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Teshome AA, Ashagrie BK, Agmas AA, Mengstie MA, Molla YM, Baye ND, Abate AW, Gebeyehu AA, Yazie TS, Chanie ES, Kassaw AW, Admasu FT, Walle GA. Prevalence of goiter and associated factors among adolescent girls in the highland area of Northwest Ethiopia. SAGE Open Med 2024; 12:20503121241229643. [PMID: 38347849 PMCID: PMC10860420 DOI: 10.1177/20503121241229643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 01/13/2024] [Indexed: 02/15/2024] Open
Abstract
Background Goiter is a common public health issue in Ethiopia; however, there is not much evidence of it among adolescent girls, especially in Northwest Ethiopia. Objective This study aimed to determine the prevalence and associated factors of goiter in adolescent girls living in the highlands of Northwest Ethiopia. Methods From 5 January to 15 February 2022, 560 adolescent girls participated in this study. A multistage sampling method was used. Participants were checked for goiter using World Health Organization guidelines. Using a quick test kit, the amount of iodine in samples of table salt was determined. After being entered into Epi Info version 7, the data were exported to the SPSS version 22 for statistical analysis. Binary logistic regression was applied. It was decided to set the statistically significant level at p < 0.05. Results In this study, the total prevalence of goiter among adolescent girls was 33.4% (95% CI: 26.3%-39.4%). The odds of goiter were 5.3 times higher among adolescents whose families had a history of goiter (AOR = 5.34, 95% CI: 3.65-9.74). The likelihood of developing goiter was 3.7 times greater among adolescent girls who consumed cabbage at least once per week (AOR = 3.74, 95% CI: 2.46-8.31). In addition, adolescent girls who did not consume meat at all were 3.3 times more likely to develop goiter (AOR = 3.32, 95% CI: 1.95-6.78). Similarly, the odds of getting goiter among adolescent girls from families who use salt with inadequate levels of iodine (0-14) were 9.84 times greater compared to their counterparts (AOR = 9.84, 95% CI: 5.61-26.24). Conclusion In the study area, goiter was very common. Therefore, the district's health sector should make an effort to raise community knowledge by spreading important messages regarding the proper use of iodized salt and food sources.
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Affiliation(s)
- Assefa Agegnehu Teshome
- Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Berhanu Kindu Ashagrie
- Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Atalo Ayenew Agmas
- Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yalew Melkamu Molla
- Department of Pediatrics and Child Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Nega Dagnaw Baye
- Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Agmas Wassie Abate
- Department of Psychiatry, Dr. Ambachew Memorial Hospital, Amhara Regional Health Bureau, South Gondar Zone, Tach Gaynt, Ethiopia
| | - Asaye Alamneh Gebeyehu
- Department of Social and Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Taklo Simeneh Yazie
- Pharmacology and Toxicology Unit, Department of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ermias Sisaye Chanie
- Department of Pediatrics and Child Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amare Wolie Kassaw
- Department of Adult Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fitalew Tadele Admasu
- Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gashaw Ayehu Walle
- Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
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Mezgebu GS, Enyew EA, Tefera BZ, Feleke FW. Nearly one-in-five households utilized inadequate iodized salt in Nifas Silk Sub-City, Addis Ababa, Ethiopia. BMC Nutr 2023; 9:96. [PMID: 37550749 PMCID: PMC10405470 DOI: 10.1186/s40795-023-00754-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 08/02/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND There is no country in the developing world where iodine deficiency is not a public health problem including Ethiopia. Therefore, this study aimed to assess inadequate utilization of iodized salt and associated factors at household level in woreda 11 Nifas Silk Sub-city, Addis Ababa, Ethiopia. METHODS A community-based cross-sectional study was conducted with multistage sampling technique on 348 household respondents. The data were collected using interviewer-administered structured questionnaires and an iodine rapid test kit. The data were edited, cleaned, and entered using Epi-data version 4.6.2 and exported to SPSS version 25 for analysis. A multivariable logistic regression model was fitted to identify associated factors for inadequate utilization of iodized salt. The statistical significance was declared at a p-value of less than 0.05 with 95% confidence interval. RESULTS A total of 348 household respondents were participated. The amount of iodine content in salt 0 ppm, < 15ppm and > 15ppm were 11.8%, 7.2% and 81.0% respectively. Total inadequate utilization of iodized salt was 19%. Using unpacked salt [AOR; 0.50 (95%CI: 0.27, 0.93)], using a container without a lid [AOR; 0.29 (95%CI: 013, 0.63)], and having insufficient knowledge [AOR; 2.10 (95%CI: 1.14, 3.86)] were all significantly connected with using inadequate iodized salt. CONCLUSIONS Iodized salt utilization was inadequate. Using containers without a lid, unpacked salt, and poor knowledge were associated factors. There should be a provision of adequate knowledge about iodized salt, a proper storage and handling.
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Affiliation(s)
- Getachew Sale Mezgebu
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
- Department of Human Nutrition, School of human nutrition and food science technology, College of agriculture, Hawassa University, P.O.BOX 05, Hawassa, Ethiopia
| | - Endalkachew Amare Enyew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Beakal Zinab Tefera
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Fentaw Wassie Feleke
- Department of Human Nutrition, School of human nutrition and food science technology, College of agriculture, Hawassa University, P.O.BOX 05, Hawassa, Ethiopia.
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Woldia University, P.O.BOX 400, Woldia, Ethiopia.
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Asfaw A, Behailu M, Oumer A, Gebremariam T, Asefa K. Factors associated with recent iodine intake level among household food handlers in Southwest Ethiopia: a cross-sectional study. BMC Womens Health 2023; 23:354. [PMID: 37403023 DOI: 10.1186/s12905-023-02516-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/29/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Iodine deficiency is a global public health threat, affecting an estimated two billion people. The median urinary iodine concentration is more reliable in determining recent iodine intakes and the risks of iodine deficiency. Therefore, this study was aimed to identify the factors associated with recent iodine intake level using median urinary iodine concentration as an indicator among household food handlers in southwest Ethiopia. METHODS A community-based survey was conducted with selected households using a pretested interviewer-administered questionnaire in southwest Ethiopia. A 20-gram sample of table salt and a 5 ml causal urine samples were also collected and analyzed using rapid test kit and a Sandell-Kolthoff reaction, respectively. A salt iodine concentration above 15 ppm was classified as adequately iodized and a median urinary iodine concentration between 100 and 200µgl- 1 was considered as adequate iodine intake. A bivariable and multivariable logistic regression model was fitted. Crude and adjusted odds ratios with their 95% confidence levels were reported. Associations with a p-value ≤ 0.05 were used to declare statistical significance. RESULTS A total of 478 women were included, with a mean age of 33.2 (± 8.4 years). Only 268 (56.1%) of the households had adequately iodized salt (> 15 ppm). The median urinary iodine concentration (interquartile range) was 87.5 µg l- 1 (45.6-107.6). In a fitted multivariable logistic regression model (p-value = 0.911), illiterate women (AOR = 4.61; 95% CI: 2.17, 9.81), poorly iodized salt in the household (AOR = 25.0; 95% CI: 13-48), salt purchased from open market (AOR = 1.93; 95% CI: 1.0, 3.73) and women who do not read the label during purchasing the salt (AOR = 3.07; 95% CI: 1.31, 7.17) were important predictors of the risk of Iodine deficiency. CONCLUSION Despite public health efforts to improve iodine intake, its deficiency is still a major public health problem among southwest Ethiopian women.
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Affiliation(s)
- Agize Asfaw
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, P.O. Box: 07, Ethiopia.
| | - Mifta Behailu
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, P.O. Box: 07, Ethiopia
| | - Abdu Oumer
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, P.O. Box: 07, Ethiopia
| | - Tigist Gebremariam
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, P.O. Box: 07, Ethiopia
| | - Kenzudin Asefa
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, P.O. Box: 07, Ethiopia
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Shiferaw YF, Negash WD, Belay DG, Birhan H, Asmamaw DB. Availability of adequate iodized salt at household level in rural communities in Farta district, Northwest, Ethiopia: a cross-sectional study. BMC Nutr 2023; 9:71. [PMID: 37353810 DOI: 10.1186/s40795-023-00728-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/15/2023] [Indexed: 06/25/2023] Open
Abstract
INTRODUCTION Iodine is a crucial trace element for thyroid hormone synthesis. All age groups are affected by iodine deficiency disorders (IDD), especially pregnant women, young women, and children. Iodine deficiency disorder has been recognized as a serious public health issue in Ethiopia. Therefore, the aim of the current study was to assess the availability of iodized salt and associated factors at the household (HH) level in the Farta district, northwest, Ethiopia. METHODS A community-based cross-sectional study was conducted involving 704 participants in Farta District, Northwest Ethiopia, between February and March 2021. A multi-stage sampling technique was employed to recruit participants. Data were collected using pretested and structured questionnaires administered by face-to-face interviewers. The data were entered into Epi-data version 4.6 software and exported into Stata version 14 for the purpose of analysis. Both bivariable and multivariable logistic regression analyses were used to identify factors associated with the availability of iodized salt. Statistical significance was declared at a p-value ≤ 0.05 with a corresponding 95% confidence interval. RESULTS The availability of adequately iodized salt in the study area was 26.6% (CI = 23.8%, 29.4%) of households. Good knowledge about iodine deficiency disorder (IDD) and iodized salt (AOR = 3.85, 95% CI: 3.65, 6.11); short-term storage of salt at the HH [AOR = 2.76, 95% CI: 1.98, 3.23); and stored in covered containers (AOR = 1.57, 95% CI: 1.11, 1.78) were significantly associated with the outcome variable. CONCLUSION The availability of adequate iodized salt at the HH level was far below the WHO target (more than 90%) in the study area. Knowledge about IDD and iodized salt, stored in covered containers, and short-term storage of salt at the HH were significantly associated with the availability of iodized salt. Hence, at the household level, increasing awareness and disseminating information about the benefits of using iodized salt could be effective. Moreover, education about the proper storage and handling of iodized salt, as well as the recommended storage duration of salt in the home, should be provided as part of our community outreach programs.
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Affiliation(s)
- Yalelet Fentaw Shiferaw
- Department of Nutritional Care and Counseling, University of Gondar Specialized Hospital, Gondar, Ethiopia
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haileyesus Birhan
- Department of Nutritional Care and Counseling, University of Gondar Specialized Hospital, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Muluneh AG, Merid MWM, Kassa GM. Hotspots of un-iodized salt availability among Ethiopian households, evidence from the national survey data. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:20. [PMID: 36927806 PMCID: PMC10021937 DOI: 10.1186/s41043-023-00359-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Universal salt iodization was started before decades but there are communities using the un-iodized salt till now. More than one-tenth of the Ethiopian community uses un-iodized salt. OBJECTIVE This study aimed to identify the hotspots and associate factors of un-iodized salt availability in Ethiopia based on Ethiopian national household survey data. METHODS We conducted an in-depth analysis of the Ethiopian Demographic and Health Survey 2016 data. A total of 15,567 households were included in the final analysis. We cleaned and weighed the data using Stata version 16 software and descriptive outputs were reported in graphs and tables. We computed the weighted prevalence of un-iodized salt and prepared it for spatial analysis. Global-level spatial autocorrelation, hotspot analysis using the Getis-Ord Gi* statistics, and spatial interpolation using empirical Bayesian interpolation were executed using ArcGIS 10.3 to predict the magnitude of un-iodized salt at the national level. The binary logistics regression model was used to identify the contributing factors of un-iodized salt utilization. Model goodness of fit was tested with Hosmer and Lemeshow goodness-of-fit test (P = 0.96). Finally, the adjusted odds ratio (AOR) with 95% CI was reported to identify significant factors. RESULTS The magnitude of un-iodized salt availability was 14.19% (95% CI: 13.65, 14.75) among Ethiopian households. Un-iodized salt hotspots were found in Afar, Somalia, and Benishangul Gumuz regions. Compared to poorest wealth index: poorer (AOR = 0.55, 95% CI: 0.48, 0.64), middle (AOR = 0.51, 95% CI: 0.44, 0.60), richer (AOR = 0.55, 95% CI: 0.47, 0.64), and richest (AOR = 0.61, 95% CI: 0.50, 0.75); compared to uneducated household head: heads with secondary (AOR = 0.72, 95% CI: 0.60, 0.67) and above secondary (AOR = 0.54, 95% CI: 0.43, 0.67) education reduced the odds of un-iodized salt viability, while households living in highland (AOR = 1.16, 95% CI: 1.05, 1.29) had increased the odds of un-iodized salt availability. CONCLUSION More than a tenth of the households in Ethiopia uses un-iodized salt. Hotspots of un-iodized salt availability were found in Somali and Afar regions of Ethiopia. Better wealth index and education of the household heads reduces the odds of un-iodized salt availability while living in a high altitude above 2200 m increases the odds of un-iodized salt availability in Ethiopia.
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Affiliation(s)
- Atalay Goshu Muluneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Mehari W Mariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Getahun Molla Kassa
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Molla A, Giza M, Kebede F, Kebede T. Iodine status, impact of knowledge, and practice for adequate iodized salt utilization in house hold at North West Ethiopia. SAGE Open Med 2023; 11:20503121221148612. [PMID: 36643209 PMCID: PMC9834809 DOI: 10.1177/20503121221148612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Iodine is one of the crucial micronutrients required for the normal growth of humans from the fetal stage to adulthood through the synthesis of thyroxin (t3) and triiodothyronine (t4) hormones in the thyroid gland for regulation of metabolism, protein synthesis, and brain development. This study aimed to assess iodine status, the impact of knowledge and practice for adequate iodized salt utilization in household levels in North West Ethiopia. Method A population-based cross-sectional study was carried out using multistage sampling among 1398 residents from 28 December 2021 to 30 January 2022. A systematic random sampling technique was used to select the study participants. The collected data were entered into Epi-Data version 3.1 and then exported to STATA/R version 14 for further analysis. An adjusted odds ratio with 95% CI was used to declare statistical significance at p < 0.05. Result The overall mean (±SD) age of participants was 34.9 (±12.8) years. About 678 (48.5%) had 15-80 ppm, 23 (1.6%) had >80 ppm, 533 (38.13%) had 1.1 ppm to 14.9 ppm, and 147 (10.5) had no iodine in salt (0 ppm) after assessed by Rapid Test Kit. Only 48.5% of the sampled household had used adequate iodized salt with ≥15 ppm. The overall burden of goiter was estimated at 11.4/1000 population. Adequate iodized salt utilization was significantly associated with having formal education (adjusted odds ratio = 1.89: 95% confidence interval: 1.4, 2.6, p = 0.001), monthly income ≥5000 ETB/month (adjusted odds ratio = 1.99: 95% confidence interval: 1.5, 2.9, p = 0.001), and good knowledge score (adjusted odds ratio = 1.6: 95% confidence interval: 1.12, 2.6, p = 0.03) were predictors for proper iodized salt utilization. Conclusion Coverage of adequately iodized salt was low and respondents' formal education, monthly income ≥5000 Ethiopian Birr/month, and good knowledge score were all significantly associated with proper iodized salt utilization. While the prevalence of goiter was not significantly identified as a public health problem as compared in the regions, however, in light of previous iodine deficiency in this region of Ethiopia, the salt iodization program should be done continually.
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Affiliation(s)
- Alebechaw Molla
- Concern Worldwide Non-Governmental
Organization, Gondar City, North West Ethiopia
| | - Mastewal Giza
- Department of Public Health, College of
Health Sciences, Woldia University, Woldia, Ethiopia
| | - Fassikaw Kebede
- Department of Public Health, College of
Health Sciences, Woldia University, Woldia, Ethiopia,Fassikaw Kebede, Department of Public
Health, College of Health Sciences, Woldia University, Woldia Town North Wollow,
Amhara Regions, Woldia 2022, Ethiopia.
(FK)
| | - Tsehay Kebede
- Department of Geography& Population
Studies, College of Social Science, Bahir Dare University, Bahir Dar, Ethiopia
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Asfaw A, Tamiru D, Belachew T. Mandatory Versus Voluntary Implementation of Salt Iodization Program for the Last Two Decades in Ethiopia: A Comparative Review of Existing Literatures. Food Nutr Bull 2022; 43:500-516. [PMID: 35903899 DOI: 10.1177/03795721221114523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Ethiopian government was implementing mandatory salt iodization program for the last decade to eliminate iodine deficiency disorders, but several recent studies reported mixed findings. OBJECTIVE This review aimed to assess the difference in implementation of iodized salt program 10 years before and after mandatory salt iodization being implemented in Ethiopia since 2011. METHODS In Ethiopia, legislation that enforces salt producers to iodize all salts used for human consumption started in February 2011. All studies about iodine deficiency and iodized salt conducted in Ethiopia in the last 2 decades were searched. Searches were performed in PubMed database. Google Scholar, Iodine Global Network, and Ethiopian Public Health Institute websites were also searched. RESULTS A total of 235 titles and abstracts were identified. After scanning the abstracts and full papers, 43 articles were remained for final data synthesis. In this review, all studies conducted before 2011 reported a urinary iodine concentration (UIC) value of < 100 μg/L and 66.7% of them reported a goiter prevalence of > 30%. On the other hand, among studies conducted after 2011, 88.9% reported UIC value < 100 μg/L and 73.7% reported goiter prevalence of > 30%. Household availability of adequately iodized salt increased from nearly 20% in pre 2011 to more than 50% in post 2011 period. CONCLUSION Despite the efforts made by the Ethiopian government on mandatory salt iodization for the last decade, iodine deficiency is sustained in the country. Moreover, the goal of universal salt iodization program is offtrack and needs urgent revision. REGISTRATION Registered on PROSPERO register with reg. no CRD42021251124.
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Affiliation(s)
- Agize Asfaw
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Gubrei, Wabe Bridge, Ethiopia
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Tadesse S, Hymete A, Lieberman M, Gebreyesus SH, Ashenef A. Iodine status, household salt iodine content, knowledge and practice assessment among pregnant women in Butajira, South Central Ethiopia. PLoS One 2022; 17:e0277208. [PMID: 36441747 PMCID: PMC9704620 DOI: 10.1371/journal.pone.0277208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 10/22/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Iodine is one of the crucial micronutrients needed by the human body, and is vitally important during pregnancy. This study aimed to determine the relationship between the iodine status of pregnant women and their knowledge, and practices regarding iodized salt. All participants were enrolled in the Butajira nutrition, mental health and pregnancy (BUNMAP) cohort, Butajira, Ethiopia in February-May, 2019. METHODS In this cross-sectional study, 152 pregnant women without hypertension or known thyroid disease before or during pregnancy were randomly selected from the BUNMAP mother to child cohort (n = 832). Spot urine samples were collected to estimate the level of urinary iodine concentration (UIC). Salt samples were also collected from their homes. The Sandall-Kolthoff (S-K) method was used to measure the level of iodine in the urine samples, and iodometric titration was used to measure the level of iodine in the salt. Data was entered and cleaned using Epi-info version 3.5.3 and then exported to SPSS version 20 for further analysis. Multivariate logistic regression analysis was performed to identify associations in the collected data. RESULTS The WHO recommended level of iodine for populations of pregnant women is 150-249 F06Dg/L. The median UIC among pregnant women in this study was 151.2 μg/L [interquartile range (IQR) = 85.5-236.2 F06Dg/L], at the low end of this range. About half (49.65%) of the participants were likely to be iodine deficient. There was a significant association between having a formal job (AOR = 2.56; CI = 1.11-5.96) and iodine sufficiency. Based on a cutoff of >15 ppm (mg/kg), 91.7% (95% CI: 87.2-96.2) of the salts collected from the household had adequate iodine content. The median iodine level of the collected salt samples was 34.9 mg/kg (ppm) (IQR = 24.2-44.6 mg/kg). CONCLUSIONS The UNICEF 2018 guidelines for adequate iodine nutrition in pregnant women include both a recommended median range of 150-249 μg/L, and an upper limit of 20% on the fraction of the population with UIC below 50 μg/L. Because our study population's median level is 151.2 μg/L and the percentage of pregnant women with urinary iodine concentration of less than 50 μg/L is 9.7% (14/145), the women received adequate iodine nutrition. The availability of adequately iodized salt in households is more than 90%, as recommended by WHO. In light of previous iodine deficiency in this region of Ethiopia, the salt iodization program promotes the health of babies and mothers.
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Affiliation(s)
- Senait Tadesse
- Department of Pharmaceutical Chemistry and Pharmacognosy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ariaya Hymete
- Department of Pharmaceutical Chemistry and Pharmacognosy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Marya Lieberman
- Department of Chemistry & Biochemistry, University of Notre Dame, Notre Dame, IN, United States of America
| | - Seifu Hagos Gebreyesus
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ayenew Ashenef
- Department of Pharmaceutical Chemistry and Pharmacognosy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
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Tareke AA, Zerfu TA. Magnitude, Trends, and Determinants of Iodized Salt Availability among Households in Ethiopia: Analysis of Ethiopian Demographic and Health Surveys (2000-2016). Nutr Metab Insights 2021; 14:11786388211025342. [PMID: 34188487 PMCID: PMC8212372 DOI: 10.1177/11786388211025342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 05/27/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Iodine deficiency causes various health problems such as mental defects,
goiter, reproductive damage, hypo and hyperthyroidism, stillbirth, abortion,
congenital abnormalities, cretinism, mental retardation, muscle anomalies,
and reduced work output. Although the adverse effects on health and
socio-economic development are well known, they persisted as a public health
problem worldwide. Salt iodization is recommended as a simple cost-effective
method to prevent iodine deficiency disorders. This study aimed to determine
the magnitude, trends, and determinants of iodized salt availability in the
household in Ethiopia. Methods: The current study used the Ethiopian Demographic and Health Surveys conducted
from 2000 to 2016 with a total of 57 939 households. Descriptive statistics
were performed on selected background characteristics to provide an overall
picture of the sample after considering sample weights. To ensure the
representativeness of the sample we applied a complex sample design
considering household weights, primary sampling units, and the strata
associated with it. The Cochran–Armitage test was performed to assess the
trend of iodized salt availability in the household. Multivariate logistic
regression was used to determine the association between the dependent
variable and independent variables. A significance level of .05 was chosen
for all analyses. Results: The magnitude of iodized salt availability in the household was 28.45% in
2000, 54.34% in 2005, 15.42% in 2011, and 89.28% in 2016. Iodized salt
availability increased from 28.45% [95% CI: 27.69-29.21] in 2000 to 89.28%
[95% CI: 88.79-89.75] in 2016. Despite the decline from 2005 to 2011 in the
percentage of households with iodized salt, overall, there was a significant
increment from 2000 to 2016 in Ethiopia (P-value <.001).
There were differences in the status of salt iodization in the
administrative region, wealth, family size, and ownership of radio or
television. Conclusion: Remarkable progress has been made in Ethiopia regarding iodized salt
availability in recent years. Besides the current efforts to achieve
universal salt iodization, future interventions should prioritize specific
groups like those with lower socioeconomic status and geographic areas with
lower availability of iodized salt in the household.
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Affiliation(s)
- Amare Abera Tareke
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Taddese Alemu Zerfu
- College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.,Global Academy of Agriculture and Food Security, University of Edinburgh, Edinburgh, UK
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Adequately Iodized Salt Utilization and Associated Factors among Households in Tach Armachio District, Northwest Ethiopia: A Community-Based Cross-Sectional Study. J Nutr Metab 2021; 2021:6630450. [PMID: 33953976 PMCID: PMC8064771 DOI: 10.1155/2021/6630450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/03/2021] [Accepted: 04/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background For the synthesis of thyroid hormones, iodine is a crucial trace element. Iodine deficiency disorders affect all groups particularly: pregnant, young women and children. Iodine deficiency disorder has been recognized as a serious public health issue in Ethiopia. Therefore, this study planned to assess iodized salt utilization and associated factors at the household level. Methods A community-based cross-sectional study was conducted from January 25 to February 24, 2019, in Tach Armachio district, Northwest Ethiopia. A single population proportion formula was used to calculate the sample size and a total of 555 households were sampled. A multistage sampling technique was conducted to select the household. An iodometric titration method was performed. A structured, pretested, and face-to-face interview questionnaire was used to collect data; then, it was entered in Epi Info 7 and exported to SPSS version 25 for analysis. Bivariable and multivariable analyses were done to identify predictor variables. A 95% confidence interval and adjusted odd ratio were reported. P values less than 0.05 were considered statistically significant in the multivariable analysis. Results This study showed that iodized salt was adequately utilized by 61.1% (CI = 57%–65%) of households. Good knowledge of iodine deficiency disorder (AOR = 2.25, 95% CI = (1.44, 3.50)), keeping salt in the kitchen house away from fire (AOR = 5.09, 95% CI = (3.25, 7.98)), buying packed salt [AOR = 1.89, 95% CI = (1.12, 3.19)), keeping salt in a covered container (AOR = 2.18, 95% CI = (1.24, 3.81)), and exposing salt to sunlight (AOR = 0.39, 95% CI = (0.23, 0.65)) were significantly associated. Conclusion In the district, adequately iodized salt utilization was low. Therefore, it is necessary to enforce the current law for merchants to sell iodized packed salt and teach the community how to handle it.
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Alamneh AA, Leshargie CT, Desta M, Birhanu MY, Assemie MA, Denekew HT, Alamneh YM, Ketema DB. Availability of adequately iodized salt at the household level in Ethiopia: A systematic review and meta-analysis. PLoS One 2021; 16:e0247106. [PMID: 33592066 PMCID: PMC7886221 DOI: 10.1371/journal.pone.0247106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/01/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Iodine deficiency disorder (IDD) is a global, regional, and national public health problem that is preventable. Universal salt iodization is a worldwide accepted strategy to prevent IDD. The level of iodine in the salt should be adequate at the household level (≥15ppm). Though there was fragmented evidence on the proportion of adequately iodized salt at the household level in Ethiopia, the national level proportion of adequately iodized salt at the household level was remaining unknown. Therefore, this systematic review and meta-analysis estimated the pooled proportion of adequately iodized salt at the household level in Ethiopia from 2013-2020. METHOD We systematically searched the databases: PubMed/MEDLINE, Google Scholar, and Science Direct for studies conducted in Ethiopia on the availability of adequately iodized salt at the household level since 2013. We have included observational studies, which were published between January first, 2013, and 10 August 2020. The report was compiled according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The quality of included studies was scored based on the Newcastle Ottawa quality assessment scale adapted for cross-sectional studies. The data were extracted in Microsoft excel and analyzed using Stata version 14.1 software. We employed a random-effects model to estimate the pooled proportion of adequately iodized salt at the household level in Ethiopia. The presence of statistical heterogeneity within the included studies was evaluated using the I-squared statistic. We used Egger's regression test to identify evidence of publication bias. The pooled proportion with a 95% confidence interval (CI) was presented using tables and forest plots. RESULTS We screened a total of 195 articles. Of these, 28 studies (with 15561 households) were included in the final systematic review and meta-analysis. In Ethiopia, the pooled proportion of adequately iodized salt at the household level was 37% (95% CI: 28, 46%). The subgroup analyses of 28 studies by residence revealed that the pooled proportion of adequately iodized salt at the household level was 32% (95% CI: 29, 35%) and 48% (95% CI: 31, 66%) in rural and urban areas, respectively. Based on geographic location, the highest proportion was found in Addis Ababa (81%; 95%CI: 78, 83), and the lowest proportion found in Dire Dawa (20%; 95%CI: 17, 22). Besides, the proportion of adequately iodized salt at the household level was significantly increased during 2017-2020 (42%; 95% CI: 30, 53%) as compared with 2013-2016 (27%; 95% CI: 17, 39%). CONCLUSIONS In Ethiopia, the pooled proportion of adequately iodized salt at the household level was very low as compared to the world health organization's recommendation. Thus, the Federal Ministry of Health of Ethiopia and different stakeholders should give more attention to improve the proportion of adequately iodized salt at the household level.
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Affiliation(s)
- Alehegn Aderaw Alamneh
- Department of Human Nutrition and Food Sciences, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Cheru Tesema Leshargie
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.,Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Melaku Desta
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | | | - Moges Agazhe Assemie
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Habtamu Temesgen Denekew
- Department of Human Nutrition and Food Sciences, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Yoseph Merkeb Alamneh
- Departments of Biomedical Sciences, Schools of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Daniel Bekele Ketema
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Availability of Adequately Iodized Dietary Salt and Associated Factors in a Town of Southeast Ethiopia: A Community-Based Cross-Sectional Survey. J Nutr Metab 2021; 2020:1357192. [PMID: 33489359 PMCID: PMC7803098 DOI: 10.1155/2020/1357192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 11/25/2022] Open
Abstract
Background Iodine deficiency is the world's major cause of preventable intellectual impairment, and nearly 2 billion people are at risk of iodine deficiency worldwide. Prevention and control of iodine deficiency disorders primarily aim at ensuring the intake of adequate iodine to maintain normal thyroid function. In our study area, studies regarding the coverage of adequately iodized salt at household level are meager. Hence, this study aimed to assess the magnitude of adequately iodized dietary salt at a household level in Kore Town, Southeast Ethiopia. Methods A community-based cross-sectional study was conducted in the Kore town from August 1 to 30, 2019. A total of 394 households were selected for this study using a simple random sampling technique. The level of salt iodine content was determined using the rapid field test kit. Then, iodine contents of dietary salt were reported as <15 parts per million and ≥15 parts per million. Data regarding sociodemographic factors, knowledge of respondents about iodized salt, and iodized salt handling practices were collected through a face-to-face interview. The binary logistic regression model was used to assess the association between independent factors and the outcome variable. Statistical significance was declared at p < 0.05. Result Out of all the households, 223 (56.6%) had adequately iodized salt. Not exposing iodized salt to sunlight (AOR = 2.35, 95% CI: 1.1, 5.2), storing the salt at a dry or cold place [(AOR = 4.77, 95% CI: 1.39, 16.45) and (AOR = 8.23, 95% CI: 1.44, 47.19), respectively], and having good knowledge about iodized salt (AOR = 1.88, 95% CI: 1.18, 3.01) were significantly associated with the presence of adequately iodized salt at the household level. Conclusion Availability of adequately iodized salt in the study area was far below the World Health Organization recommendation. Information regarding the importance and proper handling of iodized dietary salt should be communicated to the householders.
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Yeshaw Y, Alem AZ, Tesema GA, Teshale AB, Liyew AM, Tesema AK. Spatial distribution and determinants of household iodized salt utilization in Ethiopia: a spatial and multilevel analysis of Ethiopian demographic and Health survey. BMC Public Health 2020; 20:1421. [PMID: 32943046 PMCID: PMC7500019 DOI: 10.1186/s12889-020-09538-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Iodine deficiency disorder is a significant public health problem, affecting both developed and developing nations worldwide. It is associated with poor body growth and irreversible mental retardation. However, little is known about the spatial distribution and determinants of household iodized salt utilization in Ethiopia. Therefore, this study aimed to explore the spatial distribution and determinants of iodized salt utilization at national level. METHODS Ethiopian Demographic and Health Survey 2016 data was used to investigate the spatial distribution and determinants of household iodized salt utilization in Ethiopia. ArcGIS 10.6 and SaTScan™ version 9.6 software were used to explore the spatial distribution and detect significant clusters, respectively. The odds ratio with its 95% confidence interval (CI) was determined for potential determinants included in the multivariable multilevel logistic regression model. RESULTS Household iodized salt utilization was spatially clustered in Ethiopia (Moran's Index = 0.076, p-value = 0.01). The significant hotspot areas with high iodized salt utilization were located in Benishangul, Amhara, Gambella, Tigray and Northwest Oromia regions. Significant cold spot areas (areas with low iodized salt utilization) were found in Somali, and East Afar regions. Those households with higher education level ((Adjusted Odds Ratio [AOR] =1.49, 95% CI =1.14-1.93), high community level education (AOR = 1.51, 95% CI = 1.03-2.20), middle wealth index (AOR = 1.31, 95% CI = 1.04-1.65) and high community media exposure (AOR = 1.52, 95% CI = 1.07-2.17) had higher odds of iodized salt utilization. CONCLUSIONS Household iodized salt utilization had significant spatial variation across the country. Both household and community level variables were found to be associated with household iodized salt utilization in Ethiopia. Therefore, increasing the education level, wealth status and community media exposure is recommended to improve iodized salt utilization in a country. A targeted intervention is also needed for those regions with low household iodized salt utilization.
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Affiliation(s)
- Yigizie Yeshaw
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Ayenew Kassie Tesema
- Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
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Dida N, Legese A, Aman A, Muhamed B, Damise T, Birhanu T, Hailu S, Darega J, Woldamichael B, Gadisa E. Availability of adequately iodised salt at household level and its associated factors in Robe town, Bale Zone, South East Ethiopia: community-based cross-sectional study. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2018. [DOI: 10.1080/16070658.2018.1551767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Nagasa Dida
- Department of Public Health, Medicine and Health Science College, Ambo University, Ambo, Ethiopia
| | - Abiyot Legese
- Department of Public Health Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Abdurhim Aman
- Department of Public Health Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Bilkisa Muhamed
- Department of Public Health Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Teshome Damise
- Department of Public Health Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Tizita Birhanu
- Department of Public Health Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Sintayehu Hailu
- Department of Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Jiregna Darega
- Department of Public Health, Medicine and Health Science College, Ambo University, Ambo, Ethiopia
| | - Bedasa Woldamichael
- Department of Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Eshetu Gadisa
- Department of Microbiology, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
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Wassie MM, Abebe Z, Tariku A, Gebeye E, Awoke T, Gete AA, Yesuf ME, Kebede Y, Biks GA, Zhou SJ. Iodine status five years after the mandatory salt iodization legislation indicates above requirement: a cross sectional study in Northwest Ethiopia. BMC Nutr 2018; 4:52. [PMID: 32153913 PMCID: PMC7050929 DOI: 10.1186/s40795-018-0261-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 12/10/2018] [Indexed: 11/12/2022] Open
Abstract
Background Iodine deficiency is one of a major nutritional problem. The study aimed to assess the iodine status of populations in Dabat district using median urinary iodine concentration (UIC) in school-age children (6–12 years) and compared the results with goiter prevalence. Methods The study used a cross-sectional study design. The study was conducted in Dabat district, northwest Ethiopia in May 2016. Spot urine samples were used for the determination of UIC. Manual examination of the thyroid gland was performed to assess presence of goiter. The MBI international Rapid Test Kits (RTK) were used to determine the level of salt iodine content. Children aged 6–12 years were recruited from schools using a multistage stratified sampling. One-way Analysis of Variance (ANOVA) was used to compare mean of log-transformed UIC values among key variables. Significant was determined at P-value less than 0.05. Results A total of 358 school age children enrolled to the study. The mean age of children was 10.8((Standard Deviation (SD) = 1.45) years and 56.7% were males. The median UIC was 235 μg/l ((Inter Quartile Range (IQR): 161, 320]. Excessive iodine intake and inadequate iodine intake was observed on 29.1 and 8.7% of school aged children, respectfully. The coverage of iodized salt use in school-age children were 66.8%. The UIC was higher in urban children than rural counterparts and in those used adequately iodised salt than inadequately iodized salt (P < 0.05). Thirty-four percent of school-age children had a goiter. The prevalence of grade 1 and grade 2 goiter was 26.5 and 7.5%, respectively. There was a poor agreement between UIC and goiter (k = 0.1) in classifying iodine status of populations. Conclusions The study population is classified as above requirements by median UIC in school-age children but severe iodine deficiency by goiter prevalence. Further research investigating the agreement between UIC and goiter prevalence in classifying iodine status of populations with various iodine status is warranted.
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Affiliation(s)
- Molla Mesele Wassie
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Po Box: 196, Gondar, Ethiopia.,2School of Agriculture Food and Wine, Faculty of sciences, The University of Adelaide, Adelaide, Australia
| | - Zegeye Abebe
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Po Box: 196, Gondar, Ethiopia
| | - Amare Tariku
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Po Box: 196, Gondar, Ethiopia
| | - Ejigu Gebeye
- 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadese Awoke
- 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Azeb Atenafu Gete
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Po Box: 196, Gondar, Ethiopia
| | - Melkie Edris Yesuf
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Po Box: 196, Gondar, Ethiopia
| | - Yigzaw Kebede
- 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Biks
- 4Department of Health Service Management and Heath Economics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Shao Jia Zhou
- 2School of Agriculture Food and Wine, Faculty of sciences, The University of Adelaide, Adelaide, Australia
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Animut Y, Assefa AT, Lemma DG. Blood pressure control status and associated factors among adult hypertensive patients on outpatient follow-up at University of Gondar Referral Hospital, northwest Ethiopia: a retrospective follow-up study. Integr Blood Press Control 2018; 11:37-46. [PMID: 29720880 PMCID: PMC5918628 DOI: 10.2147/ibpc.s150628] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Large segments of the hypertensive population in the world are either untreated or inadequately treated. The incidence of heart failure and mortality from cardiovascular complications of hypertension is high among patients with uncontrolled blood pressure (BP). But BP control status of hypertensive patients has not been investigated in the study area. The study aimed to assess BP control status and determinant factors among adult hypertensive patients on antihypertensive medication attending outpatient follow-up at University of Gondar Referral Hospital, northwest Ethiopia. Methods An institution-based retrospective follow-up study was conducted from September 2015 to April 2016. Data were collected using a structured and pretested questionnaire adopted from the World Health Organization STEPwise approach. BP records of 6 months were used, and patients were classified as having controlled BP if their BP readings were <140/90 mmHg for all adults ≥18 years of age and <150/90 mmHg for adults aged ≥60 years. A generalized estimating equation was fitted, and the odds ratio with a 95% confidence level was used to determine the effect of covariates on BP control status. Results Among 395 participants, 50.4% (95% CI: 45–55) of them controlled their BP in the last 6 months of the survey. Physical activity (adjusted odds ratio [AOR]=1.95, 95% CI: 1.41–2.68), duration on antihypertensive drugs of 2–4 years (AOR=1.70, 95% CI: 1.13–2.56) and 5 years or more (AOR=1.96, 95% CI: 1.32–2.92), and high adherence (AOR=2.18, 95% CI: 1.14–4.15) to antihypertensive drugs were positively associated with BP control, while salt intake (AOR=0.67, 95% CI: 0.49–0.93), overweight (AOR=0.50, 95% CI: 0.36–0.68), and obesity (AOR=0.56, 95% CI: 0.36–0.87) were inversely associated with BP control. Conclusion In this study, only half of the hypertensive patients controlled their BP. Thus, health care providers need to be made aware about the importance of counseling hypertensive patients on drug adherence, moderate physical activity, and salt restriction to improve BP control.
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Affiliation(s)
- Yaregal Animut
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemu Takele Assefa
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dereseh Gezie Lemma
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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