Endemic goiter and iodine deficiency status among Guinea-Bissau school-age children

Spatial and Seasonal Drinking Water Quality Assessment in a Sub-Saharan Country (Guinea-Bissau)

The United Nations Sustainable Development Goal target 6.1 calls for universal and equitable access to safe and affordable drinking water. Worldwide, about 2.2 billion people live without access to safe water, and millions of people suffer from waterborne pathogens each year, representing the most pressing situation in developing countries. The aim of this study was to investigate the drinking water quality dynamics across an endemic cholera sub-Saharan country (Guinea-Bissau), and understand its implications for public health. Microbiological and physical–chemical quality parameters of 252 major water sources spread all over the country were seasonally surveyed. These comprised hand-dug shallow wells and boreholes, fitted with a bucket or a pump to retrieve water. The results showed that the majority of water sources available to the population were grossly polluted with faecal material (80%), being unsuitable for consumption, with significantly (p < 0.05) higher levels during the wet season. Hand-dug wells revealed the highest contamination levels. The chemical contamination was less relevant, although 83% of the water sources were acidic (pH < 6.5). This study highlights the potential health risk associated with the lack of potable drinking water, reinforcing the evidence for water monitoring, and the need to improve WASH (water, sanitation, and hygiene) infrastructure and water management in West African countries. In addition, the authors suggest easy-to-implement interventions that can have a dramatic impact in the water quality, assisting to reduce the associated waterborne diseases rise.

Iodine Deficiency Disorders as a Predictor of Stunting among Primary School Children in the Aseer Region, Southwestern Saudi Arabia

OBJECTIVES

To investigate the present occurrence of stunting and explore the role of iodine deficiency disorders (IDDs) as a predictor of stunting among primary school children in the Aseer Region.

METHODS

In a cross-sectional investigation on school children in the Aseer region, thyroid enlargement was evaluated clinically. Urine was collected to evaluate iodine content.

RESULTS

The present study involved 3046 school-age pupils. The study disclosed a total goiter rate of 24.0% (95% CI: 22.5-25.5%). The median urinary iodine content (UIC) was 17.0 µg/L. A prevalence of stunting (height for age z score of less than -2) of 7.8% (95% CI: 6.9-8.8%) was found. In a logistic regression model, pupils having clinical goiter (aOR = 1.739; 95% CI: 1.222-2.475) and students having UIC of less than 17 µg/L (aOR = 1.934; 95% CI: 1.457-2.571) were considerably related with stunting. In the receiver operating characteristic (ROC) curve, urinary iodine content to forecast stunting was good (AUC = 0.611, 95% CI: 0.594-0.629). The curve recognized the optimum cutoff point of urinary iodine content to be ≤19.0 µg/L. The sensitivity was 59.66% (95% CI: 53.1-66.0) and the specificity was 57.62% (95% CI: 55.8-59.5). Conclusion: The present study showed that stunting among school-aged children presents a mild public health problem. On the other hand, a severe iodine deficiency situation was revealed among school children in the Aseer region. Continuous monitoring of iodine status among school children is therefore necessary. Concerted interventions that blend nutrition-sensitive with nutrition-specific approaches are expected to influence decreasing stunting significantly.

The relationship of different levels of high iodine and goiter in school children: a meta-analysis

Background

Over the past decade, the phenomenon of high urine iodine (HUI) and high water iodine (HWI) has become more common. But the risk of goiter caused by different levels of HUI and HWI remains unclear.

Objectives

To explore the risk of goiter development caused by HUI and HWI, and compare the risk of goiter development from different levels of high iodine.

Methods

The Medline, Cochrane library, Embase, China National Knowledge Infrastructure and Wan fang databases were searched for relevant population-based studies investigating the link between high iodine levels and goiter development in mainland China. Three reviewers extracted data from the included studies independently, assessing the prevalence of goiter development due to high iodine.

Results

Taking 100 μg/L ≤ UIC < 300 μg/L (UIC = urinary iodine concentration) as the reference group, the odds ratio (OR) regarding high iodine levels and goiter formation was 1.74 (95% CI 1.50, 2.01, P < 0.001), if the water iodine concentration (WIC) was greater than 100 μg/L, the OR between goiter development and WIC was 4.74 (95% CI 1.15, 19.46, P = 0.001). The Linear trend analysis of HUI and goiter showed that the prevalence of goiter increased with the increase of UIC (χ² = 734.605, P < 0.001).

Conclusions

When the UIC ≥ 300 μg/L or the WIC ≥ 100 μg/L, the risk of goiter will increase. The higher the UIC, the greater the risk of goiter development. In order to improve the public thyroid health, we should adhere to the monitoring of urinary iodine and water iodine, and keep them at an appropriate level.

Trial registration

PROSPEROCR, CRD42020197620. Registered 8 August 2020, https://www.crd.york.ac.uk/PROSPERO/.