Iodine-deficiency disorders, due to insufficiency of iodine in the diet, are a global public health problem. The Kenyan Food, Drugs and Chemical Substances Act stipulates that processed retail-available edible salts contain 50–84 mg of potassium iodate (KIO3) per kilogram of salt. The present study determined the status of KIO3 levels in commercial salts, for public health action.

As part of the Kenya Demographic and Health Survey 2013, field workers collected salt samples from seven different local manufacturers/packers across eight regions of the country and sent them to the National Public Health Laboratory (NPHL) for KIO3 titration analysis.

A total of 539 samples were collected and analysed at NPHL. The samples had a mean KIO3 of 62 mg/kg. Thirty-three (6 %) samples had KIO3 of <25 mg/kg; ninety-eight (18 %) had 25–49 mg/kg; 335 (62 %) had 50–84 mg/kg; and seventy-three (13 %) had KIO3 of >84 mg/kg.

The study found that 62 % of salts sampled met the Kenyan standards, 24 % were below the required limits and 13 % were above the recommended range. Continuous monitoring of edible salts at the retail level is important to detect brands not adhering to standards and trace them for remedy. However, governmental efforts should be directed to the quality control and quality assurance of the salt-manufacturing industries.

Low iodine intakes are associated with goitre and other iodine-deficiency disorders (IDD) that have affected billions of people worldwide. We aimed to assess total goitre rate (TGR) and urinary iodine concentration (UIC) in schoolchildren between 2007 and 2015, percentage of iodized salt consumption by households, and salt iodine content at production, distribution and household levels in north-west Iran.

UIC assessed among schoolchildren in nine consecutive years; 240 schoolchildren aged 8–10 years selected by systematic random sampling each year in the West Azerbaijan Province.

Median UIC was >100 μg/l in all years. More than 50 % of children had iodine deficiency (UIC≤99 μg/l) in 2010 and 2011, while this rate was approximately 15–35 % in other years. Proportion with UIC below 50 μg/l was <20 % in all years except 2010 and 2011. Excessive UIC (≥300 μg/l) rate was between 5·4 and 27·5 %. TGR decreased from 44 % in 1996 to 7·6 % and 0·4 % in 2001 and 2007, respectively. Regular surveys from 2002 to 2015 showed that 98 % or more of households consumed iodized salt. Iodine level ≥20 ppm was observed in 87·5, 83 and 73 % of salt at production, distribution and household level, respectively (data from national study in 2007). The last national study in 2014 showed that median iodine level in household salt was 27 ppm.

Our focused data suggest that the universal salt iodization programme is improving the iodine status of schoolchildren in the West Azerbaijan Province of Iran. Reduction of TGR to less than 5 % in schoolchildren indicates successful elimination of IDD as a major public health problem.

Over 300 million people rely on desalinated seawater and the numbers are growing. Desalination removes iodine from water and could increase the risk of iodine-deficiency disorders (IDD). The present study assessed the relationship between iodine intake and thyroid function in an area reliant on desalination.

A case–control study was performed between March 2012 and March 2014. Thyroid function was rigorously assessed by clinical examination, ultrasound and blood tests, including serum thyroglobulin (Tg) and autoimmune antibodies. Iodine intake and the contribution made by unfiltered tap water were estimated by FFQ. The contribution of drinking-water to iodine intake was modelled using three iodine concentrations: likely, worst-case and best-case scenario.

The setting for the study was a hospital located on the southern Israeli Mediterranean coast.

Adult volunteers (n 102), 21–80 years old, prospectively recruited.

After screening, seventy-four participants met the inclusion criteria. Thirty-seven were euthyroid controls. Among those with thyroid dysfunction, twenty-nine were classified with non-autoimmune thyroid disease (NATD) after excluding eight cases with autoimmunity. Seventy per cent of all participants had iodine intake below the Estimated Average Requirement (EAR) of 95 µg/d. Participants with NATD were significantly more likely to have probable IDD with intake below the EAR (OR=5·2; 95 % CI 1·8, 15·2) and abnormal serum Tg>40 ng/ml (OR=5·8; 95 % CI 1·6, 20·8).

Evidence of prevalent probable IDD in a population reliant on desalinated seawater supports the urgent need to probe the impact of desalinated water on thyroid health in Israel and elsewhere.

To study (i) the current prevalence of iodine-deficiency disorders among schoolchildren in south-western Saudi Arabia after universal salt iodization and (ii) the iodine content of table salts and water.

Cross-sectional study on a stratified proportional allocation sample of children. Thyroid gland enlargement was assessed clinically and by ultrasound scanning. Urine, table salt and water samples were taken to measure iodine content.

The Aseer region, south-western Saudi Arabia.

Schoolchildren aged 8–10 years.

The study included 3046 schoolchildren. The total goitre rate amounted to 24·0 %. Prevalence of enlarged thyroid by ultrasound was 22·7 %. The median urinary iodine concentration of the study sample amounted to 17·0 µg/l. The iodine content of table salt ranged from 0 to 112 mg/kg; 22·5 % of the table salt samples were below the recommended iodine content (15 mg/kg) set by WHO. The total goitre rate increased significantly from 19·8 % among children using table salt with iodine content ≥15 mg/kg to reach 48·5 % among children using table salt with 0 mg iodine/kg. Analysis of water samples taken from schools showed that the majority of water samples (78·8 %) had an iodine content of 0 µg/l.

The study documented that 18 years after the national study, and after more than a decade of universal salt iodization in Saudi Arabia, the problem of iodine-deficiency disorders is still endemic in the Aseer region. Efforts should focus on fostering advocacy and communication and ensuring the availability of adequately iodized salt.

Iodine is an essential micronutrient needed for the production of thyroid hormones. Pregnant mothers who are deficient in iodine provide less iodine to the fetal thyroid. This results in low production of thyroid hormones by the fetal thyroid, thereby leading to compromised mental and physical development of the fetus. The current study aimed to assess the current status of iodine nutrition among pregnant mothers in Himachal Pradesh, India, a known endemic region for iodine deficiency.

Three districts, namely Kangra, Kullu and Solan, were selected.

In each district, thirty clusters (villages) were identified by utilizing the population-proportional-to-size cluster sampling methodology. In each cluster, seventeen pregnant mothers attending the antenatal clinics were included.

A total of 1711 pregnant mothers (647 from Kangra, 551 from Kullu and 513 from Solan) were studied. Clinical examination of the thyroid of each pregnant mother was conducted. Spot urine samples were collected from ten pregnant mothers in each cluster. Similarly, salt samples were collected from eleven pregnant mothers in each cluster.

Total goitre rate was 42·2 % (Kangra), 42·0 % (Kullu) and 19·9 % (Solan). The median urinary iodine concentration was 200 μg/l (Kangra), 149 μg/l (Kullu) and 130 μg/l (Solan). The percentage of pregnant mothers consuming adequately iodized salt (iodine content of 15 ppm and more) was found to be 68·3 % (Kangra), 60·3 % (Kullu) and 48·5 % (Solan).

Pregnant mothers in Kullu and Solan districts had iodine deficiency as indicated by a median urinary iodine concentration less than 150 μg/l.

The present study was conducted to assess the current status of iodine-deficiency disorders (IDD) in the National Capital Region of Delhi (NCR Delhi) and evaluate the implementation and impact of the National Iodine Deficiency Disorders Control Programme (NIDDCP).

Cross-sectional study.

School-going children (n 1230) in the age group of 6–12 years were enrolled from thirty primary schools in the Municipal Corporation of Delhi. Thirty schools were selected using the probability-proportional-to-size cluster sampling methodology. In each identified school forty-one children were surveyed. Urine and salt samples were collected and studied for iodine concentration. A total of sixty salt samples from retail level were also collected.

Schoolchildren aged 6–12 years.

The median urinary iodine excretion (UIE) was found to be 198·4 μg/l. The percentage of children with UIE levels of <20·0, 20·0–49·9, 50·0–99·9 and ≥100·0 μg/l was 1·9, 4·3, 9·5 and 84·2 %, respectively. The proportion of households consuming adequately iodized salt (salt with iodine levels of at least 15 ppm at consumption level) was 88·8 %. The assessment of iodine content of salt revealed that only 6·1 % of the families were consuming salt with iodine content less than 7 ppm. At retail level 88·3 % of salt samples had >15 ppm iodine.

Significant progress has been achieved towards elimination of IDD from NCR Delhi. There is a need for further strengthening of the system to monitor the quality of iodized salt provided to the beneficiaries under the universal salt iodization programme and so eliminate IDD from NCR Delhi.

Although goitre and cretinism were brought under control in Kyrgyzstan during the 1960s by centrally directed iodized salt supplies, iodine-deficiency disorders (IDD) had made a comeback when the USSR broke up in 1991. Upon independence, Kyrgyzstan started developing its own salt processing industry and by 2001 the Government enacted a law on IDD elimination, mandating universal salt iodization (USI) at 25–55 mg/kg. The present study aimed to evaluate the effectiveness of the USI strategy on the iodine consumption, iodine status and burden of IDD in the population of Kyrgyzstan.

A national, population-representative survey during autumn 2007 collected household salt and urine samples of school-age children and pregnant women for quantitative iodine measurements. Thyroid volume was measured by ultrasound.

The median iodine content in household salt was 11·2 mg/kg; 97·9 % of salt samples were iodized, but only 39·5 % had ≥15 mg iodine/kg. The median urinary iodine concentration (UIC) of 114 μg/l in children did not differ from the UIC of 111 μg/l in pregnant women. Thyroid volume in pregnant women increased with the duration of pregnancy. Strong relationships existed between salt iodine levels and the UIC values in children and women.

The iodine nutrition status of the Kyrgyz population is highly responsive to household salt iodization. Although the results in children suggest adequate iodine nutrition, the iodine consumption among pregnant women did not assure their dietary requirements. In-depth analysis of the survey data suggest that excess iodine intake is not likely to become a public health concern in Kyrgyzstan when the salt supply meets agreed standards.

The aim of the present study was to determine the impact of universal salt iodization (USI) on the prevalence of iodine deficiency in the population of an area previously known to have severe iodine deficiency in India.

In a cross-sectional survey, a total of 2860 subjects residing in fifty-three villages of four sub-districts of Gonda District were examined for goitre and urinary iodine concentration. Free thyroxine and thyroid-stimulating hormone levels were also measured. Salt samples from households were collected for estimation of iodine content.

A reduction in goitre prevalence was observed from 69 % reported in 1982 to 27·7 % assessed in 2007. However, 34 % of villages still had very high endemicity of goitre (goitre prevalence >30 %). Twenty-three per cent of households consumed a negligible amount (<5 ppm) and 56 % of households consumed an insufficient amount (5–15 ppm) of iodine from salt.

Although there was an overall improvement in iodine nutrition as revealed by decreased goitre prevalence and increased median urinary iodine levels, there were several pockets of severe deficiency that require a more targeted approach. Poor coverage, the use of unpackaged crystal salt with inadequate iodine and the washing of salt before use by 90 % of rural households are the major causes of persisting iodine-deficiency disorders. This demonstrates lapses in USI implementation, lack of monitoring and the need to identify hot spots. We advocate strengthening the USI programme with a mass education component, the supply of adequately iodized salt and the implementation of complementary strategies for vulnerable groups, particularly neonates and lactating mothers.