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Excess dietary iodine intake in long-term African refugees

Published online by Cambridge University Press:  02 January 2007

Andrew J Seal*
Affiliation:
Centre for International Child Health, Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
Paul I Creeke
Affiliation:
Centre for International Child Health, Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
Daniella Gnat
Affiliation:
Department of Clinical Chemistry, Saint-Pierre Hospital, Brussels, Belgium
Fathia Abdalla
Affiliation:
United Nations High Commissioner for Refugees, Geneva, Switzerland
Zahra Mirghani
Affiliation:
United Nations High Commissioner for Refugees, Geneva, Switzerland
*
*Corresponding author: Email a.seal@ich.ucl.ac.uk
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Abstract

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Objective

To assess the iodine status of long-term refugees dependent on international food aid and humanitarian assistance.

Design

A series of cross-sectional two-stage cluster or systematic random sample surveys which assessed urinary iodine excretion and the prevalence of visible goitre. Salt samples were also collected and tested for iodine content by titration.

Setting

Six refugee camps in East, North and Southern Africa.

Subjects

Male and female adolescents aged 10–19 years.

Main results

The median urinary iodine concentration (UIC) ranged from 254 to 1200 μg l−1 and in five of the camps exceeded the recommended maximum limit of 300 μg l−1, indicating excessive iodine intake. Visible goitre was assessed in four surveys where it ranged from 0.0 to 7.1%. The camp with the highest UIC also had the highest prevalence of visible goitre. The iodine concentrations in 11 salt samples from three camps were measured by titration and six of these exceeded the production-level concentration of 20 to 40 ppm recommended by the World Health Organization (WHO), but were all less than 100 ppm.

Conclusions

Excessive consumption of iodine is occurring in most of the surveyed populations. Urgent revision of the level of salt iodisation is required to meet current WHO recommendations. However, the full cause of excessive iodine excretion remains unknown and further investigation is required urgently to identify the cause, assess any health impact and identify remedial action.

Type
Research Article
Copyright
Copyright © The Authors 2006

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