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Salma L, Musameh T, Motawea A, Elshafiey A, Al Ketbi K, Alkindi A, Alnakhi W. Knowledge, Attitudes, and Practices of Iodized Salt Among Adults Aged 18 to 65 in the United Arab Emirates. Cureus 2024; 16:e55844. [PMID: 38590460 PMCID: PMC11001161 DOI: 10.7759/cureus.55844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Iodine plays a big role in growth and development and is used in the synthesis of thyroid hormones that regulate body organ functions. Its most important source is iodized salt. Iodine deficiency impairs cognitive development and precipitates many thyroid diseases. AIM The purpose of our study is to measure the knowledge, attitudes, and practices towards iodized salt in adults aged 18-65 years in the United Arab Emirates. METHODS This is a cross-sectional study that included 406 participants. A self-administered questionnaire was distributed in public places across the Emirates. The survey included the socio-demographic characteristics of the participants with questions related to knowledge, attitudes, and practices towards iodized salt. A knowledge score out of 13 was calculated. Chi-square, Mann-Whitney U, and Independent T-tests were used for analysis on the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 22.0, Armonk, NY), with a p-value less than 5% considered statistically significant. RESULTS Out of the 406 respondents, 60% (n=246) were between the ages of 18-34 years and 71% (n=287) were at university level. The mean knowledge score was higher in participants with higher educational levels compared to participants with lower education levels (4.30 vs 2.63, respectively) and in older ages (35-65 years) compared to younger ages (18-34 years) (4.20 vs 3.59, respectively). Almost half of the participants buy iodized salt (48%, n=196), a minority buy non-iodized salt (14%, n=55), and the rest do not know what type of salt they buy. Most of the participants who use iodized salt store it in a closed container and do not expose it to sunlight. CONCLUSION Knowledge about iodized salt is relatively low. Less than half of the participants use it, while most of the participants who use iodized salt follow the right storage recommendations. Our study suggests the implementation of public campaigns to raise awareness about the importance of iodized salt and the benefits of using it.
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Affiliation(s)
- Leen Salma
- College of Medicine, University of Sharjah, Sharjah, ARE
| | - Tasnim Musameh
- College of Medicine, University of Sharjah, Sharjah, ARE
| | - Adham Motawea
- College of Medicine, University of Sharjah, Sharjah, ARE
| | | | | | - Amna Alkindi
- College of Medicine, University of Sharjah, Sharjah, ARE
| | - Wafa Alnakhi
- Department of Family and Community Medicine and Behavioral Sciences, University of Sharjah, Sharjah, ARE
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Momentti AC, de Souza Macedo M, de Sousa Silva AF, de Oliveira Souza VC, Júnior FB, do Carmo Castro Franceschini S, Navarro AM. Household Salt Storage and Seasoning Consumption Are Predictors of Insufficient Iodine Status Among Pregnant Women in Southeastern Brazil. Biol Trace Elem Res 2023; 201:5529-5539. [PMID: 36884126 PMCID: PMC9993368 DOI: 10.1007/s12011-023-03615-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/25/2023] [Indexed: 03/09/2023]
Abstract
Iodine deficiency in pregnancy may lead to adverse maternal and fetal outcomes, including impaired child development. Sociodemographic factors and different dietary habits may be related to iodine status in pregnant women. The aim of this study was to evaluate the iodine status and its predictors among pregnant women in a city of Southeastern Brazil. This cross-sectional study was conducted with 266 pregnant women receiving prenatal care in 8 primary health care units. Sociodemographic, obstetric and health, habits of acquisition, storage and consumption of iodized salt, and dietary iodine intake data were collected through a questionnaire. The iodine content was evaluated in urinary iodine concentration (UIC), household salt and seasonings, and drinking water samples. Pregnant women were categorized into three groups according to the UIC, determined by iodine coupled plasma-mass spectrometry (ICP-MS): insufficient (< 150 μg/L), adequate (150-249 μg/L), and more than adequate iodine nutrition (≥ 250 μg/L). The median (p25-p75) UIC was 180.2 μg/L (112.8-262.7). It was found 38% and 27.8% of insufficient and more than adequate iodine nutrition, respectively. Number of gestations, KI content of supplement, alcohol consumption, salt storage, and frequency of using industrialized seasoning were associated to iodine status. Alcohol consumption (OR = 6.59; 95%CI 1.24-34.87), pack the salt in opened container (OR = 0.22; 95%CI 0.08-0.57), and use industrialized seasoning weekly (OR = 3.68; 95% CI 1.12-12.11) were predictors of iodine insufficiency. The pregnant women evaluated have adequate iodine nutrition. Household salt storage and seasoning consumption were risk factors for insufficient iodine status.
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Affiliation(s)
- Ana Carolina Momentti
- Nutrition and Metabolism Program, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Mariana de Souza Macedo
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Ana Flávia de Sousa Silva
- Nutrition and Metabolism Program, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Vanessa Cristina de Oliveira Souza
- Department of Clinical, Toxicological and Bromatological Analysis, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fernando Barbosa Júnior
- Department of Clinical, Toxicological and Bromatological Analysis, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Anderson Marliere Navarro
- Department of Health Sciences, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Temech EC, Said O, Endalik G, Demilew YM, Belay MA, Kassie TD, Dessie AM. Adequacy of iodized salt and its associated factors among households in the Bahir Dar Zuria district, Northwest Ethiopia, 2022. Front Nutr 2023; 10:1215613. [PMID: 37964937 PMCID: PMC10641846 DOI: 10.3389/fnut.2023.1215613] [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: 05/02/2023] [Accepted: 09/29/2023] [Indexed: 11/16/2023] Open
Abstract
Background The inadequacy of iodine in salt is the a contributing factor behind lack of awareness and poor economic performance in developing countries. To address the issue of iodine deficiency, universal salt iodization has been implemented globally. Nevertheless, it is imperative to closely monitor the sufficiency of iodine in salts to achieve its intended objective at the household level in the Bahir Dar Zuria district. Objective To assess the adequacy of iodized salt and its associated factors among households in the Bahir Dar Zuria district, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted from May to June 2022 among households in Bahir Dar Zuria district. The data were gathered from 825 households that were chosen using a multistage sampling process. Iodometric titration was used to assess the amount of iodine in salt. The data were gathered using a structured questionnaire that was administered by an interviewer. For data entry and analysis, EpiData version 3.01 and SPSS version 25.0 were used, respectively. To evaluate the association between explanatory factors and the outcome variable, binary logistic regression was conducted, and significance was determined at alpha 0.05. Result This study analyzed a total of 825 households. Of these, only 384 [46.5, 95% CI, 43.5-50.5%] households had adequately iodized salt at home. Age increase of 1 year [AOR = 1.04, 95% CI = 1.02-1.06], being an urban resident [AOR = 3.18, 95% CI = 1.84-5.48], diploma and above educational attainment [AOR = 3.74, 95% CI = 1.99-7.02], checking salt by asking the seller [AOR = 2.21, 95% CI = 1.26-3.88], storing salts in closed containers [AOR = 1.57, 95% CI = 1.13-2.19], and storing salts in a dry and cool area [AOR = 2.72, 95% CI =1.37-5.42] were associated with the adequacy of iodized salt at the household level. Conclusion and recommendation The percentage of households in the district (46.5%) that had enough iodized salt in their homes is still extremely low and falls short of the targeted level for the country. At the household level, adequate iodized salt was found to be associated with age, place of residence, level of education, checking salt iodization while purchasing, place of salt storage, and cover use for salt containers. Therefore, increasing the accessibility of iodized salt at the household level is essential.
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Affiliation(s)
| | - Oumer Said
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Genete Endalik
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yeshalem Mulugeta Demilew
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mahider Awoke Belay
- Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
| | - Tadele Derbew Kassie
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Anteneh Mengist Dessie
- Department of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
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Deresa EM, Befkadu DM, Hamda MG. Investigation of the effects of heat and light on iodine content of packaged and open salt brands collected from Jimma town. Heliyon 2023; 9:e20412. [PMID: 37790957 PMCID: PMC10543208 DOI: 10.1016/j.heliyon.2023.e20412] [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: 05/02/2023] [Revised: 09/08/2023] [Accepted: 09/23/2023] [Indexed: 10/05/2023] Open
Abstract
Iodine deficiency is one of the most common micronutrient deficiencies in developing countries, which leads to iodine deficiency disorders (IDD). To combat iodine deficiency disorders, universal salt iodization is mandatory. However, iodized salt can lose its iodine due to environmental factors such as heat, light, moisture, and so on. Therefore, the aim of this study is to investigate the effects of heat and light on the iodine content of packaged and open salt brands available in Jimma town, Oromia, Ethiopia. An experimental study design was employed to determine the effects of heat and light on the iodine content of salts. A total of six salt samples were collected from retailers selected based on convenience sampling technique. Among six different salt brands, three were packaged salts, and the rest were non-packaged (open) salts. The iodine content of the salt samples was determined by the iodometric titration method, and the effects of heat and light on the concentration of iodine were also investigated. It has been revealed that heat and light decrease the iodine content of salt samples. The findings of this study provide valuable insights into the stability of iodized salt against heat and light. It is also helpful in identifying the right time at which salt should be added while cooking and the appropriate storage conditions for salt in households.
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Affiliation(s)
- Ebisa Mirete Deresa
- Department of Chemistry, College of Natural Sciences, Jimma University, Jimma, Ethiopia
| | | | - Milkessa Geletu Hamda
- Department of Chemistry, College of Natural Sciences, Jimma University, Jimma, 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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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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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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Ajema D, Bekele M, Yihune M, Tadesse H, Gebremichael G, Mengesha MM. Socio-demographic correlates of availability of adequate iodine in household salt: a community-based cross-sectional study. BMC Res Notes 2020; 13:125. [PMID: 32131883 PMCID: PMC7057523 DOI: 10.1186/s13104-020-04983-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/26/2020] [Indexed: 11/22/2022] Open
Abstract
Objective This study aimed to assess the availability of adequately iodized salt at a household level and associated factors in Arba Minch town, South Ethiopia using the gold standard technique, the iodometric titration. Results 41.8% (95% CI (confidence interval) 38.6 to 45.1) of households had inadequately iodized salt, and 9.3% (95% CI 7.5 to 11.4) had an iodine content below 10 ppm (parts per million). Compared to households with a monthly income of greater than 2000 ETB (Ethiopian Birr), households with a monthly income between 1000 ETB to 2000 ETB (adjusted odds ratio (AOR) = 0.52, 95% CI 0.390.36 to 00.77) and main food handlers aged 30 years or above compared to those aged less than 20 years of age (aOR = 0.55, 95% CI 0.34 to 0.91) had higher odds of having adequately iodized salt. Food handler’s knowledge and practice were not found to be correlated with the availability of adequately iodized salt in household salt.
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Affiliation(s)
- Dessalegn Ajema
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Muluken Bekele
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Manaye Yihune
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Hiwot Tadesse
- Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gebrekiros Gebremichael
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Melkamu Merid Mengesha
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Dessie G, Amare D, Dagnew AB, Mulugeta H, Haile Kassa D, Negesse A, Kassa GM, Wagnew F, Islam SMS, Burrowes S. Prevalence of goiter among children in Ethiopia and associated factors: a systematic review and meta-analysis. BMC Public Health 2019; 19:1191. [PMID: 31464605 PMCID: PMC6716873 DOI: 10.1186/s12889-019-7505-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 08/15/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The distribution of goiter among children and its risk factors are not well investigated in Ethiopia. Therefore, this systematic review and meta-analysis was designed to determine the pooled prevalence of goiter and its associated factors among children in Ethiopia. METHODS Electronic web-based searches of PubMed, Google Scholar, EMBASE, and the World Health Organization's Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) were conducted to find primary studies. Relevant data were extracted and descriptive summaries of the studies were presented in tables. The I2 statistic was used to assess heterogeneity across studies. Funnel plot asymmetry and Egger's tests were used to check for publication bias. A random effects model was used to estimate the pooled prevalence of goiter. Odds ratios (OR) with 95% Confidence Intervals (CI) were also used to determine the association of identified variables with goiter. All statistical analyses were conducted using Stata version 14 software. RESULTS Our search identified 982 studies, of which, 19 articles were eligible for inclusion in the final meta-analysis. The pooled estimate of goiter among children in Ethiopia was 40.50% (95% CI: 33.6-47.40). The regional distribution of goiter ranged from 44.22 (95% CI: 17.44-71) in Southern Nations Nationalities and Peoples' Region, to 32.79% (95% CI: 19.86-45.73) in Benishangul Gumez region. The prevalence of goiter among female children (44.34%) was higher than among male (32.88%) children. Goiter prevalence was also significantly higher among children who consumed vegetables three or more times per week OR = 1.3 (95% CI: 1.02-1.66); those who had family history of goiter, OR = 2.38 (95% CI: 1.9-2.99); and those whose family stored salt near to fires, OR = 1.4 l (95% CI: 1.1-1.79). CONCLUSION The prevalence of goiter among children in Ethiopia was high, and endemic according to the WHO criteria. Our findings suggest the need for interventions to improve salt iodization, and for improved health education on appropriate salt storage. In addition, more research may be needed to improve our understanding of foods that increase the risk of goiter among children.
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Affiliation(s)
- Getenet Dessie
- Department of Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Desalegne Amare
- Department of Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Amare Belachew Dagnew
- Department of Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Henok Mulugeta
- Department of Nursing, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Dessalegn Haile Kassa
- Department of Nursing, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Ayenew Negesse
- Department of Human Nutrition and Food Science, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Getachew Mullu Kassa
- College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Fasil Wagnew
- Department of Nursing, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | | | - Sahai Burrowes
- Public Health Program, College of Education and Health Sciences, Touro University California, 1310 Club Drive, Mare Island, Vallejo, CA 94592 USA
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