The Use of Iodized Salt and Iodine Deficiency Disorders ( IDD ) : The Saudi Arabian Experience (original) (raw)
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Public Health Nutrition, 2017
Objective: Low iodine intakes are associated with goitre and other iodinedeficiency disorders (IDD) that have affected billions of people worldwide. We aimed to assess total goitre rate (TGR) and urinary iodine concentration (UIC) in schoolchildren between 2007 and 2015, percentage of iodized salt consumption by households, and salt iodine content at production, distribution and household levels in northwest Iran. Design/Setting/Subjects: UIC assessed among schoolchildren in nine consecutive years; 240 schoolchildren aged 8-10 years selected by systematic random sampling each year in the West Azerbaijan Province. Results: Median UIC was >100 μg/l in all years. More than 50 % of children had iodine deficiency (UIC ≤ 99 μg/l) in 2010 and 2011, while this rate was approximately 15-35 % in other years. Proportion with UIC below 50 μg/l was <20 % in all years except 2010 and 2011. Excessive UIC (≥300 μg/l) rate was between 5•4 and 27•5 %. TGR decreased from 44 % in 1996 to 7•6 % and 0•4 % in 2001 and 2007, respectively. Regular surveys from 2002 to 2015 showed that 98 % or more of households consumed iodized salt. Iodine level ≥20 ppm was observed in 87•5, 83 and 73 % of salt at production, distribution and household level, respectively (data from national study in 2007). The last national study in 2014 showed that median iodine level in household salt was 27 ppm. Conclusions: Our focused data suggest that the universal salt iodization programme is improving the iodine status of schoolchildren in the West Azerbaijan Province of Iran. Reduction of TGR to less than 5 % in schoolchildren indicates successful elimination of IDD as a major public health problem.
Eastern Mediterranean Health Journal
This study aimed at establishing updated data on iodine nutrition among schoolchildren in Saudi Arabia. A cross-sectional cluster survey among schoolchildren aged 8-10 years was conducted during February-April 2012. Children were clinically examined for goitre, urine and household salt samples were collected to estimate urinary iodine concenteration (UIC) and iodine content in salt. The overall goitre prevalence at the national level among 4 016 children was 4.2%. The prevalence was < 5% in all regions of the country except southern region with a prevalence of 12.7%. The median UIC of 2224 samples was 133 µg/L, with 74.3% of the surveyed children with UIC ≥ 100 µg/L. Analysis of salt samples (n = 4242) revealed that 69.8% of households were consuming adequately iodized salt. The findings suggest iodine sufficiency at the national level, however southern region still has a goitre prevalence of mild degree severity and the proportion of households consuming adequately iodized salt is still below recommendations.
Background: The iodine deficiency elimination program thatbegan two decades ago resulted in Iran becoming an iodinedeficiency disorders free country in the Middle East region.The present study was performed to evaluate the adequacy ofiodine supplementation after 17 years of universal salt iodizationin Fars province.Methods: In a cross-sectional study, 1200 schoolchildren (480girls and 720 boys) aged 8 to10 years, were randomly selectedfrom Fars province and evaluated in 2007. Goiter prevalence,urinary iodine excretion, and iodine content of household saltswere measured and the data were compared with those obtainedin 1996 and 2001.Results: Total prevalence of goiter was 1.3% (CI: 0.53-2.47)and no grade 2 goiter was found. One-tenth of the childrenenrolled for goiter assessment, were randomly selected forurinary iodine measurement. The median urinary iodine inthese 120 schoolchildren was 159.4 μg/L (85.6-252.3), with14.8% having urinary iodine excretion less than 50 μg/L. 98%of house...
Public Health Nutrition, 2015
Objective: 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. Design: 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. Subjects: Schoolchildren aged 8-10 years. Results: 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. Conclusions: 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.
Iodine nutrition status among schoolchildren after salt iodisation
Ceylon Medical Journal, 2009
Earlier studies done in Sri Lanka have indicated the importance of iodine deficiency as a public health problem. The universal salt iodisation programme has been implemented since 1995. The goals of salt iodisation are reduction of the goitre rate to <5% in school-aged children, to maintain the median urinary iodine level in the population between 100-200 µg/L and >90% of households using iodised salt. Objective To estimate the goitre prevalence, the urinary iodine level, and measure the household iodised salt consumption pattern by Province. Method A school-based study of 6574 randomly selected children in the age group 8-10 years, from 263 schools was assessed for goitre by palpation. The concentration of urinary iodine levels was measured in 2630 of these children. Estimation of iodine in the 6181 samples of salt used in households of the schoolchildren was also assessed by test kits. Results The prevalence of goitre in the Provinces varied from 16.3% to 26.2%. The median urinary iodine levels were above the cutoff point of 100 µg/L in all Provinces except in Uva. The highest median urinary iodine level was reported in North Central Province (231.3 µg/L). Overall, 35.4% of the children had urine iodine levels in the 'ideal' range (100-199.9 µg/L); 30.6% with lower values (<100 µg/L) indicated iodine deficiency and 16.3% with higher values (< 300 µg/L) indicated excessive iodine intake. Only 49.5% of households had used adequately iodised salt. Conclusions This study showed that iodine deficiency still exists in Uva Province, and that more than adequate iodine levels were found in the North Central Province. The level of permitted salt iodine at household level needs to be revised.
Iodine deficiency in Saudi Arabia
Annals of Saudi medicine, 1997
Data on the status of iodine deficiency in the Arabian peninsula is scarce. We have conducted a cross-sectional national epidemiological survey in Saudi Arabia to study the iodine status of Saudi schoolchildren, between eight and ten years, who were randomly selected, after taking into consideration the gender, provincial population and area distribution. Casual urine samples were collected and sent to the central laboratory for analysis. Clinical assessment for the presence of goiter was conducted in four areas with different geographical natures. The survey included 4638 subjects, and their median and mean (SD) of urinary iodine concentration was 18 and 17 m g/dL, respectively. We found provincial differences with respect to urinary iodine concentration and the percentage of subjects with urinary iodine concentration <10 m g/dL. The Southern province had the lowest median (11 m g/dL) and the highest percentage (45%) of subjects with urinary iodine concentration <10 m g/dL. O...
Iodine status of children (8-11 Years) in District Peshawar
A cross-sectional study was conducted in two urban (University Town and Gulberg) and two rural (Charkhana and Landi Akhoon Ahmad) communities of district Peshawar to estimate the consumption of iodized salt at household's level and to assess the prevalence of iodine deficiency disorders (IDD) by clinical and biochemical measurements. Three hundred and sixty eight households from the four communities were selected to assess the type of salt being consumed. A urine sample from every third child was also collected for urinary iodine excretion. The semi-quantitative results by rapid salt iodine spot test revealed that 67.7% of the households were consuming iodized salt and that consumption of noniodized salt in the rural areas was higher (67.93%) than that of urban areas (4.3%). The results showed that 53.27% of the children had sub-normal urinary iodine level. Similarly, amongst the different communities, children from Charkhana and Landi Akhoon Ahmad had highest prevalence of sub-clinical iodine deficiency (100%). The study concludes that there was less consumption of iodized salt in the rural communities which was associated with low median urinary iodine levels and high prevalence of sub-clinical iodine deficiency disorders.
A study to assess the iodine deficiency disorder and salt consumption pattern in Lucknow
International Journal of Community Medicine and Public Health, 2015
Background: Iodine is an essential element for thyroid function, necessary for the normal growth, development and functioning of the brain and body. In India, about 200 million people are already affected with IDD. In India, about 200 million people live at risk of IDD, whereas more than 71 million people are suffering from goiter and other IDDs. Aims and objectives: 1) To estimate the prevalence of goiter in Lucknow district. 2) To study the level of urinary iodine excretion of the study population. 3) To study the salt consumption pattern in Lucknow district. Methods: A descriptive cross sectional study was carried out amongst School children in the age group of 6 to 12 years in urban and rural areas of Lucknow district over a period of one year. A sample size of 400 was estimated. A pre structured & pre tested questionnaire was used to interview. Data was Tabulated on Microsoft excel and, analysis was carried out using Chi square test & other necessary statistical test as appropriate, using software SPSS 17.0 version. Results: A total No. of 400 children were studied. In urban areas 54% were males and 46% were females. Mean age of children were found to be 9.22 years with standard deviation of 2.28. By history, majority (79.8%) of the families were using iodized salt and only 20.3% were using non-iodized salt. Over all prevalence of goiter was 12.7%. Prevalence of goiter was more in rural areas (18%) than in urban areas (7.5%). Prevalence of goiter was more among females (19.9%) than in males (6.8%). Conclusions: To conclude, findings of the present study demonstrates that prevalence of goitre was high (12.7%) among children in Lucknow district and therefore it constitutes a public health problem in this region. Strict implementation of salt iodization and marketing in hard to reach areas is recommended as a measure to control the situation.
Nutrients, 2016
In the framework of a worldwide policy to eliminate iodine deficiency (ID) disorders, universal salt iodization was adopted in Tunisia two decades ago. The present study aims to evaluate this strategy, using both performance and impact indicators. A total of 1560 children, aged 6-12 years, were randomly sampled using a national, two-stage, stratified, cross-sectional cluster survey in 2012. Urinary iodine concentration (UIC) of the subjects, and household salt iodine content, were analyzed. The national median UIC was 220 µg/L (95% confidence interval (CI): 199-241), indicating an acceptable iodine status at the population level. Only 11.4% (95% CI: 8.6-14.9) of the children had UIC <100 µg/L, but with large regional disparities (4.3% to 25.5%, p < 0.01); however, more than a quarter of the subjects were at risk of adverse health consequences due to iodine excess. Children from households of low socioeconomic levels were more prone to inadequate UIC. The national median iodine concentration of household salt was 22 mg/kg (95% CI: 21-23). Only half of the households used adequately iodized salt (15-25 ppm), with large regional disparities. National ID rates are now well below the target criteria of WHO (World Health Organization) certification (<20% of children with UIC <50 µg/L and <50% with UIC <100 µg/L). The coverage of adequately iodized salt fell short in meeting the goals of USI (Universal Salt Iodization), i.e., >90% of households. Regular monitoring of iodized salt production lines must be strengthened with involvement by producers.