Adequacy of iodized salt and its associated factors among households in the Bahir Dar Zuria district, Northwest Ethiopia, 2022

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.

Factors associated with recent iodine intake level among household food handlers in Southwest Ethiopia: a cross-sectional study

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.

Iodine concentration level of iodized dietary salt and its associated factors: a systematic review and meta-analysis

Background

Iodine deficiency disorder (IDD) is a major public health problem in Ethiopia. The availability of adequate iodized dietary salt at the household level is immensely important. Hence, this review aimed to estimate the pooled prevalence of adequate iodine concentration level of iodized dietary salt at the household level and its associated factors in Ethiopia.

Methods

We searched the literature using electronic databases (PubMed/Medline, Google Scholar, Science Direct, and Embase) and gray literature from January 9, 2022, to February 25, 2022. The rapid test kit was used to measure the adequacy of iodine level of dietary salt. The quality of studies was assessed using Joanna Briggs Institute critical appraisal tool. Heterogeneity between studies was checked using I2 test statistics and publication bias was checked using funnel plot and Egger's statistical test at a 5% significance level. A random-effects model was employed to estimate the pooled prevalence of the outcome variable and its determinants in Ethiopia.

Results

The search identified 149 studies of which 18 studies were included with a total of 10,556 participants. The pooled prevalence of adequate iodine levels of iodized salt in Ethiopia was 44.37% (95% CI: 35.85-52.88). Women who had formal education (adjusted odds ratio (AOR) = 1.99 (95% CI: 1.47-2.48)), good knowledge of women (AOR = 2.14, 95% CI: 1.36-3.36), packed iodized salt (AOR = 3.85 (95% CI: 1.88-7.87)) and storage of iodized salt at home for less than 2 months (AOR = 2.66 (95% CI: 2.11-3.35) were the significant factors.

Conclusion

This review suggests that the pooled prevalence of adequate iodine levels was low. Our finding highlights the need for considering the educational status, knowledge, and duration of salt storage to enhance the prevalence of adequate levels of iodized salt at the national level.