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Women's iodine status and its determinants in an iodine-deficient area in the Kayes region, Mali

Published online by Cambridge University Press:  02 January 2007

Liv E Torheim ,
Gry I Granli ,
Cheick S Sidibé ,
Abdel K Traoré  and
Arne Oshaug
Liv E Torheim*
Affiliation:
Akershus University College, PO Box 423, N-2001 Lillestrøm, Norway
Gry I Granli
Affiliation:
Pedriatric Ward, Rikshospitalet, Oslo, Norway
Cheick S Sidibé
Affiliation:
Ecole Secondaire de la Santé, Bamako, Mali
Abdel K Traoré
Affiliation:
Faculté de Medicin, Farmacie et d'Odonto-Stomotoligie, Université du Mali, Bamako, Mali
Arne Oshaug
Affiliation:
Akershus University College, PO Box 423, N-2001 Lillestrøm, Norway
*
*Corresponding author: Email livelin.torheim@hiak.no
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Abstract

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Objective

To assess iodine status and its determinants in women of childbearing age in a rural area in the Kayes region, Mali, West Africa.

Design

Cross-sectional study where women's iodine status was indicated by urinary iodine concentration (UIC) and level of goitre based on palpation. Salt iodine was assessed semi-quantitatively at household level. Individual characteristics were collected using questionnaires.

Setting

Fifteen villages in a rural area in the Kayes region of Mali.

Subjects

Women aged 15–45 years (n = 423).

Results

Median UIC was 2.7 μg dl−1, and only 6% of the women had adequate iodine status of UIC > 10 μg dl−1. Most women (60%) had visible goitre, and only 9% were classified as without goitre. Only 39% of the households were using salt with any iodine, and level of knowledge about salt iodisation was low. Main determinants of UIC were breast-feeding and level of salt iodisation; currently breast-feeding women had lower UIC, and UIC increased with increasing level of iodine in household salt. Prevalence of goitre was lower in older women with higher body mass index.

Conclusion

The study indicates severe iodine deficiency in the study area. Urgent action is needed to improve the situation through enforcing salt iodisation legislation and increasing the level of knowledge about the importance of iodised salt in the population.

Keywords

Iodine deficiencyIodised saltUrinary iodine concentrationWomenHuman nutritionMaliAfrica
Type
Research Article
Information
Public Health Nutrition , Volume 8 , Issue 4 , June 2005 , pp. 387 - 394
Copyright
Copyright © The Authors 2005

References

1Delange, F. The role of iodine in brain development. Proceedings of the Nutrition Society 2000; 59: 75–9.CrossRefGoogle ScholarPubMed
2Pharoah, POD, Connolly, KJ. Iodine deficiency in Papua New Guinea. In: Stanbury, JB, ed. The Damaged Brain of Iodine Deficiency. New York: Cognizant Communication Corporation, 1994; 299–305.Google Scholar
3World Health Organization (WHO)/International Council for Control of Iodine Deficiency Disorders/United Nations Children's Fund. Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination – A Guide for Programme Managers. Geneva: WHO, 2001.Google Scholar
4Hetzel, BS, Dunn, JT, Stanbury, JB. The Prevention and Control of Iodine Deficiency Disorders. Amsterdam: Elsevier, 1987.CrossRefGoogle ScholarPubMed
5United Nations Children's Fund (UNICEF). The State of the World's Children 2004. New York: UNICEF, 2003.Google Scholar
6United Nations Standing Committee on Nutrition (SCN). 5th Report on the World Nutrition Situation. Geneva: SCN, 2004.Google Scholar
7World Health Organization (WHO)/United Nations Children's Fund/International Council for Control of Iodine Deficiency Disorders. Conference on Sustainable Elimination of Iodine Deficiency Disorders in Africa by the Year 2000. Geneva: WHO, 1998.Google Scholar
8Global Micronutrient Project. Iodine Situation in Mali [online]. New Orleans, LA: University of Tulane. Available at http://www.tulane.edu/~internut/Countries/Mali/malixx.html. Accessed April 2004.Google Scholar
9 Cellule de Planification et de Statistique du Ministère de la Santé (CPS/MS), Direction Nationale de la Statistique et de l'Informatique (DNSI) and ORC Macro. Enquête Démographique et de Santé au Mali 2001. Calverton, MD: CPS/MS, DNSI and ORC Macro, 2001.Google Scholar
10Torheim, LE. Assessing Dietary Intake in Rural Mali – Challenges when People eat from Shared Plates. Oslo: Faculty of Medicine, University of Oslo, 2003.Google Scholar
11Torheim, LE, Ouattara, F, Diarra, MM, Thiam, FD, Barikmo, I, Hatløy, A, et al. Nutrient adequacy and dietary diversity in rural Mali: association and determinants. European Journal of Clinical Nutrition 2004; 58: 594–604.CrossRefGoogle ScholarPubMed
12World Health Organization (WHO)/United Nations Children's Fund/International Council for Control of Iodine Deficiency Disorders. Indicators for Assessing Iodine Deficiency Disorders and Their Control through Salt Iodization. Geneva: WHO, 1994.Google Scholar
13Perez, C, Schrimshaw, NS, Munoz, JA. Technique of endemic goitre surveys. In: Endemic Goiter. World Health Organization (WHO). Monograph Series No. 44. Geneva: WHO, 1960; 369–83.Google Scholar
14Dunn, JT, Crutchfield, HE, Gutekunst, R, Dunn, AD. Methods for Measuring Iodine in Urine. The Netherlands: International Council for Control of Iodine Deficiency Disorders, 1993.Google ScholarPubMed
15Dunn, JT, Crutchfield, HE, Gutekunst, R, Dunn, AD. Two simple methods for measuring iodine in urine. Thyroid 1993; 3: 119–23.CrossRefGoogle ScholarPubMed
16Kibambe, N, Ouedraogo, A, Acakpo, A, Salami, M. Projet Thyromobil en Afrique de L'Ouest (première phase). Rapport Final. Lome: Conseil International de Lutte contre les Troubles Dus à la Carence en Iode/Organisation Mondiale de la Santé/Centre Régional de Recherche en Alimentation et Nutrition/Fonds des Nations Unies pour l'Enfance, 2000.Google Scholar
17Pawloski, LR, Shier, NW, Fernandez, XE, Jamison, PL. Examination of urinary iodine status from a sample of Malian adolescent girls. African Journal of Food, Agriculture, Nutrition and Development 2003; 3: 20–8.CrossRefGoogle Scholar
18Diosady, LL, Alberti, JO, Venkatesh Mannar, MG, FitzGerald, S. Stability of iodine in iodised salt used for correction of iodine-deficiency disorders II. Food and Nutrition Bulletin 1998; 19: 240–9.CrossRefGoogle Scholar
19Schulze, KJ, West, KP Jr, Gautschi, LA, Dreyfuss, ML, LeClerq, SC, Dahal, BR, et al. Seasonality in urinary and household salt iodine content among pregnant and lactating women of the plains of Nepal. European Journal of Clinical Nutrition 2003; 57: 969–76.CrossRefGoogle ScholarPubMed
20Torheim, LE, Barikmo, I, Hatløy, A, Diakité, M, Solvoll, K, Diarra, MM, et al. Validation of a quantitative food-frequency questionnaire for use in Western Mali. Public Health Nutrition 2001; 4: 1267–77.CrossRefGoogle ScholarPubMed
21Parr, CL, Barikmo, I, Torheim, LE, Ouattara, F, Kaloga, A, Oshaug, A. Validation of the second version of a quantitative food-frequency questionnaire for use in Western Mali. Public Health Nutrition 2002; 5: 769–81.CrossRefGoogle ScholarPubMed
22Verma, M, Raghuvanshi, RS. Dietary iodine intake and prevalence of iodine deficiency. Journal of Nutritional and Environmental Medicine 2001; 11: 175–80.CrossRefGoogle Scholar
23Pandav, CS, Arora, NK, Krishnan, A, Sankar, R, Pandav, S, Karmarkar, MG. Validation of spot-testing kits to determine iodine content in salt. Bulletin of the World Health Organization 2000; 78: 975–80.Google ScholarPubMed
24Eltom, A, Eltom, M, Elnagar, B, Elgabir, M, Gebre-Medhin, M. Changes in iodine metabolism during late pregnancy and lactation: a longitudinal study among Sudanese women. European Journal of Clinical Nutrition 2000; 54: 429–33.CrossRefGoogle ScholarPubMed
25Glinoer, D. Feto-maternal repercussions of iodine deficiency during pregnancy. An update. Annales d'Endocrinologie 2003; 64: 37–44.Google ScholarPubMed
26Dunn, JT, Delange, F. Damaged reproduction: the most important consequence of iodine deficiency. Journal of Clinical Endocrinology and Metabolism 2001; 86: 2360–3.CrossRefGoogle ScholarPubMed
27Brander, L, Als, C, Buess, H, Haldimann, F, Harder, M, Hanggi, W, et al. Urinary iodine concentration during pregnancy in an area of unstable dietary iodine intake in Switzerland. Journal of Endocrinological Investigation 2003; 26: 389–96.CrossRefGoogle Scholar
28Dorea, JG. Iodine nutrition and breast feeding. Journal of Trace Elements in Medicine and Biology 2002; 16: 202–20.CrossRefGoogle ScholarPubMed
29Adesunkanmi, AR, Makinde, ON. Goitre prevalence in pregnant women attending antenatal clinic in a teaching hospital. Journal of Obstetrics and Gynaecology 2003; 32: 156–9.CrossRefGoogle Scholar
30Rotondi, M, Amato, G, Biondi, B, Mazziotti, G, Del Buono, A, Rotonda Nicchio, M, et al. Parity as a thyroid size-determining factor in areas with moderate iodine deficiency. Journal of Clinical Endocrinology and Metabolism 2000; 85: 4534–7.CrossRefGoogle ScholarPubMed
31Knudsen, N, Bülow, I, Jørgensen, T, Laurberg, P, Ovesen, L, Perrild, H. Goitre prevalence and thyroid abnormalities at ultrasonography: a comparative epidemiological study in two regions with slightly different iodine status. Clinical Endocrinology 2000; 53: 479–85.CrossRefGoogle ScholarPubMed
32Knudsen, N, Bülow, I, Laurberg, P, Ovesen, L, Perrild, H, Jørgensen, T. Parity is associated with increased thyroid volume solely among smokers in an area with moderate to mild iodine deficiency. European Journal of Endocrinology 2002; 146: 39–43.CrossRefGoogle Scholar
33Smyth, PP, Hetherton, AM, Smith, DF, Radcliff, M, O'Herlihy, C. Maternal iodine status and thyroid volume during pregnancy: correlation with neonatal iodine intake. Journal of Clinical Endocrinology and Metabolism 1997; 82: 2840–3.CrossRefGoogle ScholarPubMed
34Rasmussen, NG, Hornnes, PJ, Hegedus, L. Ultrasonographically determined thyroid size in pregnancy and post partum: the goitrogenic effect of pregnancy. American Journal of Obstetrics and Gynecology 1989; 160: 1216–20.CrossRefGoogle ScholarPubMed
35Glinoer, D, Lemone, M, Bourdouc, P, De Nayer, P, Delange, F, Kinthaert, J, et al. Partial reversibility during late postpartum of thyroid abnormalities associated with pregnancy. Journal of Clinical Endocrinology and Metabolism 1992; 74: 453–7.Google ScholarPubMed
36Glinoer, D. Pregnancy and iodine. Thyroid 2001; 11: 471–81.CrossRefGoogle ScholarPubMed
37Gaitan, JE, Mayoral, LG, Gaitan, E. Defective thyroidal iodine concentration in protein–calorie malnutrition. Journal of Clinical Endocrinology and Metabolism 1983; 57: 327–33.CrossRefGoogle ScholarPubMed
38Tonglet, R, Bourdoux, P, Dramaix, M, Hennart, P, Ermans, AM. Interobserver variation in the assessment of thyroid enlargement: a pitfall in surveys of the prevalence of endemic goitre. Food and Nutrition Bulletin 1994; 15: 64–70.CrossRefGoogle Scholar
39Altman, DG. Practical Statistics for Medical Research. London: Chapman & Hall, 1997.Google Scholar