Goiter prevalence and median urinary iodine concentration in Ethiopian reproductive age women and school age children

Abstract

Background: Iodine deficiency occurs when the diet is low in iodine. Goiter prevalence in school-age children is an important indicator of iodine deficiency disorders in a population. Urinary iodine concentration is the prime indicator of a person’s recent nutritional iodine intake. The effectiveness of universal salt iodization is reflected by an increase in urinary iodine excretion in school age children.

Objective: To assess goiter rate and urinary iodine level in reproductive age women and school age children in Ethiopia.

Method: National and regional representative cross-sectional study was conducted. Data was collected from 356 enumeration areas across the country. Households with in each enumeration area were selected randomly. Goiter examination was done by trained data collectors with background of nursing, laboratory technician and nutritionists using WHO goiter categorization. Urine samples were collected from reproductive age women and school age children. Urinary iodine excretion was determined by the Sandell–Kolthoff reaction method.

Results: The prevalence of goiter was 10.8% in reproductive age women and 3.7% in school age children. Highest goiter rate was found in Benishangul/Gumuz (28%) and Tigray (20%) regions. There was goiter rate and median urinary iodine concentration difference between regions. Median urinary iodine concentration was 106 µg/l in school age children and 98 µg/l in reproductive age women with cumulative median urinary iodine at national level of 101.1µg/l. Half of school age children and reproductive age women were getting adequate iodine intake. Based on rapid test kit assessment, the coverage of iodized salt was around 85%, but only 26% of the household gets adequate iodized salt (>15 ppm).

Conclusion: There is promising progress to eliminate iodine deficiency disorder in Ethiopia. Adequately iodized salt intake is very limited in both age groups. Considering that the presence of both iodine deficiency and excessive intake in Ethiopia, health planners and programmers needs to focus on standardizing salt iodization process and strengthening control of illegal non-iodized salt trading