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.
Based on new evidence and lessons learned within the last decade, pregnant women may not receive adequate iodized salt where the coverage of universal salt iodisation is poor. World Health Organisation has stated this could jeopardize optimal brain development of the fetus. This study was aimed to assess the iodine status of pregnant women in Sri Lanka. A cross-sectional clinic based nationally representative study was conducted. Three randomly selected antenatal clinics from each province, 30 randomly selected pregnant women from each selected clinic were included in the study. A total of 739 pregnant women were studied and casual urine samples collected to estimate iodine levels. Median urinary iodine levels in pregnant women was 113.7 g/L, which is far below the WHO recommendation between 150 and 249 μg/L indicating inadequate iodine status of pregnant women in Sri Lanka. Urine iodine distribution indicated 61.3%, 21.7%, 15.2% and 1.8% of pregnant women had an inadequate, adequate, above requirement and excessive intake respectively. Urinary iodine concentration significantly decreased with advancing pregnancy. Inadequate iodine intake was evident in 47.4%, 60.2% and 68.8% of pregnant women in the first, second and third trimester respectively. In conclusion, there is an urgent need to identify a programme to provide adequate iodine to pregnant women to ensure optimum fetal brain development.
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