enlarged thyroid by ultrasound was 22·7 %. The median urinary iodine concentration of the study sample amounted to 17·0 µg/l. The iodine content of table salt ranged from 0 to 112 mg/kg; 22·5 % of the table salt samples were below the recommended iodine content (15 mg/kg) set by WHO. The total goitre rate increased significantly from 19·8 % among children using table salt with iodine content ≥15 mg/kg to reach 48·5 % among children using table salt with 0 mg iodine/kg. Analysis of water samples taken from schools showed that the majority of water samples (78·8 %) had an iodine content of 0 µg/l. The study documented that 18 years after the national study, and after more than a decade of universal salt iodization in Saudi Arabia, the problem of iodine-deficiency disorders is still endemic in the Aseer region. Efforts should focus on fostering advocacy and communication and ensuring the availability of adequately iodized salt.

Urinary iodine levels, goiter rates and intelligence quotient in primary school children in Giwa Local Government area of Kaduna State, Nigeria

Background: Iodine deficiency can cause brain damage and/or cognitive impairment in children. It is preventable and of public health concern. After sixteen years of universal salt iodization in Nigeria, we undertook this study in north-western Nigeria to determine: prevalence of iodine deficiency in school children, any relationship between iodine deficiency, goiter and intelligence quotient and iodine content of table salt from their households. Methodology: A cross-sectional study of school children aged 6-12 years. Data was collected using structured questionnaire. Enrolled children had physical examination and anthropometric measurements. Presence of goiter was clinically assessed using criteria jointly recommended by WHO, UNICEF and ICCIDD. Intelligence quotient was assessed using the Draw-A-Man test. Specimen of urine was obtained from each child and table salt specimen from their homes. Atomic absorption spectrophotometry was used to analyze urinary iodine in μg/L. Iodine content of salt was semi-quantitatively analyzed. Results: A total of 544 children were studied. Their mean age (±1SD) was 9.5 ± 2.0 years. Median urinary iodine excretion (UIE) level was 148 μg/L. Forty-seven (8.6%) children had goiter. Three hundred and seventy- six (69.1%) children had normal body build. Of 118 (21.7%) children with adequate iodine status, 18 (15.3%) were stunted; a similar proportion in iodine deficient children. One hundred and thirty-four (57.0%) of 235 iodine-deficient children and 67 (56.8%) of 118 iodine-sufficient children had normal Intelligence Quotient. All household table salts contained iodine. Conclusion: There was no relationship between nutritional status and Iodine status; iodine status and intelligence quotient in study children.

Environmental, urinary iodine status and prevalence of goitre among schoolchildren in a high altitude area of Saudi Arabia.

Objective:This study aimed to assess the iodine deficiency, prevalence of goitre among schoolchildren and measuring environmental iodine in Taif city, Saudi Arabia.Methods:A cross-sectional multistage cluster-sampling methodology was done on 1887 schoolchildren. Their urinary iodine concentration (UIC) and goitre prevalence was assessed. Blood level of triiodothyronin, thyroxine and thyroid-stimulating-hormone was carried out for students with normal, mild; moderate and sever iodine deficiency. The iodine content of salt, water and soil was also assessed.Results:Goitre prevalence was 7.4% and about 71% of the participants had UIC less than 100μg/L. An inverse relationship between median UIC and the percent prevalence of goitre was found. The mean serum T3, T4 and TSH were 1.05ng/dL, 6.81µg/dL, and 5.69mIU/L, respectively. A significant positive correlation was found between the mean value of urinary iodine and the mean value of both T3 and T4. While a significant negative correlation between the mean value of urinary iodine and the mean value of TSH was also noted.Conclusions:The results revealed the presence of a potential public health problem of iodine deficiency among school going children in high altitude areas of Saudi Arabia. There is a need to monitor and evaluate the salt iodization process, and distribute adequately iodized salt in the affected areas.

Prevalence of iodine deficiency among adult population residing in Rural Ballabgarh, district Faridabad, Haryana.

Community-based surveys are essential to monitor iodine deficiency disorders (IDD) program at both the state and national levels. There is paucity of information on population iodine nutrition status in Haryana state using standard methods. A cross-sectional study was conducted in villages of Comprehensive Rural Health Services Project (CRHSP), Ballabgarh, Haryana, India. A total of 465 randomly selected individuals were assessed for urinary iodine concentration (UIC) by microplate method and household salt iodine content using iodometric titration. Of the interviewed households, 73% were using adequately iodized salt (≥15 ppm). Iodine nutrition was deficient in 17% respondents (UIC <100 μg/L); 20.2% among males and 13.9% among females. Iodine intake of the study population as measured by UIC was adequate but nearly one-fourth of households in the study population were consuming inadequately iodized salt. The availability and access to adequately iodized salt in the study population should be improved by strengthening regulatory monitoring.

A study on the influencing factors of urinary iodine concentration and the relationship between iodised salt concentration and urinary iodine concentration.

The aim of the present study was to explore the influencing factors of urinary iodine concentration (UIC) and the relationship between iodised salt concentration and UIC in order to give suggestions for the surveillance of iodine nutrition status. For this purpose, a multi-stage cluster sampling technique was employed in the present cross-sectional study. Correlations between UIC and salt iodine concentration were evaluated by Spearmen's correlation analysis. Risk factors of having a lower UIC were identified by logistic regression analysis, and the equations of UIC and salt iodine concentration were fitted by curve regression analysis. The median UIC was found to be 162·0 (25th-75th percentile 98·2-248·6) μg/l. The UIC was correlated with salt iodine concentration (Spearman's ρ = 0·144, P< 0·05). The multiple logistic regression analysis found the following influencing factors for having a lower UIC: age (OR 0·98, 95% CI 0·98, 0·98, P< 0·05); sex (OR 0·81, 95% CI 0·71, 0·92, P< 0·05); education level (OR 0·87, 95% CI 0·83, 0·90, P< 0·05); status of occupation (OR 0·91, 95% CI 0·86, 0·96, P< 0·05); occupation (OR 1·03, 95% CI 1·00, 1·05, P< 0·05); pickled food (OR 1·24, 95% CI 1·08, 1·42, P< 0·05); salt iodine concentration (OR 1·03, 95% CI 1·02, 1·03, P< 0·05). The curve regression analysis found that UIC (y) and salt iodine concentration (x) could be expressed by the following equation: y= 1·5772x 1·4845. In conclusion, the median UIC of individuals in Zhejiang Province falls within optimal status as recommended by the WHO/UNICEF/International Council for Control of IDD. To maintain optimal iodine nutrition status, salt iodine concentration should be in the range of 16·4 to 34·3 mg/kg.

Assessment of iodine status and associated factors in vulnerable populations in Henan Province, China, in 2012.

Iodine content in table salt was adjusted from 30-50 mg/kg to 21-39 mg/kg from March of 2012 in Henan Province, China. The vulnerable population may be at risk of iodine deficiency. To determine whether the iodine intake was sufficient in vulnerable populations and to investigate what factors may be associated with iodine status in these vulnerable populations in Henan Province, China. A cross-sectional survey was conducted in 17 cities in Henan Province, China, from April 2012 to December 2012 to assess the iodine status in vulnerable populations, including women of reproductive-age (n=2648), pregnant women (n=39684), lactating women (n=6859), infants <2 years of age (n=16481), and children aged 8-10 years (n=3198). Questionnaires (n=4865) related to demographic and dietary factors were collected from the investigated women to identify factors that were related to iodine intake and iodine status. The median urinary iodine concentrations (mUICs) were 205 μg/L, 198 μg/L, 167 μg/L, 205 μg/L and 200 μg/L, respectively, in reproductiveage, pregnant and lactating women, infants <2 years of age and children aged 8-10 years. Higher income, and consuming more poultry and fish in the diet had positive impact on UIC levels. Low salt intake, consuming more rice and vegetables in the diet were negative factors for UIC. Iodine status of the vulnerable populations was generally adequate in Henan Province, China, according to WHO criteria. But the mUICs were slightly above the adequate level in reproductive-age women and children aged 8-10 years. It's important to monitor the iodine status in vulnerable populations after the adjustment on iodine content in table salt.

ASUPAN IODIUM ANAK USIA SEKOLAH DI INDONESIA

IODINE INTAKE AMONG SCHOOL-AGED CHILDREN IN INDONESIA Iodine Deficiency Disorders (IDD) has been recognized in many areas mainly around volcanoes in Indonesia for a long time. Fortification of salt with iodine has been used for national IDD control for over two decades. Monitoring survey of iodized salt was conducted regularly by Central Bureau of Statistics and Ministry of Health. In 2007, national survey on iodine was conducted by Ministry of Health through Basic Health Research. The objective of this article is to study the intake of iodine through iodized salt at household level and urinary iodine concentration (UIC) among school-aged children (6-12 years). Rapid test for iodine content in households salt was carried out throughout the country (280.000 households). Meanwhile, the UIC of 8.250 children’s casual urin sample were carried out from 30 selected districts/cities. Selection of 30 districts/cities was using stratified random sampling from all districts/cities throughout the country. Overall, from the rapid test survey showed that 62,3% households salt contained sufficient iodine. Only 14% of households salt contained no iodine. The median value of UIC among school-aged children was 224 µg/L or far higher than the define population of iodine deficiency. The distribution of UIC values were as follows: 12,9% of children had UIC value less than 100 µg/L, 65,2% between 100-299 µg/L, and 21,9% had UIC value 300 µg/L or over. UIC value of 300 µg/L or over is regarded as having the risk of iodine excess. Children with UIC value 300 µg/L or over were found in almost all of the districts/cities. The majority of household salt contained iodine but has not reached the universal salt iodisation. Median value of UIC of school age children that is the proxy of iodine intake is under the tolerable upper intake level. Keywords : school aged children, household, iodized salt, urinary iodine

Assessment of the iodine status of the Wa national boarding school students in Southwest China.

Iodine deficiency disorder (IDD) has been recognized as a major public health problem worldwide and has serious detrimental effects on the growth and development of the children. Therefore, monitoring the iodine status of the school-aged children is of great importance. We randomly recruited 159 boarding school students (aged from 6 to 14) from 10 primary schools in Lincang County, Yunnan Province. The dietary iodine level of the students was measured by the new mixed meal method and chemical analysis. Fifty-seven daily water samples and 32 salt samples were collected from the same surveyed area to determine the iodine content using the sulfate cerium catalytic spectrophotometric method and the hyposulphite quantitative titration method, respectively. The iodine level of each water sample was ranged from 0.611 to 1.473 μg/L. The median and the mean value of the iodine content in water were 0.972 and 0.979 ± 0.189 μg/L. The average iodine intake of each age group was higher that the recommended nutrient intakes (RNI) but lower than the tolerable upper intake level (UL). The median and the mean value of the iodine content in salt were 25.53 and 25.62 ± 1.70 mg/kg. Taken together, the present study investigated the iodine intake status of Wa school-aged children through examination of their dietary iodine intake, the environment, and the salt iodine status. Results showed that the status of the iodine uptake of the Wa children were higher than the RNI, but lower than the UL.

Mothers' behaviour contributes to suboptimal iodine status of family members: findings from an iodine-sufficient area.

Iodine deficiency still remains a major public health concern worldwide despite global progress in its elimination. The aims of the present study were to evaluate dietary iodine status in the mother and one adult member of each family and the association between mothers' knowledge, attitude and behaviour and the dietary iodine status of adult family members in Tehran. In this cross-sectional study, 24 h urinary iodine and Na concentrations and the iodine content of household salt were measured. Mothers' knowledge, attitude and behaviour were assessed using a questionnaire administered in face-to-face interviews. Health-care centres from four distinct areas of Tehran. Mother-adult family member pairs aged ≥ 19 years (n 290), enrolled through randomized cluster sampling. In mothers and adult family members, median 24 h urinary iodine concentration was 73 (interquartile range (IQR) 36-141) µg/l and 70 (IQR 34-131) µg/l, dietary iodine intake was 143 (IQR 28-249) µg/d and 130 (IQR 26-250) µg/d and dietary salt intake was 8.0 (IQR 5.9-10.2) g/d and 7.5 (IQR 5.3-10.0) g/d, respectively. Significant correlations were observed between mothers' attitude and behaviour and the 24 h urinary iodine concentration, dietary iodine intake and iodine content of salt of adult family members. In multiple analysis, lower quartiles of salt iodine content and salt intake and inappropriate behaviour scores in mothers increased the risk of urinary iodine concentration <100 µg/l in adult family members. The present study showed that mothers' behaviour, but not knowledge and attitude, was among major contributors to the suboptimal dietary iodine status observed in adult family members.

The iodized salt programme in Bangalore, India provides adequate iodine intakes in pregnant women and more-than-adequate iodine intakes in their children.

To compare the iodine status of pregnant women and their children who were sharing all meals in Bangalore, India. A cross-sectional study evaluating demographic characteristics, household salt iodine concentration and salt usage patterns, urinary iodine concentrations (UIC) in women and children, and maternal thyroid volume (ultrasound). Antenatal clinic of an urban tertiary-care hospital, which serves a low-income population. Healthy pregnant women in all trimesters, aged 18-35 years, who had healthy children aged 3-15 years. Median (range) iodine concentrations of household powdered and crystal salt were 55·9 (17·2-65·9) ppm and 18·9 (2·2-68·2) ppm, respectively. The contribution of iodine-containing supplements and multi-micronutrient powders to iodine intake in the families was negligible. Adequately iodized salt, together with small amounts of iodine in local foods, were providing adequate iodine during pregnancy: (i) the overall median (range) UIC in women was 172 (5-1024) µg/l; (ii) the median UIC was >150 µg/l in all trimesters; and (iii) thyroid size was not significantly different across trimesters. At the same time, the median (range) UIC in children was 220 (10-782) µg/l, indicating more-than-adequate iodine intake at this age. Median UIC was significantly higher in children than in their mothers (P=0·008). In this selected urban population of southern India, the iodized salt programme provides adequate iodine to women throughout pregnancy, at the expense of higher iodine intake in their children. Thus we suggest that the current cut-off for median UIC in children indicating more-than-adequate intake, recommended by the WHO/UNICEF/International Council for the Control of Iodine Deficiency Disorders may, need to be reconsidered.

Variation in iodine concentration of salt at the local level following national salt iodization in Ethiopia (804.31)

Ethiopia launched a salt iodization program in 2011. The objective of this study was to evaluate the concentration of iodine in salt 2 years after the national proclamation that all salt for human consumption should be iodized. Salt samples were collected from 193 randomly selected households in Sidama zone, southern Ethiopia. The study participants were from farming communities where more than two‐thirds of the families were subsistence farmers. Iodine concentration of salt was analyzed using a portable digital electronic iodine checker (WYD, UNICEF) and by inductively coupled plasma mass spectrometry (ICP‐MS). Correlation between the analyses was 0.69 (p&lt;0.001). Mean (±SEM) iodine concentration using the digital iodine checker was 7.8 (8.0) ppm and by ICP‐MS was 9.8 (8.6) ppm. The recommended salt iodine concentration at the household level should be 15 to 40 ppm, but in this survey varied from 0 to 41.1 ppm; only 21% of households had &gt;15 ppm. Salt samples from 10 retail shops and open markets had a mean iodine concentration of 5.3 (4.0) ppm with a range from 0 to 10.9 ppm which was far below the recommended retail level of 20‐40 ppm. The results indicate that salt may not be homogenously or adequately iodized and/or storage and handling may not be appropriate. Hence a strong monitoring strategy from production to household level for Ethiopia’s salt iodization program is of great importance.Grant Funding Source: Supported by Nestlé Foundation and Oklahoma State University

Monitoring and estimation of iodine content of edible salt in urban areas of Meerut district, after four decades of Universal Salt Iodization

Objective: It is estimated that 200 million people in India are exposed to the risk of iodine deficiency disorders (IDD). To protect future generations, Universal Salt Iodization (USI) is the mainstay of the intervention. So, we carried out the study to estimate salt iodine content at the house hold and retail level in urban areas of Meerut district of Uttar Pradesh. Method: A total no of 64 (48 from house hold and 16 from retail) samples of salt were estimated by iodometric titration method for the iodine content. Legal requirement for iodine level in India ranges from 30 parts per million (ppm) at retail level and 15ppm at consumer level. Results: We found that at retail level the range of concentrations of iodine in salt samples from Shiv Kunj, Krishna Vihar, Yadav colony, Ratan nagar. At retail level the range of concentration of iodine in salt sample was 26.5 to 33.6 ppm, 28.8 to 34.6 ppm, 31.3 to 36.8 ppm, 29.6 to 32.6 ppm respectively, while at house hold level were 12.7 to 34.6 ppm, 15.1 to 33.9 ppm, 15.8 to 38.4 ppm, 15.2 to 29.6 ppm respectively. Conclusion: Our study reveals a positive new momentum that reflects changes in India's salt industry. These changes include better production, better refining and iodization practices, improvement in salt quality, improvement to packaging, effective monitoring to iodine levels from production to consumption and better consumer awareness in the urban areas. Key words - Iodine Deficiency Disorder (IDD), Iodometric titration, Universal Salt, Iodization (USI), Urinary Iodine (UI)

Iodine Malnutrition and Associated Factors in Schoolchildren Aged 6 to 14 Years in a Municipality Situated in the Semi-Arid Region of the State of Minas Gerais, Brazil, 2008

The objective of this study was to assess the prevalence of iodine deficiency and possible correlated factors among schoolchildren in the municipality of Novo Cruzeiro-MG by means of an evaluation of urinary iodine excretion. Five hundred and forty schoolchildren aged 6 to 14 years selected by stratified sampling, were evaluated. Urine samples were analyzed using the Sandell-Kolthoff method preconized by the WHO and iodine concentrations in the salt were assessed by means of volumetric analysis, in accordance with recommendations from the Ministry of Health. Iodine deficiency was observed in 38.9% of the schoolchildren. Of these, 28.7% of them presented slight deficiency, 6.2% of them were moderately deficient and 4% of them were seriously deficient. Median urinary iodine levels in the urban and rural population were 150.8 and 119.2 μg/L, respectively, with a clear distribution of iodine deficiency among the populations (p < 0.001) being registered. It was also observed that there was a high prevalence of deficient urinary iodine excretion among schoolchildren that consumed salt with an insufficient iodine content. In relation to the quality of the salt consumed by families, in 12.2% of the residences studied the iodine content in salt was below the recommended level (20 mg/kg), while the iodine content was below 15 mg/kg in only 5.3% of them. The results indicated that, although not characterized as a public health issue, according to WHO criteria, iodine deficiency showed very high prevalence among schoolchildren in this region. Regarding the iodine content of salt found in household consumption, our findings indicated the National Program of Salt Iodination was not efficient in the city, since it did not hit the target proposed by the Ministry of Health. Furthermore, low urinary iodine excretion associated with the consumption of salt with low iodine content suggests the need for periodical evaluations in order to provide effective control of the endemic disease.

Goiter prevalence, urinary iodine, and salt iodization level in sub-Himalayan Darjeeling district of West Bengal, India

National iodine deficiency disorders control program needs to be continuously monitored. Hence, a cross-sectional study was conducted during the period from April-May 2011 to assess the prevalence of goiter, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level in Darjeeling district, West Bengal. Study subjects were 2400 school children, aged 8-10 years selected through "30 cluster" sampling methodology. Goiter was assessed by standard palpation technique, UIE was estimated by wet digestion method and salt samples were tested by spot iodine testing kit. Overall goiter prevalence rate was 8.7% (95% confidence intervals = 7.6-9.8) and goiter prevalence was significantly different with respect to gender. Median UIE level was 15.6 mcg/dL (normal range: 10-20 mcg/dL). About 92.6% of the salt samples tested had adequate iodine content of ≥15 ppm. Findings of the present study indicate that the district is in a transition phase from iodine-deficiency to iodine sufficiency.

Successful implementation of a laboratory iodization quality assurance system in small-scale salt production facilities in India.

To establish a laboratory iodization quality assurance system to support small-scale salt production facilities in India and to assess the level of agreement for the internal quality assurance (IQA) and external quality assurance (EQA) protocols. Operational research. The IQA and EQA programme was established in the year 2008. Agreement between field laboratories and the reference laboratory for estimation of iodine content of salt from 2008 to 2011 was assessed. Agreement was assessed using the χ 2 test, kappa statistics and the Bland-Altman plot. Small-scale salt producers in the states of Andhra Pradesh, Gujarat, Rajasthan, Tamil Nadu, Odisha and Karnataka; 'field laboratories' supporting the small-scale salt producers; and the 'reference laboratory' of the Regional Office (South Asia) of the International Council for the Control of Iodine Deficiency Disorders. Three hundred small-scale salt producers in the states of Andhra Pradesh, Gujarat, Rajasthan, Tamil Nadu, Odisha and Karnataka and seventeen 'field laboratories'. A total of 6573 salt samples for IQA and 347 salt samples for EQA were exchanged between field and reference laboratories during 2008-2012. Out of the total salt sample exchanges, 527 were from Andhra Pradesh and Odisha, 2343 from Gujarat, 2016 from Rajasthan and 1677 from Tamil Nadu and Karnataka. The overall between-laboratory agreement was for 61·6 % for IQA and 64·8 % for EQA. The mean difference between iodine content estimation of field laboratories and the reference laboratory was 0·3 ppm (sd 8·2 ppm) for IQA and -0·3 ppm (sd 3·5 ppm) for EQA. Our study successfully documents implementation of a laboratory iodization quality assurance protocol in laboratories supporting small-scale salt production facilities in India.