Background Iodine is a trace element required for the synthesis of thyroid hormones. The multiple effects of iodine deficiency on human health are called iodine deficiency disorders (IDDs). IDDs have been common nutritional problems in Ethiopia. In 2012, Ethiopia launched a national salt iodization program to address IDDs. The objective of this study was to assess the effects of this program after 5 years by measuring urinary iodine concentration (UIC) and prevalence of goiter in school age children as well as household salt iodine concentration (SIC). Methods A school-based cross-sectional design was employed. After ethical approval, 408 children from eight randomly selected primary schools provided urine samples. UIC was analyzed by inductively coupled plasma mass spectrophotometry (ICP-MS). A 10 g salt sample was collected from each household of a sampled child. SIC was analyzed with a digital electronic iodine checker (WYD, UNICEF) and goiter was assessed by palpation. Results The mean (±SD) age of the children was 9 ± 2 years. The prevalence of goiter was 4.2% and no child had grade 2 goiter. The median (IQR) UIC was 518 (327, 704) μg/L and UIC ranged from 3.1 to 2530 μg/L. Of the salt samples, 15.6% were not adequately iodized (< 15 ppm), 39.3% were adequately iodized (≥15 to ≤40 ppm), and 45.1% were > 40 ppm. SIC ranged from 4.2 to 195 ppm. Of the mothers, 92% said iodized salt prevents goiter and 8% mentioned prevents mental retardation. Conclusions In 2017 iodine deficiency was no longer a public health problem in the study area. However, the high variability in UIC and SIC and excessive iodine intake are of great concern. It is vital to ensure that salt is homogenously iodized at the production site before being distributed to consumers.
Aflatoxins are mycotoxins that can contaminate grains, legumes, and oil seeds. These toxic compounds are an especially serious problem in tropical and sub-tropical climates. The objective of this study was to raise awareness of aflatoxin exposure among primary school children in Shebedino woreda, southern Ethiopia, by measuring urinary aflatoxin M1 (AFM1). The study employed a cross-sectional design and systematic random sampling of children from eight schools in the district. The mean ± SD age of the children was 9.0 ± 1.8 years. Most (84.6%) households were food insecure with 17.9% severely food insecure. Urinary AFM1 was detected in more than 93% of the children. The median [IQR] concentration of AFM1/Creat was 480 [203, 1085] pg/mg. Based on a multiple regression analysis: DDS, consumption of haricot bean or milk, source of drinking water, maternal education, and household food insecurity access scale scores were significantly associated with urinary AFM1/Creat. In conclusion, a high prevalence of urinary AFM1 was observed in this study. However, the relation between AFM1 and dietary intake was analyzed based on self-reported dietary data; hence, all of the staple foods as well as animal feeds in the study area should be assessed for aflatoxin contamination.
Ethiopia launched a salt iodization program in 2011. The objective of this study was to evaluate the concentration of iodine in salt 2 years after the national proclamation that all salt for human consumption should be iodized. Salt samples were collected from 193 randomly selected households in Sidama zone, southern Ethiopia. The study participants were from farming communities where more than two‐thirds of the families were subsistence farmers. Iodine concentration of salt was analyzed using a portable digital electronic iodine checker (WYD, UNICEF) and by inductively coupled plasma mass spectrometry (ICP‐MS). Correlation between the analyses was 0.69 (p<0.001). Mean (±SEM) iodine concentration using the digital iodine checker was 7.8 (8.0) ppm and by ICP‐MS was 9.8 (8.6) ppm. The recommended salt iodine concentration at the household level should be 15 to 40 ppm, but in this survey varied from 0 to 41.1 ppm; only 21% of households had >15 ppm. Salt samples from 10 retail shops and open markets had a mean iodine concentration of 5.3 (4.0) ppm with a range from 0 to 10.9 ppm which was far below the recommended retail level of 20‐40 ppm. The results indicate that salt may not be homogenously or adequately iodized and/or storage and handling may not be appropriate. Hence a strong monitoring strategy from production to household level for Ethiopia’s salt iodization program is of great importance. Grant Funding Source: Supported by Nestlé Foundation and Oklahoma State University
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