Survey of iodine deficiency and intestinal parasitic infections in school-going children: Bie Province, Angola.

OBJECTIVE: To obtain baseline pre-intervention prevalence levels of iodine deficiency and parasitic and helminth infections in school-going children in Bie Province, Angola. DESIGN: A cross-sectional study conducted in randomly selected schools. The target population was children aged 6-10 years. SETTING: Bie Province, Angola. SUBJECTS: A total of 1029 children sampled, with 791 stool samples and 826 urine samples collected from twenty-four schools. RESULTS: Widespread severe and moderate deficiencies in iodine. Children in five schools were severely iodine deficient. All sampled schoolchildren were iodine deficient to a greater or lesser extent. In all, 80 % of all children across the twenty-four schools were infected with one or a combination of intestinal helminths and intestinal protozoa. CONCLUSIONS: These findings have serious implications for the cognitive development of Angolan children, as well as for Angola's development in terms of productivity and economic potential. It is strongly recommended that the provincial and national Ministries of Health, in collaboration with international health agencies, immediately plan and implement a strategy to provide sufficient iodine through iodised oil capsules and iodised salt to the iodine-deficient population. National coalitions need to be strengthened among the government, partners and salt producers. It is also recommended that all the children in schools be de-wormed for multiple helminth species at least twice a year.

saltPAD: A New Analytical Tool for Monitoring Salt Iodization in Low Resource Settings.

We created a paper test card that measures a common iodizing agent, iodate, in salt. To test the analytical metrics, usability, and robustness of the paper test card when it is used in low resource settings, the South African Medical Research Council and GroundWork performed independent validation studies of the device. The accuracy and precision metrics from both studies were comparable. In the SAMRC study, more than 90% of the test results (n=1704) were correctly classified as corresponding to adequately or inadequately iodized salt. The cards are suitable for market and household surveys to determine whether salt is adequately iodized. Further development of the cards will improve their utility for monitoring salt iodization during production.

Iodine Concentration in Breastmilk and Urine among Lactating Women of Bhaktapur, Nepal.

Adequate iodine concentration in breastmilk (BMIC) is essential for optimal neonatal thyroid hormone synthesis and neurological development in breastfed infants. For many decades, iodine deficiency has been a public health problem in Nepal. However, recently, excessive iodine intakes among Nepali infants have been reported. This study aimed to measure BMIC and urinary iodine concentration (UIC) among lactating women in a peri-urban area of Nepal. Iodine concentration was measured in spot urine (n = 485) and breastmilk samples (n = 291) of 500 randomly selected lactating women. The median (p25, p75) BMIC and median UIC were 250 (130, 370) µg/L and 230 (135-377) µg/L, respectively. Around 82% had BMIC > 100 µg/L, 61% had BMIC > 200 µg/L and 81% had UIC > 100 µg/L, 37% had >300 µg/L and 20% had >500 µg/L. In multiple linear regression models, time since birth (ß 3.0, 95% CI (0.2, 5.0)) and UIC (ß 1.0, 95% CI (0.1, 2.0)) were associated with BMIC, explaining 26% of the variance. A large proportion of the women had adequate BMIC and UIC; however, a subset had high iodine concentrations. These findings emphasize the importance of carefully monitoring iodine intake to minimize the risk of iodine excess and subsequently preventing transient iodine-induced hypothyroidism in breastfed infants.

Methods for determination of iodine in urine and salt.

Good quality data on iodine concentrations in urine and salt samples are indispensable for the efficient management of national salt iodisation programmes and for evaluating iodine interventions. Most of the analytical methods for urinary iodine concentration are based on the manual spectrophotometric measurement of Sandell-Kolthoff reduction reaction catalysed by iodine using different oxidising reagents in the initial digestion step. Other analytical methods include semi-quantitative methods, a microplate method, automated methods; and the technologically advanced methods include the inductively coupled plasma mass-spectrometer method. Iodine in salt is determined quantitatively by the titration method, colorimetrically by the WYD iodine checker or by a technologically advanced potentiometric method. Worldwide, titration is the method of choice because of its accuracy, ease of operation and low cost. Rapid test kits are suitable for qualitative use in situations where iodised salt need to be distinguished from non-iodised salt, preferably with titration back-up.