Iodine level concentration, coverage of adequately iodized salt consumption and factors affecting proper iodized salt utilization among households in North Ethiopia: a community based cross sectional study

Abstract Introduction Adequate iodine fortified salt is the most common and effective method of preventing iodine deficiency. Studies showed households using iodized salt (15 Parts Per Million (PPM) to 80 PPM) of iodine at household level were low in Tigray region and other regions of Ethiopia. Limited studies have conducted on utilization of iodized salt at the household level and none of them did not addressed on factors affecting to proper iodized salt utilization. The aim of this study was to determine the iodine concentration in the collected salt samples, adequately iodized salt consumption coverage and identify factors affecting to proper iodized salt utilization amongst the households of Northern Ethiopia. Methods Community based cross-sectional designs on selected 318 household food caterers were interviewed and salt samples were accordingly collected. Data was analyzed by the SAS-9.2 statistical software package. The iodine concentrations of the salt samples were determined by using the golden standard iodometric titration technique. Logistic Generalized Estimating Equation (GEE) statistical analysis method was used to assess factors affecting proper iodized salt utilization at household level. Results Adequately iodized salt coverage among the households was only 51 (17.5%). About 42 (14.38%) had 15 ppm (ppm) – 80 ppm, 9 (3.08%) had > 80 ppm, 188 (64.4%) had 1.1 ppm to 14.9 ppm and 53 (18.2%) had no iodine in the salt (0 ppm). Only 26 (8.9%) of the households had used iodized salt properly. Family size with Adjusted Odds Ratio (AOR) (0.82) and 95%CI [0.67, 0.92], residency of the household with AOR (2.83) and 95%CI [1.48, 5.40], the availability of iodized salt with AOR (3.90) and 95% CI [1.74, 8.7] and affordability to iodized salt with AOR (3.33) and 95% CI [1.41, 7.34] was strong predictors to proper iodized salt utilization. Conclusions Coverage of adequately iodized salt was low. Family size, residency, availability and affordability of iodized salt were the predictors of proper iodized salt utilization. To enhance USI utilization effective inspection and regulatory measures should be taken to prevent the production and distribution of under/ over iodized salt in the market

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BackgroundInfective endocarditis (IE) is a continuously evolving disease with a high mortality rate despite different advances in treatment. In Ethiopia, there is a paucity of data regarding IE. Therefore, this study is aimed at assessing IE-related in-hospital mortality and characterization of IE patients based on their microbiological, clinical features, and management profiles in the Ayder Comprehensive Specified Hospital (ACSH).MethodsWe conducted a hospital-based prospective follow-up study with all consecutive sampling techniques for suspected infective endocarditis patients admitted to ACSH from January 2020 to February 2022. Echocardiography was performed, and three sets of blood samples for blood culture were taken as per the standard protocol. We also performed isolation of microbial etiologies and antimicrobial susceptibility tests. The data was analyzed using STATA version 16. Stepwise logistic regression was run to identify predictors of in-hospital mortality. Effects were measured through the odds ratio at the 5% level of significance.ResultsSeventy-four cases of suspected infective endocarditis were investigated; of these, 54 episodes fulfilled modified Duke’s criteria. Rheumatic heart disease (RHD) (85.2%) was the most common underlying heart disease. Murmur (94.4%), fever (68.5%), and pallor (57.4%) were the most common clinical findings. Vegetation was present in 96.3% of episodes. Blood culture was positive only in 7 (13%) episodes. Complications occurred in 41 (75.9%) cases, with congestive heart failure being the most common. All patients were managed medically, with no surgical intervention. The in-hospital mortality was 14 (25.9%). IE-related in-hospital mortality was significantly associated with surgery recommendation and myalgia clinical symptoms.ConclusionIE occurred relatively in a younger population, with RHD as the most common underlying heart disease. There was a high rate of culture-negative endocarditis, and the majority of patients were treated empirically. Mortality was high. The establishment of cardiac surgery and strengthening microbiology services should be given top priority.</div

Echocardiographic profile of IE (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).

Echocardiographic profile of IE (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).</p

Laboratory and microbiology profiles of IE (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).

Laboratory and microbiology profiles of IE (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).</p

Socio-demographic characteristics of IE (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).

Socio-demographic characteristics of IE (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).</p

Management and treatment outcome of IE (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).

Management and treatment outcome of IE (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).</p

Complications of IE (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).

Complications of IE (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).</p

Clinical features of infective endocarditis (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).

Clinical features of infective endocarditis (Definite or possible) patients in Ayder Comprehensive Specialized Hospital, Tigray region, Northern Ethiopia, 2020–2022 (n = 54).</p

Predictors of in-hospital mortality among patients with IE in Ayder Comprehensive Specialized Hospital (n = 54).

Predictors of in-hospital mortality among patients with IE in Ayder Comprehensive Specialized Hospital (n = 54).</p