Iodine Deficiency Disorders Among Primary School Children in Eastern Nepal

Objective To assess the iodine status among primary school children of Dhankuta and Dharan in eastern Nepal. Methods A population based cross sectional study was conducted on schools of Dhankuta and Dharan from January–March 2008. 385 samples of both urine and salt were collected from school children aged 6–11 yrs. Urinary iodine excretion (UIE) was measured in casual urine samples by the ammonium-persulphate digestion microplate (APDM) method and salt iodine content by using a semi quantitative rapid test kit. Results The median UIEs of school children of Dhankuta and Dharan were 157.1 μg/L and 180.3 μg/L respectively. The percentage of iodine deficient (UIE <100 μg/L) children were 26.6% in Dhankuta and 15.6% in Dharan. The majority of children consumed packet salt. The percentages of salt samples with adequately iodized salt (≥15 ppm) were 81.3% in Dhankuta and 89.6% in Dharan. Conclusions Eastern Nepal is continuously progressing towards the sustainable elimination of iodine deficiency disease as illustrated by a normal median UIE and the majority of households consuming adequately iodized packet salt. It is necessary to maintain the program continuously to ensure adequate iodine nutrition of the population

Dried blood spot thyroglobulin as a biomarker of iodine status in pregnant women

Context: Thyroglobulin (Tg) could be a sensitive biomarker of iodine nutrition in pregnant women (PW). A dried blood spot (DBS) assay would simplify collection and transport in field studies. Objectives: Our aims were to (1) establish and test a reference range for DBS-Tg in PW; (2) determine whether co-measurement of Tg antibodies (Abs) is necessary to define population iodine status. Design, Setting, and Participants: Standardized cross-sectional studies of 3870 PW from 11 countries. For the DBS-Tg reference range, we included TgAb-negative PW (n = 599) from 3 countries with sufficient iodine intake. Main Outcome Measures: We measured the urinary iodine concentration and DBS thyroid-stimulating hormone, total thyroxin, Tg, and TgAb. Results: In the reference population, the median DBS-Tg was 9.2 μg/L (95% confidence interval, 8.7 to 9.8 μg/L) and was not significantly different among trimesters. The reference range was 0.3 to 43.5 μg/L. Over a range of iodine intake, the Tg concentrations were U-shaped. Within countries, the median DBS-Tg and the presence of elevated DBS-Tg did not differ significantly between all PW and PW who were TgAb-negative. Conclusions: A median DBS-Tg of ∼10 μg/L with <3% of values ≥44 μg/L indicated population iodine sufficiency. Concurrent measurement of TgAb did not appear necessary to assess the population iodine status.ISSN:0021-972XISSN:1945-719