Public Health Nutrition

Research Paper

Remaining challenges in Tanzania's efforts to eliminate iodine deficiency

Vincent D Asseya1a2 c1, Celestin Mgobaa1, Nicholaus Mlingia1, Alfred Sangaa1, Godwin D Ndossia1, Ted Greinera2 and Stefan Petersona3a4

a1 Tanzania Food and Nutrition Centre, PO Box 977, Dar-Es-Salaam, Tanzania

a2 Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden

a3 Department of Public Health Sciences, International Health, Karolinska Institute (IHCAR), Stockholm, Sweden

a4 Institute of Public Health, Makerere University, Kampala, Uganda

Abstract

Objective To determine iodine levels in salt and iodine deficiency prevalence in school-aged children in 16 districts in Tanzania with previous severe iodine deficiency.

Design A cross-sectional study in schoolchildren. Systematic probability sampling was used to select schools and subjects for goitre assessment and urinary iodine determination.

Setting Sixteen districts randomly selected from the 27 categorised as severely iodine-deficient in Tanzania.

Subjects The study population was primary-school children aged 6–18 years who were examined for goitre prevalence and urinary iodine concentration (UIC). Salt samples from schoolchildren's homes and from shops were tested for iodine content.

Results The study revealed that 83.3% of households (n = 21 160) in the surveyed districts used iodised salt. Also, 94% of sampled shops (n = 397) sold iodised salt, with a median iodine level of 37.0 ppm (range 4.2–240 ppm). Median UIC in 2089 schoolchildren was 235.0 μg l− 1 and 9.3% had UIC values below 50 μg l− 1. The overall unweighted mean visible and total goitre prevalence was 6.7% and 24.3%, respectively (n = 16 222). The age group 6–12 years had the lowest goitre prevalence (3.6% visible and 18.0% total goitre, n = 7147). The total goitre prevalence had decreased significantly in all districts from an unweighted mean of 65.4% in the 1980s to 24.3% in 1999 (P < 0.05). We believe this difference was also biologically significant.

Conclusion These findings indicate that iodine deficiency is largely eliminated in the 16 districts categorised as severely iodine-deficient in Tanzania, and that the iodine content of salt purchased from shops is highly variable.

(Received February 28 2006)

(Accepted November 21 2006)

(Online publication February 22 2007)

Correspondence

c1 Corresponding author: Email vincentassey@yahoo.co.uk

Footnotes

† Currently Senior Nutritionist, PATH, Washington, DC, USA.

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