Iodine Status and Risk Factors for Iodine Deficiency, Among Primary School Children in Mt. Elgon Sub-County, Bungoma County, Kenya

Abstract

Iodine deficiency (ID) is a global health problem. Approximately 2 billion people globally are at risk of ID disorder which is leading cause of preventable brain damage. Mental impairment arising from deficiency may affect children's learning capacity, quality of life, and economic productivity. In addition, increased risk to clinical conditions. A cross- sectional design utilizing multi-stage sampling was employed to determine iodine status and risk factor for deficiency among school-going-children (SAC). A total of 362 spot urine samples were collected from SAC who also provided (336) salt samples from their homes. Additionally, 53 water samples from domestic sources and 38 salt samples from distribution points were obtained. Ethical standards were upheld throughout the study. A questionnaire was administered to parents/guardians of SAC to assess social- demographic-characteristics and frequency of consuming foods from different food groups and antinutrients (goitrogens). Spot urine samples were analyzed using Sandell Kolthoff reaction and finding interpreted as median urinary iodine concentration (UIC) based on World Health Organization (WHO) recommendation and cut-offs to determine iodine status. A median 200.7μg/l was obtained which fall within the iodine nutrition adequacy region (100-299μg/l) deeming the population iodine sufficient. However, 24% of SAC reported UIC <100μg/l which fall within the insufficient levels. Similarly, iodine levels in water was determined using Sandell Kolthoff reaction and WHO cut-offs. No iodine was detected in the samples. This can imply that iodized salt is the only source of iodine to this population. Salt iodine levels were determined using iodometric titration. Although, all the samples indicated iodine presence a notable proportion were not iodized as recommended (50-84mg/Kg): about 50% of household (HH) and 36% from distribution level. Salt dampening reported in the question can be attributed to the notable proportion of HH salt with iodine levels below standard while poor iodization or packaging can be attributed to the findings at distribution levels. A fairly adequate dietary diversity was observed within the population with high consumption of foods rich in antinutrients-goitrogens. However, the impact of goitrogens seems to be minimal since the population status is adequate. High proportion of poorly iodized salt, losses due to dampening, lack of alternative sources and effects of antinutrients might be contributing to deficiencies observed. More effort is required to ensure salt iodization is as recommended coupled with continuous monitoring of the intervention to assess the impact.