Salt iodisation and public health campaigns to eradicate iodine deficiency disorders in Armenia

2003 ◽  
Vol 6 (5) ◽  
pp. 463-469 ◽  
Author(s):  
Laura Rossi ◽  
Francesco Branca
Keyword(s):  
Iodine Deficiency ◽  
Control Measure ◽  
Urinary Iodine ◽  
Vulnerable Groups ◽  
Urinary Iodine Excretion ◽  
Urinary Iodine Concentration ◽  
Iodine Deficiency Disorders ◽  
Children Under Five ◽  
Iodised Salt ◽  
Under Five

AbstractBackground:Iodine deficiency disorders (IDD) are endemic in the mountain regions of Armenia. Universal salt iodisation has been chosen as the control measure.Objectives:(1) To measure the prevalence of iodine deficiency in the Armenian population; (2) to evaluate household use of iodised salt; and (3) to monitor iodised salt promotion strategies.Design:Cross-sectional study on a nationally representative sample of 2627 households, including 3390 children under five and 2649 women of fertile age. Cluster sampling design on four population strata: residents, refugees, rural and urban.Results:Thyroid was palpable in one-third of the women, 6% of them having a visible goitre. Median of urinary iodine excretion in children was 139.5 μgl−1. One-third of the children showed low urinary iodine concentration. Iodised salt was consumed in 66% of the households. The national IDD control programme included modernisation of the Yerevan Salt Factory, legislative regulation of the iodine content of the salt, and public information by the media.Conclusions:Armenia was still an endemic zone for goitre in 1997. The iodine status of children under five in 1997 was not considered alarming even though 33% of them had low values of urinary iodine. After four years of intervention strategies, the use of iodised salt has increased by 17%. Further efforts should be made to control salt imports and to monitor IDD indicators in vulnerable groups.

scholarly journals Adequately iodized salt is an important strategy to prevent iodine insufficiency in pregnant women living in Central Java, Indonesia

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242575
Author(s):  
Ina Kusrini ◽  
Jessica Farebrother ◽  
Donny Kristanto Mulyantoro
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Interquartile Range ◽  
Iodized Salt ◽  
Vulnerable Groups ◽  
Urinary Iodine Excretion ◽  
Urinary Iodine Concentration

Iodine is an essential micronutrient for cognitive development and growth. Optimal intakes are critical during pregnancy. We report the iodine status and thyroid function of pregnant women living in areas previously affected by severe iodine deficiency and in longstanding iodine sufficient areas in Java, Indonesia. This cross-sectional study was conducted in Magelang, Java, from July to November 2015, in four sub-districts; two previously affected by severe iodine deficiency (area 1) and two that were iodine-sufficient (area 2). Iodine intake was estimated using median urinary iodine concentration in spot samples and mean urinary iodine excretion in 3 x 24-hour samples, thyroid hormones (thyroid-stimulating hormone and free thyroxine) were measured in venous blood samples, and iodine content of household salt samples was estimated by titration. We recruited a total of 244 pregnant women, 123 in area 1 and 121 in area 2. Urinary iodine results suggested adequate habitual iodine intakes in both areas (median urinary iodine concentration in area 1: 222 μg/l (interquartile range 189, 276 μg/l), area 2: 264 μg/l (interquartile range 172, 284 μg/l), however, the risk of inadequate intakes increased with advancing trimester (Odds Ratio = 2.59 (95% CI 1.19–5.67) and 3.85 (95% CI 1.64–9.02) at second and third trimesters, respectively). Estimated prevalence of thyroid function disorders was generally low. Salt was iodized to approximately 40 ppm and foods rich in native iodine did not contribute significantly to dietary intakes. Adequately iodized salt continues to prevent iodine insufficiency in pregnant women living in areas previously affected by severe iodine deficiency in Java, Indonesia. Monitoring and surveillance, particularly in vulnerable groups, should be emphasized to ensure iodine sufficiency prevails.

scholarly journals Persistence of severe iodine-deficiency disorders despite universal salt iodization in an iodine-deficient area in northern India

2009 ◽  
Vol 13 (3) ◽  
pp. 424-429 ◽  
Author(s):  
Subhash Yadav ◽  
Sushil Kumar Gupta ◽  
Madan M Godbole ◽  
Manoj Jain ◽  
Uttam Singh ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Vulnerable Groups ◽  
Urinary Iodine Concentration ◽  
Iodine Deficiency Disorders ◽  
Cross Sectional Survey ◽  
Iodine Nutrition ◽  
Salt Iodization ◽  
Goitre Prevalence ◽  
The Impact

AbstractObjectiveThe aim of the present study was to determine the impact of universal salt iodization (USI) on the prevalence of iodine deficiency in the population of an area previously known to have severe iodine deficiency in India.DesignIn a cross-sectional survey, a total of 2860 subjects residing in fifty-three villages of four sub-districts of Gonda District were examined for goitre and urinary iodine concentration. Free thyroxine and thyroid-stimulating hormone levels were also measured. Salt samples from households were collected for estimation of iodine content.ResultsA reduction in goitre prevalence was observed from 69 % reported in 1982 to 27·7 % assessed in 2007. However, 34 % of villages still had very high endemicity of goitre (goitre prevalence >30 %). Twenty-three per cent of households consumed a negligible amount (<5 ppm) and 56 % of households consumed an insufficient amount (5–15 ppm) of iodine from salt.ConclusionsAlthough there was an overall improvement in iodine nutrition as revealed by decreased goitre prevalence and increased median urinary iodine levels, there were several pockets of severe deficiency that require a more targeted approach. Poor coverage, the use of unpackaged crystal salt with inadequate iodine and the washing of salt before use by 90 % of rural households are the major causes of persisting iodine-deficiency disorders. This demonstrates lapses in USI implementation, lack of monitoring and the need to identify hot spots. We advocate strengthening the USI programme with a mass education component, the supply of adequately iodized salt and the implementation of complementary strategies for vulnerable groups, particularly neonates and lactating mothers.

scholarly journals Thyroid ultrasound compared with World Health Organization 1960 and 1994 palpation criteria for determination of goiter prevalence in regions of mild and severe iodine deficiency

2000 ◽  
pp. 727-731 ◽  
Author(s):  
M Zimmermann ◽  
A Saad ◽  
S Hess ◽  
T Torresani ◽  
N Chaouki
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Classification Systems ◽  
World Health ◽  
Urinary Iodine Concentration ◽  
Thyroid Ultrasound ◽  
Iodine Deficiency Disorders ◽  
Goiter Prevalence

OBJECTIVES: In 1994, WHO/International Council for the Control of Iodine Deficiency Disorders recommended replacing the WHO 1960 four-grade goiter classification with a simplified two-grade system. The effect of this change in criteria on the estimation of goiter prevalence in field studies is unclear. In areas of mild iodine deficiency disorders (IDD) where goiters are small, ultrasound is preferable to palpation to estimate goiter prevalence. However, in areas of moderate to severe IDD, goiter screening by palpation may be an acceptable alternative to thyroid ultrasound. To address these two issues, we compared WHO 1960 and 1994 criteria with thyroid ultrasound for determination of goiter prevalence in areas of mild and severe IDD in Morocco. DESIGN: A cross-sectional study of 400 six- to 13-year-old children from two mountain villages (Ait M'hamed and Brikcha) in rural Morocco was carried out. METHODS: Urinary iodine concentration (UI), whole blood TSH and serum thyroxine were measured. Thyroid size was graded by inspection and palpation by two examiners using both WHO 1960 and 1994 criteria. Thyroid volume was determined by ultrasound. Variation between examiners and examination methods was assessed. Sensitivity and specificity of the two classification systems compared with ultrasound were calculated. RESULTS: Median UIs in Ait M'hamed and Brikcha were 183 and 24 microg/l respectively. In Ait M'hamed, using 1960 and 1994 criteria, goiter prevalence was 21 and 26% respectively, compared with 13% by ultrasound. In Brikcha, with 1960 and 1994 criteria, goiter prevalence was 64 and 67% respectively, compared with 64% by ultrasound. Agreement between observers was better with the 1994 criteria than with the 1960 criteria in Ait M'hamed (kappa=0.53 and 0.47 respectively), while in Brikcha observer agreement was similar with the two systems (kappa=0.67). Using either the 1994 or 1960 criteria, agreement with ultrasound was only moderate in Ait M'hamed (kappa=0.41-0.44), but good in Brikcha (kappa=0.55-0.64). Overall, compared with ultrasound, sensitivity increased 3-4% using 1994 criteria, while specificity decreased 4-5%. CONCLUSIONS: The WHO 1994 criteria are simpler to use than the 1960 criteria and provide increased sensitivity with only a small reduction in specificity. Agreement between observers is better with the 1994 criteria than with the 1960 criteria, particularly in areas of mild IDD. Like the 1960 criteria, the 1994 criteria overestimate goiter prevalence in areas of mild IDD, compared with ultrasound. However, the 1994 palpation criteria provide an accurate estimate of goiter prevalence in areas of severe IDD, and may be an acceptable and affordable alternative to thyroid ultrasound in these areas.

scholarly journals Iodine Intake and Thyroid Function in Pregnant Women in a Private Clinical Practice in Northwestern Sydney before Mandatory Fortification of Bread with Iodised Salt

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Norman Blumenthal ◽  
Karen Byth ◽  
Creswell J. Eastman
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
Blood Collection ◽  
Antenatal Visit ◽  
Urinary Iodine Concentration ◽  
Cross Sectional

Aim. The primary objective of the study was to assess the iodine nutritional status, and its effect on thyroid function, of pregnant women in a private obstetrical practice in Sydney.Methods. It was a cross-sectional study undertaken between November 2007 and March 2009. Blood samples were taken from 367 women at their first antenatal visit between 7 and 11 weeks gestation for measurement of thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels and spot urine samples for urinary iodine excretion were taken at the same time as blood collection.Results. The median urinary iodine concentration (UIC) for all women was 81 μg/l (interquartile range 41–169 μg/l). 71.9% of the women exhibited a UIC of <150 μg/l. 26% of the women had a UIC <50 μg/l, and 12% had a UIC <20 μg/l. The only detectable influences on UIC were daily milk intake and pregnancy supplements. There was no statistically significant association between UIC and thyroid function and no evidence for an effect of iodine intake on thyroid function.Conclusions. There is a high prevalence of mild to moderate iodine deficiency in women in Western Sydney but no evidence for a significant adverse effect on thyroid function. The 6.5% prevalence of subclinical hypothyroidism is unlikely to be due to iodine deficiency.

scholarly journals Urinary iodine excretion in urine samples among children in Dang district, Gujarat

2017 ◽  
Vol 4 (7) ◽  
pp. 2339
Author(s):  
Rahul Damor ◽  
Jatin Chhaya ◽  
Sukesha Gamit ◽  
Jayant Patel ◽  
J. K. Kosambiya
Keyword(s):  
Iodine Deficiency ◽  
Primary Schools ◽  
Urinary Iodine ◽  
Human Growth ◽  
Iodine Intake ◽  
Urine Samples ◽  
Urinary Iodine Excretion ◽  
Urinary Iodine Concentration ◽  
Cross Sectional ◽  
Iodine Excretion

Background: Iodine is an essential micronutrient required for normal human growth and development as it is needed for the synthesis of thyroid hormones produced by thyroid glands. The sicknesses occurred due to deficiencies of iodine in the nutrition are termed iodine deficiency disorders. Urinary iodine concentration is the prime indicator of a person’s nutritional iodine status. So, the aim of this study was to assess the status of iodine deficiency based on median urinary iodine excretion.Methods: Community based cross sectional study was carried out among purposively selected primary schools of the Dang district. All students between the age group of 6 to 12 years who were present on the day of visit were included in the study. A total 387 urine samples were collected during the period of August 2015 to September 2016.Results: Based on median urinary iodine excretion, among total analysed samples, about 6.5% samples confirmed severe iodine deficiency, 22% samples showed moderate iodine deficiency and about 36% samples indicated mild iodine deficiency. About one third (31.3%) samples suggested optimum iodine intake. Only few samples (4.4%) revealed more than required iodine intake.Conclusions: About one third (31.3%) of the surveyed population had adequate iodine intake while majority (64.4%) of them had inadequate iodine intake. 

scholarly journals Association of Iodine-Related Knowledge, Attitudes, and Behaviours with Urinary Iodine Excretion in Pregnant Women with Mild Iodine Deficiency

2020 ◽  
Author(s):  
Zhengyuan Wang ◽  
Yiwen Wu ◽  
Zehuan Shi ◽  
Jun Song ◽  
Guoquan Wang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Significant Risk ◽  
First Trimester ◽  
Iodized Salt ◽  
Urinary Iodine Excretion ◽  
Urinary Iodine Concentration ◽  
Third Trimester ◽  
The Third

Abstract Background: China’s universal salt-iodization program has all but eliminated iodine deficiency disorders. Concern has shifted to mild iodine deficiency. Our study examined factors with the potential to predict mild iodine deficiency in pregnant women. Methods: A total of 2 400 pregnant women were enrolled using a multistage, stratified, random-sampling method. Data were collected through face-to-face interviews, a standardized questionnaire, an iodine-related knowledge questionnaire, urine samples, and household cooking salt samples. Results: The median urinary iodine concentration (MUIC) was 148.0 μg/L for all participants, and 155.0 μg/L, 151.0 μg/L, and 139.6 μg/L in the first, second, and third trimesters, respectively. The third trimester’s MUIC was significantly lower than that of the first trimester, and the usage rates of iodized salt and qualified-iodized salt were 71.5% and 59.4%, respectively. Iodine-related knowledge was significantly different between the high and low UIC groups. Participants’ MUIC increased significantly with increases in iodine-related knowledge. The third trimester was a significant risk factor for high UIC, whereas abundant iodine-related knowledge, study the dietary knowledge urgently, and consumption of iodine-rich food within 48 hours of a urine iodine test were significant protective factors for high UIC (P<0.05). Conclusions: Iodine levels are adequate among pregnant women in Shanghai during the first and second trimesters, but insufficient in the third trimester. The use of iodized cooking salt does not determine the iodine status of pregnant women. Abundant iodine-related knowledge is important for pregnant women in the third trimester to maintain adequate urinary iodine.

scholarly journals Iodine status, and knowledge about iodine deficiency disorders in adolescent school girls aged 14-19 years, 2016

2019 ◽  
Vol 9 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Zahra Heidari ◽  
Seyed Rafie Arefhosseini ◽  
Mehdi Hedayati ◽  
Elnaz Vaghef-Mehrabany ◽  
Mehrangiz Ebrahimi-Mameghani
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Food Sources ◽  
Urinary Iodine Excretion ◽  
Cluster Sampling ◽  
Iodine Deficiency Disorders ◽  
Significant Positive Association ◽  
Iodine Status ◽  
Rich Food ◽  
School Girls

Background: Adequate iodine intake by women in child-bearing age affects fetus neurodevelopment during pregnancy. A majority of previous studies has investigated iodine status among children, and there is limited data on female adolescents who are more exposed to consequences of iodine deficiency (ID) in their near-future pregnancies; thus, we aimed to assess iodine status, and knowledge on iodine deficiency disorders (IDDs) among adolescent school girls (14-19 years old) in Shahriar, Iran. Methods: This cross-sectional study was conducted among 223 female students selected through multi-stage cluster sampling from 12 schools. Iodine and creatinine concentrations were measured in casual urine samples. Iodine content of household salts was also assessed.Data on intake of salt and iodine-rich food sources were collected applying a food frequency questionnaire (FFQ), and knowledge about iodine and IDDs were assessed by a questionnaire. Results: Median and Mean (95% CI) concentrations of urinary iodine and creatinine were 129 µg/L, 137.62 µg/L (95% CI: 126.28, 148.95) and 1.72 g/L, 1.86 g/L (95% CI: 0.55-3.17),respectively. The frequency of mild, moderate and severe ID were 22.4%, 14.3% and 0%,respectively; 43.5% had adequate, and 3.1% had excessive urinary iodine levels. Mean saltiodine concentration was 21.69 (SD=10.56) ppm. Mean knowledge score was 12.7 (SD=3.44).About half of the students had a poor (25.1%) or fair (24.2%) knowledge about iodine deficiency.Adjusting for the confounders, no significant positive association was found between knowledge about iodine-rich food sources and goitrogens with urinary iodine excretion. Conclusion: Adolescent girls in Shahriar had relatively poor knowledge of iodine, and about one third of them suffered from ID.

scholarly journals Iodine deficiency among Italian children and adolescents assessed through 24-hour urinary iodine excretion

2019 ◽  
Vol 109 (4) ◽  
pp. 1080-1087 ◽  
Author(s):  
Angelo Campanozzi ◽  
Irene Rutigliano ◽  
Paolo E Macchia ◽  
Gianpaolo De Filippo ◽  
Antonio Barbato ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
Urinary Iodine Concentration ◽  
Age Related ◽  
Italian Regions ◽  
Significant Difference ◽  
Iodine Excretion

ABSTRACTBackgroundIodine is an essential micronutrient for intellectual development in children. Information on iodine intakes based on 24-h urinary iodine excretion (UIE) is scant, because iodine status is only assessed by the measurement of urinary iodine concentration (UIC) in spot urine samples.ObjectivesThe aim of our study was to evaluate the iodine intake of school-age children and adolescents, using UIE measurement in 24-h urine collections.MethodsThe study population included 1270 healthy subjects (677 boys, 593 girls) aged 6–18 y (mean age ± SD: 10.3 ± 2.9) from 10 Italian regions. Daily iodine intake was estimated as UIE/0.92, based on the notion that $\sim$92% of the dietary iodine intake is absorbed. The adequacy of intakes was assessed according to the Dietary Reference Values for iodine of the European Food Safety Authority (EFSA). Body mass index (BMI) and UIC were also measured for each subject.ResultsBased on the scientific opinion of EFSA, 600 of 1270 subjects (47.2%) had a lower than adequate iodine intake, with a higher prevalence among girls (54.6%) compared with boys (40.2%) (P < 0.001). Although UIE and 24-h urinary volumes increased with age (P < 0.001), a progressive decrease in the percentage of subjects with iodine excretion <100 µg/24 h (P < 0.001) was observed, without any significant difference in the percentage of subjects with UIC <100 µg/L. No significant association was detected between BMI z-score and UIE (P = 0.603) or UIC (P = 0.869).ConclusionsA sizable proportion of our population, especially girls, appeared to be at risk of iodine inadequacy. The simple measurement of UIC could lead to underestimation of the occurrence of iodine deficiency in younger children, because of the age-related smaller urine volumes producing spuriously higher iodine concentrations.

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

2015 ◽  
Vol 18 (14) ◽  
pp. 2523-2529 ◽  
Author(s):  
Fuad I Abbag ◽  
Saeed A Abu-Eshy ◽  
Ahmed A Mahfouz ◽  
Suliman A Al-Fifi ◽  
Hussein El-Wadie ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Iodine Deficiency ◽  
Water Samples ◽  
Urinary Iodine ◽  
Iodine Content ◽  
National Study ◽  
Urinary Iodine Concentration ◽  
Iodine Deficiency Disorders ◽  
Table Salt ◽  
Salt Iodization

AbstractObjectiveTo 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.DesignCross-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.SettingsThe Aseer region, south-western Saudi Arabia.SubjectsSchoolchildren aged 8–10 years.ResultsThe 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.ConclusionsThe 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.

scholarly journals Current trends of 24-h urinary iodine excretion in German schoolchildren and the importance of iodised salt in processed foods

2011 ◽  
Vol 106 (11) ◽  
pp. 1749-1756 ◽  
Author(s):  
Simone A. Johner ◽  
Anke L. B. Günther ◽  
Thomas Remer
Keyword(s):  
Urinary Iodine ◽  
Iodine Concentration ◽  
Urinary Iodine Excretion ◽  
Urinary Iodine Concentration ◽  
Processed Foods ◽  
Food Groups ◽  
Linear Regression Models ◽  
Iodine Status ◽  
Iodised Salt ◽  
Iodine Excretion

Worldwide, the iodisation of salt has clearly improved iodine status. In industrialised countries, iodised salt added to processed food contributes most to iodine supply. Yet it is unclear as to what extent changes in the latter may affect the iodine status of populations. Between 2004 and 2009, 24-h urinary iodine excretions (UIE) were repeatedly measured in 278 German children (6 to 12 years old) of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study (n707). Na excretion measurements and simultaneously collected 3-d weighed dietary records provided data on intakes of the most important dietary sources of iodine in the children's diet. Actual trends of UIE (2004–9) and contributions of relevant food groups were analysed by mixed linear regression models. Longitudinal regression analysis showed a plateau of UIE in 2004–6; afterwards, UIE significantly decreased till 2009 (P = 0·01; median 24-h UIE in 2004–6: 85·6 μg/d; 2009: 80·4 μg/d). Median urinary iodine concentration fell below the WHO criteria for iodine sufficiency of 100 μg/l in 2007–9. Salt, milk, fish and egg intake (g/d) were significant predictors of UIE (P < 0·005); and the main sources of iodine were salt and milk (48 and 38 %, respectively). The present data hint at a beginning deterioration in the iodine status of German schoolchildren. A decreased use of iodised salt in industrially produced foods may be one possible reason for this development. Because of the generally known risks for cognitive impairment due to even mild iodine deficits in children, a more widespread use of iodised salt, especially in industrially processed foods, has to be promoted.

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