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BackgroundIodine deficiency is a major public health problem in many developing countries including Nepal. The present study was designed to investigate the urinary iodine excretion (UIE), thyroid function status and household salt iodine content (SIC) in school-aged children (SAC) and to establish the relationships between these factors.MethodsA community-based cross sectional study was conducted in selected schools of two districts, Tehrathum and Morang, lying in the hill and plain region of eastern Nepal respectively. A total of 640 SAC, (Tehrathum n = 274 and Morang n = 366) aged 6–11 years, were assessed for UIE and household SIC. Among the 640 children, 155 consented to blood samples (Tehrathum n = 78 and Morang n = 77) to test for serum thyroglobulin (Tg), thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4). UIE was measured by ammonium persulfate digestion method. SIC was measured by iodometric titration method and Tg, TSH, fT4 and fT3 were measured by immunoassay based kit method.ResultsIn Tehrathum and Morang, 9.5 and 7.7 % of SAC had UIE values of UIE <100 µg/L while 59.5 and 41 % had iodine nutrition values of >299 µg/L, with median UIE of 345.65 and 270.36 µg/L respectively. The overall medians were as follows, Tg 14.29 µg/L, fT3 3.94 pmol/L, fT4 16.25 pmol/L and TSH 3.61 mIU/L. There was a negative correlation between UIE and Tg (r = −0.236, p = 0.003) and a positive correlation between UIE and SIC (r = 0.349, p < 0.0001). We found 19.5 %, n = 15 and 16.7 %, n = 13 subclinical hypothyroid cases in Morang and Tehrathum respectively. Iodometric titration showed only 6.4% (n = 41) of the samples had household SIC <15 ppm. Multivariate analysis revealed that use of packaged salt by SAC of Tehrathum district correlated with higher UIE values.ConclusionsOur focused data suggests that collaborative universal salt iodization (USI) programs are improving the health of children in the Tehrathum and Morang districts of Nepal. We also found that excessive iodine in a large portion of the study groups is a substantial concern and iodine intervention programs need to deal with both deficient and excessive iodine scenarios that can both be present simultaneously in study populations.

There was good improvement in iodine nutrition among children in Terai region, with a large part of population showing excessive iodine nutrition.

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Anemia is one of the most common public health problems in developing countries like Nepal. This study was done to find the prevalence of anemia among the children aged 4-13 years in eastern Nepal. A cross-sectional study was conducted in 2012 in four districts (Morang, Udayapur, Bhojpur and Ilam) of eastern Nepal to find the prevalence of anemia among the school children of eastern Nepal. Children aged 4-13 years were selected randomly from different schools of above districts and 618 venous blood samples were collected. Hemoglobin level was estimated by using cyanmethemoglobin method. The mean hemoglobin level was 12.2 ± 1.82 gm/dl. About 37.9% (n = 234) children were found anemic. Anemia prevalence was 42.4% (n = 78), 31.6% (n = 60), 45.3% (n = 48) and 34.8% (n = 48) among school children of Morang, Udayapur, Bhojpur and Ilam district, respectively. The study finds anemia as a significant health problem among the school children of eastern Nepal.

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Background: Universal salt iodization remains the best strategy for controlling iodine deficiency disorders in Nepal.Aims: This study was designed to study the salt types and the household salt iodine content of school aged children in the hilly and the plain districts of eastern Nepal. Material and Methods:This cross-sectional study was carried out on school children of seven randomly chosen schools from four districts, namely, Sunsari, Dhankuta, Sankhuwasabha and Tehrathum of eastern Nepal. The school children were requested to bring two teaspoonfuls (approx. 12-15 g) of the salt which was consumed in their households, in a tightly sealed plastic pouch. The salt types were categorized, and the salt iodine content was estimated by using rapid test kits and iodometric titrations. The association of the salt iodine content of the different districts were tested by using the Chi-square test. The sensitivity, specificity, positive predictive values, and negative predictive values of the rapid test kits were compared with the iodometric titrations.Results: Our study showed that mean±SD values of the salt iodine content in the four districts, namely, Sunsari, Dhankuta, Sankhuwasabha and Tehrathum were 34.2±17.9, 33.2±14.5, 27.4±15.1 and 48.4±15.6 parts per million (ppm). There were 270 (38.2%) households which consumed crystal salt and 437(61.8%) of the households consumed packet salts. Conclusions:Our study recommends a regular monitoring of the salt iodization programs in these regions. More families should be made aware of the need to ensure that each individual consumes iodized salt.AshWini KumAr nepAl, prem rAj shAKyA, BAsAntA GelAl, mAdhAB lAmsAl, dAvid A Brodie, nirmAl BArAl

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