| Peer-Reviewed

Factors Associated with Household Iodised Salt Use and Iodine Deficiency Among Nepalese School Children Aged 6-9 Years

Received: 1 July 2021    Accepted: 7 February 2022    Published: 16 February 2022
Views:       Downloads:
Abstract

Iodine deficiency is one of the world’s leading causes of delay in cognitive growth of children, and remains a public health problem, particularly in low-income countries including Nepal. This current study used cross-sectional data to examine factors associated with iodine deficiency and household iodised salt among Nepalese children. The source of data was the 2016 Nepal National Micronutrient Status Survey (NNMSS). Household iodised salt and urinary iodine were examined (by using and multivariate statistical models that adjust for clustering and sampling weights) against a set of non-biological and eating habits factors of 1153 Nepalese children aged 6-9 years. The mean household salt iodine concentrations (in ppm) in the Eastern, Central, Western, Mid-Western and Far-Western were 1.15 ± 1.6, 9.6 ± 2.6, 43.5 ± 12.9, 69.1 ± 3.7 and 85.6 ± 3.9 respectively. The corresponding median iron status of the children (and interquartile range IQR) in μg/l were 299 (177.6-569.2), 387.8 (197-604.8), 357.7 (203.8-566.7), 239.2 (140.3-493.1) and 238.5 (114.1-397.5) respectively. The likelihood of iodine deficiency was significantly higher among children from the Mountain ecological zone compared with those from the Terai zone [adjusted odds ratio (AOR): 0.02; 95% confidence interval (CI): (1.03, 1.49)]. Children who consumed dark green leafy vegetables were significantly less predisposed to iodine deficiency compared with those who did not [AOR: 0.87; 95% CI: (0.77, 0.99)]. The likelihood of household iodised salt use was significantly lower among children from the Far-Western region compared with those from the Eastern region [AOR: 0.81; 95% CI: (0.68, 0.97)]. The use of iodised salt was significantly more likely among children from rich households compared with those from poor households [AOR: 1.19; 95% CI: (1.06, 1.33)]. The likelihood of iodised salt use was significantly higher among households where children consumed meat compared with those in which children did not consume meat [AOR: 1.07; 95% CI: (1.01, 1.15)]. Among the development regions, it is only the Mid-Western region where household iodine concentration among the children was less than 75%. Appropriate interventions should be put in place to improve this situation. Interventions to improve household iodised salt use should target should also target children from poor households and those from households where children did not consume meat.

Published in Journal of Health and Environmental Research (Volume 8, Issue 1)
DOI 10.11648/j.jher.20220801.15
Page(s) 29-36
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Iodine, Deficiency, Household Iodised Salt, Children, Nepal

References
[1] Northrup, C. Iodine and our children's health. [cited 2018 May 25]; Available from: https://www.drnorthrup.com/iodine-and-our-childrens-health/.
[2] World Health Organisation. Nutrition: Micronutrient deficiencies. 2018 [cited 2018 April 26]; Available from: http://www.who.int/nutrition/topics/idd/en/.
[3] Caldwell, K. L., Y. Pan, M. E. Mortensen, A. Makhmudov, L. Merrill, and J. Moye, Iodine status in pregnant women in the National Children's Study and in US women (15–44 years), National Health and Nutrition Examination Survey 2005–2010. Thyroid, 2013. 23 (8): p. 927-937.
[4] Rogan, W. J., J. A. Paulson, C. Baum, A. C. Brock-Utne, H. L. Brumberg, C. C. Campbell, B. P. Lanphear, J. A. Lowry, K. C. Osterhoudt, and M. T. Sandel, Iodine deficiency, pollutant chemicals, and the thyroid: new information on an old problem. Pediatrics, 2014. 133 (6): p. 1163-1166.
[5] World Health Organization, UNICEF, and International Council for the Control of Iodine Deficiency Disorders, Assessment of iodine deficiency disorders and monitoring their elimination: A guide for programme managers. 2001, WHO: Geneva.
[6] Ministry of Health Nepal, New ERA, and ICF, Nepal Demographic and Health Survey 2016. 2017, Ministry of Health, Nepal: Kathmandu, Nepal.
[7] Baral, N., M. Lamsal, B. Koner, and S. Koirala, Thyroid dysfunction in eastern Nepal. Southeast Asian journal of tropical medicine and public health, 2002. 33 (3): p. 638-641.
[8] Devkota, S. C., A. De, and B. Sathian, Nutritional Deficiencies: Major Public Health Problem in Nepal. American Journal of Public Health Research, 2015. 3 (4A): p. 1-5.
[9] Bhandari, S. and M. R. Banjara, Micronutrients deficiency, a hidden hunger in Nepal: prevalence, causes, consequences, and solutions. International scholarly research notices, 2015. 2015.
[10] Gelal, B., R. K. Chaudhari, A. K. Nepal, G. S. Sah, M. Lamsal, D. A. Brodie, and N. Baral, Iodine deficiency disorders among primary school children in eastern Nepal. The Indian Journal of Pediatrics, 2011. 78 (1): p. 45-48.
[11] Guttikonda, K., S. Boyages, C. A. Travers, and P. R. Lewis, Iodine deficiency in urban primary school children: a cross-sectional analysis. The Medical journal of Australia, 2003. 179 (7): p. 346-348.
[12] Biswas, A. B., I. Chakraborty, D. K. Das, R. N. Roy, S. Mukhopadhyay, and S. Chatterjee, Iodine deficiency disorders among school children of Birbhum, West Bengal. Current Science, 2004: p. 78-80.
[13] Joshi, A. B., M. R. Banjara, L. R. Bhatta, T. Rikimaru, and M. Jimba, Assessment of IDD problem by estimation of urinary iodine among school children. Nepal Medical College journal: NMCJ, 2006. 8 (2): p. 111-114.
[14] Filmer, D. and L. H. Pritchett, Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States of India. Demography, 2001. 38 (1): p. 115-132.
[15] Kaluski, D. N., E. Ophir, and T. Amede, Food security and nutrition–the Ethiopian case for action. Public health nutrition, 2002. 5 (3): p. 373-381.
[16] World Bank. In Senegal, food security and women’s empowerment go hand in hand. 2017; Available from: http://blogs.worldbank.org/nasikiliza/in-senegal-food-security-and-womens-empowerment-go-hand-in-hand.
[17] Wikipedia. Geography of Senegal. Available from: https://en.wikipedia.org/wiki/Geography_of_Senegal.
[18] FAO. Nutrition and consumer protection. 2010 [cited 2018 June 7]; Available from: http://www.fao.org/ag/agn/nutrition/household_micronutrients_en.stm.
[19] Semba, R. D., S. de Pee, S. Y. Hess, K. Sun, M. Sari, and M. W. Bloem, Child malnutrition and mortality among families not utilizing adequately iodized salt in Indonesia–. The American journal of clinical nutrition, 2008. 87 (2): p. 438-444.
[20] Iodine deficiency serious cause for concern in Dhungachalna, in The Kathmandupost. 2018: Kathmandu.
[21] Haldimann, M., A. Alt, A. Blanc, and K. Blondeau, Iodine content of food groups. Journal of food Composition and Analysis, 2005. 18 (6): p. 461-471.
Cite This Article
  • APA Style

    Sanjay Rijal, Karan Courtney Haag, Naveen Paudyal, Anju Adhikari. (2022). Factors Associated with Household Iodised Salt Use and Iodine Deficiency Among Nepalese School Children Aged 6-9 Years. Journal of Health and Environmental Research, 8(1), 29-36. https://doi.org/10.11648/j.jher.20220801.15

    Copy | Download

    ACS Style

    Sanjay Rijal; Karan Courtney Haag; Naveen Paudyal; Anju Adhikari. Factors Associated with Household Iodised Salt Use and Iodine Deficiency Among Nepalese School Children Aged 6-9 Years. J. Health Environ. Res. 2022, 8(1), 29-36. doi: 10.11648/j.jher.20220801.15

    Copy | Download

    AMA Style

    Sanjay Rijal, Karan Courtney Haag, Naveen Paudyal, Anju Adhikari. Factors Associated with Household Iodised Salt Use and Iodine Deficiency Among Nepalese School Children Aged 6-9 Years. J Health Environ Res. 2022;8(1):29-36. doi: 10.11648/j.jher.20220801.15

    Copy | Download

  • @article{10.11648/j.jher.20220801.15,
      author = {Sanjay Rijal and Karan Courtney Haag and Naveen Paudyal and Anju Adhikari},
      title = {Factors Associated with Household Iodised Salt Use and Iodine Deficiency Among Nepalese School Children Aged 6-9 Years},
      journal = {Journal of Health and Environmental Research},
      volume = {8},
      number = {1},
      pages = {29-36},
      doi = {10.11648/j.jher.20220801.15},
      url = {https://doi.org/10.11648/j.jher.20220801.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jher.20220801.15},
      abstract = {Iodine deficiency is one of the world’s leading causes of delay in cognitive growth of children, and remains a public health problem, particularly in low-income countries including Nepal. This current study used cross-sectional data to examine factors associated with iodine deficiency and household iodised salt among Nepalese children. The source of data was the 2016 Nepal National Micronutrient Status Survey (NNMSS). Household iodised salt and urinary iodine were examined (by using and multivariate statistical models that adjust for clustering and sampling weights) against a set of non-biological and eating habits factors of 1153 Nepalese children aged 6-9 years. The mean household salt iodine concentrations (in ppm) in the Eastern, Central, Western, Mid-Western and Far-Western were 1.15 ± 1.6, 9.6 ± 2.6, 43.5 ± 12.9, 69.1 ± 3.7 and 85.6 ± 3.9 respectively. The corresponding median iron status of the children (and interquartile range IQR) in μg/l were 299 (177.6-569.2), 387.8 (197-604.8), 357.7 (203.8-566.7), 239.2 (140.3-493.1) and 238.5 (114.1-397.5) respectively. The likelihood of iodine deficiency was significantly higher among children from the Mountain ecological zone compared with those from the Terai zone [adjusted odds ratio (AOR): 0.02; 95% confidence interval (CI): (1.03, 1.49)]. Children who consumed dark green leafy vegetables were significantly less predisposed to iodine deficiency compared with those who did not [AOR: 0.87; 95% CI: (0.77, 0.99)]. The likelihood of household iodised salt use was significantly lower among children from the Far-Western region compared with those from the Eastern region [AOR: 0.81; 95% CI: (0.68, 0.97)]. The use of iodised salt was significantly more likely among children from rich households compared with those from poor households [AOR: 1.19; 95% CI: (1.06, 1.33)]. The likelihood of iodised salt use was significantly higher among households where children consumed meat compared with those in which children did not consume meat [AOR: 1.07; 95% CI: (1.01, 1.15)]. Among the development regions, it is only the Mid-Western region where household iodine concentration among the children was less than 75%. Appropriate interventions should be put in place to improve this situation. Interventions to improve household iodised salt use should target should also target children from poor households and those from households where children did not consume meat.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Factors Associated with Household Iodised Salt Use and Iodine Deficiency Among Nepalese School Children Aged 6-9 Years
    AU  - Sanjay Rijal
    AU  - Karan Courtney Haag
    AU  - Naveen Paudyal
    AU  - Anju Adhikari
    Y1  - 2022/02/16
    PY  - 2022
    N1  - https://doi.org/10.11648/j.jher.20220801.15
    DO  - 10.11648/j.jher.20220801.15
    T2  - Journal of Health and Environmental Research
    JF  - Journal of Health and Environmental Research
    JO  - Journal of Health and Environmental Research
    SP  - 29
    EP  - 36
    PB  - Science Publishing Group
    SN  - 2472-3592
    UR  - https://doi.org/10.11648/j.jher.20220801.15
    AB  - Iodine deficiency is one of the world’s leading causes of delay in cognitive growth of children, and remains a public health problem, particularly in low-income countries including Nepal. This current study used cross-sectional data to examine factors associated with iodine deficiency and household iodised salt among Nepalese children. The source of data was the 2016 Nepal National Micronutrient Status Survey (NNMSS). Household iodised salt and urinary iodine were examined (by using and multivariate statistical models that adjust for clustering and sampling weights) against a set of non-biological and eating habits factors of 1153 Nepalese children aged 6-9 years. The mean household salt iodine concentrations (in ppm) in the Eastern, Central, Western, Mid-Western and Far-Western were 1.15 ± 1.6, 9.6 ± 2.6, 43.5 ± 12.9, 69.1 ± 3.7 and 85.6 ± 3.9 respectively. The corresponding median iron status of the children (and interquartile range IQR) in μg/l were 299 (177.6-569.2), 387.8 (197-604.8), 357.7 (203.8-566.7), 239.2 (140.3-493.1) and 238.5 (114.1-397.5) respectively. The likelihood of iodine deficiency was significantly higher among children from the Mountain ecological zone compared with those from the Terai zone [adjusted odds ratio (AOR): 0.02; 95% confidence interval (CI): (1.03, 1.49)]. Children who consumed dark green leafy vegetables were significantly less predisposed to iodine deficiency compared with those who did not [AOR: 0.87; 95% CI: (0.77, 0.99)]. The likelihood of household iodised salt use was significantly lower among children from the Far-Western region compared with those from the Eastern region [AOR: 0.81; 95% CI: (0.68, 0.97)]. The use of iodised salt was significantly more likely among children from rich households compared with those from poor households [AOR: 1.19; 95% CI: (1.06, 1.33)]. The likelihood of iodised salt use was significantly higher among households where children consumed meat compared with those in which children did not consume meat [AOR: 1.07; 95% CI: (1.01, 1.15)]. Among the development regions, it is only the Mid-Western region where household iodine concentration among the children was less than 75%. Appropriate interventions should be put in place to improve this situation. Interventions to improve household iodised salt use should target should also target children from poor households and those from households where children did not consume meat.
    VL  - 8
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Nutrition Section, United Nations Children's Fund (UNICEF), Kathmandu, Nepal

  • Nutrition Section, United Nations Children's Fund (UNICEF), Kathmandu, Nepal

  • Nutrition Section, United Nations Children's Fund (UNICEF), Kathmandu, Nepal

  • Nepali Technical Assistance Group (NTAG), Kathmandu, Nepal

  • Sections