High Variability of Urinary Iodine Concentrations (UIC) and Iodine in Salt from Rural Households in Sidama Zone, Southern Ethiopia

Abstract

Objectives: To assess salt iodine concentrations (SIC) and UIC after the national proclamation that all salt for human consumption should be iodized. Methods: Salt was collected from 193 rural households. SIC was analyzed with a portable digital electronic iodine checker (WYY, UNICEF) and re-analyzed using inductively-coupled-plasma mass spectrometry (ICP-MS); correlation was 0.69 (p<0.001). Mean SIC was 7.8 (8.0) ppm with the digital iodine checker and 9.8 (8.6) ppm by ICP-MS. Results: The recommended household SIC should be 15-40 ppm but in this survey varied from 0 to 163 ppm; only 21% of households had SIC >15 ppm. Urine samples were collected from 100 members of 40 randomly selected rural households.UIC was analyzed by ICP-MS. Based on UIC classification,18% were iodine deficient which included 2% severe, 5% moderate, and 11% mild. The adequate category included 32% of participants while 26% were more than adequate and 24% were classified as excessive UIC.  The median (25, 75 percentile) UIC was 200 (118,296) with a range from 17 to 767 ug/L. Conclusions: Compared to previous UIC from the area, iodine deficiency is decreasing; however UICs now suggest some excessive iodine intakes. Salt may not be homogenously or appropriately iodized, and storage and handling may not be optimal. Hence a strong monitoring strategy from production to the household level for Ethiopia’s salt iodization program is of great importance. (Funded by Nestlé Foundation and Oklahoma State University).