Migration flows affect women's dietary iodine intake and jeopardize their iodine sufficiency: a pilot study

Prevalence of goiter and associated factors among adolescent girls in the highland area of Northwest Ethiopia

Background

Goiter is a common public health issue in Ethiopia; however, there is not much evidence of it among adolescent girls, especially in Northwest Ethiopia.

Objective

This study aimed to determine the prevalence and associated factors of goiter in adolescent girls living in the highlands of Northwest Ethiopia.

Methods

From 5 January to 15 February 2022, 560 adolescent girls participated in this study. A multistage sampling method was used. Participants were checked for goiter using World Health Organization guidelines. Using a quick test kit, the amount of iodine in samples of table salt was determined. After being entered into Epi Info version 7, the data were exported to the SPSS version 22 for statistical analysis. Binary logistic regression was applied. It was decided to set the statistically significant level at p < 0.05.

Results

In this study, the total prevalence of goiter among adolescent girls was 33.4% (95% CI: 26.3%-39.4%). The odds of goiter were 5.3 times higher among adolescents whose families had a history of goiter (AOR = 5.34, 95% CI: 3.65-9.74). The likelihood of developing goiter was 3.7 times greater among adolescent girls who consumed cabbage at least once per week (AOR = 3.74, 95% CI: 2.46-8.31). In addition, adolescent girls who did not consume meat at all were 3.3 times more likely to develop goiter (AOR = 3.32, 95% CI: 1.95-6.78). Similarly, the odds of getting goiter among adolescent girls from families who use salt with inadequate levels of iodine (0-14) were 9.84 times greater compared to their counterparts (AOR = 9.84, 95% CI: 5.61-26.24).

Conclusion

In the study area, goiter was very common. Therefore, the district's health sector should make an effort to raise community knowledge by spreading important messages regarding the proper use of iodized salt and food sources.

Poverty and immigration as a barrier to iodine intake and maternal adherence to iodine supplementation

PURPOSE

Iodine deficiency still remains a significant health issue worldwide. Pregnant and lactating women are at risk for iodine deficiency when living in mild iodine-deficient areas such as Italy. This study aims at evaluating the consumption of iodized salt, iodine-rich-foods and maternal micronutrient supplements in a group of women with limited access to the Italian National Health System.

METHODS

A cross-sectional survey was conducted among immigrant and Italian women living in poverty and referring to 40 Non-Governmental Organization throughout Italy for their health needs. 3483 women answered the ad hoc questionnaire between January 2017 and February 2018.

RESULTS

The consumption of iodized salt was very low, and even lower among immigrant women. Determinants of iodized salt consumption were the period spent in Italy for immigrant women and living in a family-type setting, parity and, particularly, the degree of education for Italian ones. 17.5% of immigrant women and 8.6% of the Italian ones reported a diagnosis of thyroid disease. 521 women, 75.4% of whom were immigrants, were pregnant or breast-feeding. The majority (57.3%) had no specific maternal supplementation.

CONCLUSIONS

Both Italian and immigrating women with a low income or without access to the public health system have a poor adherence both to the salt iodization policy and to folic acid and iodine supplements in preconception and pregnancy. They also referred a low-frequency intake of iodine-rich-foods. The identification of barriers to health care access could be useful to promote specific health interventions in this target population.

Reference intervals for thyrotropin in an area of Northern Italy: the Pordenone thyroid study (TRIPP)

PURPOSE

Thyrotropin (TSH) is the most accurate marker of thyroid dysfunction in the absence of pituitary or hypothalamic disease. Studies on TSH reference intervals (RIs) showed wide inter-individual variability and prompted an intense debate about the best estimation of TSH RIs.

DESIGN

We performed a population study on TSH RIs, using current data stored in the laboratory information system (LIS), at the Hospital Department of Laboratory Medicine, Pordenone (Italy), historically an area of mild-moderate iodine deficiency with a relatively high goiter prevalence.

METHODS

136,650 individuals constituted the final sample. A TSH immunoassay was performed on fasting serum samples with the Dimension Vista 1500 analyzer (Siemens Healthineers). We adopted the Kairisto's procedure to analyze TSH data downloaded by the LIS, applying the indirect strategy for deriving RIs.

RESULTS

TSH RIs of the entire population were 0.32-3.36 mIU/L with a distribution skewed towards higher values. RIs were 0.26-3.61 mIU/L for females, and 0.32-3.01 mIU/L for males. Unlike other studies, TSH median levels progressively decreased from 0-4 to 85-104 years in the overall population, both in male and in female subgroups, showing an inverse correlation between TSH and age in all groups.

CONCLUSIONS

This study is the first to analyze a high percentage (40%) of individuals from an ethnically homogenous Caucasian population. The results obtained emphasize the opportunity to define the TSH RIs according to age, gender and race, in addition to assay methods, and provide further insight about the possible role of iodine status.