Bocio endémico por exceso de yodo en la población escolar de los campos de refugiados de la RASD (República Árabe Saharaui Democrática)

Barikmo

Strand

et al. 2011

Public Health Nutr.

Objective: The main objective was to assess iodine status (thyroid volume (Tvol) and urinary iodine concentration (UIC)) and their determinants in Saharawi refugee women. Design: A cross-sectional survey was performed during January-February 2007. Tvol was measured by ultrasound and iodine concentration was analysed in spot urine samples and in household drinking water. Anthropometry and Hb concentration were measured and background variables were collected using pre-coded questionnaires. Setting: The survey was undertaken in four long-term refugee camps in the Algerian desert. Subjects: Non-pregnant women (n 394), 15-45 years old, randomly selected. Results: Median (25th percentile-75th percentile (P 25 -P 75 )) UIC was 466 (294-725) mg/l. Seventy-four per cent had UIC above 300 mg/l and 46 % above 500 mg/l. Median (P 25 -P 75 ) Tvol was 9?4 (7?4-12?0) ml and the goitre prevalence was 22 %. UIC was positively associated with iodine in drinking water and negatively associated with breast-feeding, and these two variables explained 28 % of the variation in UIC. The mean (SD) Hb level was 11?8 (2?4) g/dl. In total 46 % were anaemic with 14 %, 25 % and 7 %, classified with respectively mild, moderate and severe anaemia. Conclusions: The Saharawi women had high UIC, high levels of iodine in drinking water and increased Tvol and probably suffered from iodine-induced goitre. The high prevalence of anaemia is considered to be a severe public health concern. To what extent the excessive iodine intake and the anaemia have affected thyroid function is unknown and should be addressed in future studies. KeywordsExcess urinary iodine Iodine-rich drinking water Saharawi refuge women Iron deficiencyWomen's micronutrient status is of particular importance since it affects not only their own health, but also the health of their children (1) . Deficiencies of iodine and Fe remain major public health problems, affecting .30 % of the global population (2,3) . Insufficient iodine intake as well as excess iodine intake may cause thyroid diseases (4) . Fe deficiency is the most common and widespread micronutrient deficiency worldwide (3) and may have multiple adverse effects on thyroid metabolism (5) . Refugees from Western Sahara have been settled in the Algerian desert since 1975 and they are totally dependent on food aid in the harsh, resource-poor desert environment. The refugee population is experiencing a number of challenges related to their food, nutrition and health situation (6) . Endemic goitre has been reported among Saharawi schoolchildren and this is probably caused by iodine excess (7)(8)(9)(10) , but further studies are required to understand the aetiology. The main objective of the present paper is to assess iodine status (thyroid volume (Tvol) and urinary iodine concentration (UIC)) and their determinants in Saharawi refugee women of childbearing age. The secondary objective is to assess their prevalence of anaemia. Women (15-45 years old) were the target group. We calculated the sample size based on an esti...

Section: Discussionsupporting

confidence: 83%

Iodine-induced goitre and high prevalence of anaemia among Saharawi refugee women

Barikmo

Strand

et al. 2011

Public Health Nutr.

“…A study conducted in 1998 among the Saharawi refugees showed a prevalence of goitre of 28 % ( 4 ) . Another study from 2003 revealed a prevalence of goitre of 58 % ( 6 ) . Seemingly, the prevalence of goitre has increased; however, these earlier studies were based on palpation, not on ultrasound, and are therefore not directly comparable with our study.…”

Section: Discussionmentioning

confidence: 99%

“…We found, however, that malnourished children had lower Tvol than well-nourished children. A study among the refugees showed that thiocyanate in drinking water and urine was within normal levels ( 6 ) .…”

Section: Discussionmentioning

confidence: 99%

“…Compared with earlier studies, however, the levels seem to have decreased. A study among the refugees from 1998 showed an iodine concentration in drinking water that ranged from 259 to 934 μg/l ( 4 ) , while a study from 2003 showed the range of iodine concentration in drinking water to be 180–400 μg/l ( 6 ) . The reduction of iodine in drinking water is probably due to the introduction of new water wells during the last 3–5 years and to routine water purification.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endemic goitre and excessive iodine in urine and drinking water among Saharawi refugee children

Barikmo

Gjerlaug

et al. 2010

Public Health Nutr.

Objective: To assess the prevalence of enlarged thyroid volume (Tvol) in Saharawi refugee children, and their urinary iodine concentration (UIC), and to identify possible sources of excess iodine intake. Design: A cross-sectional survey was performed during January-February 2007. Tvol was measured by ultrasound and iodine concentration was analysed in casual urine samples, in household drinking water and in milk samples from household livestock. Setting: The study was undertaken in four refugee camps in the Algerian desert. Subjects: The subjects were 421 Saharawi children, 6-14 years old. Results: Enlarged Tvol was found in 56 % (Tvol-for-age) and 86 % (Tvol-for-bodysurface-area) of the children. The median (25th percentile-75th percentile, P 25 -P 75 ) UIC was 565 (357-887) mg/l. The median (P 25 -P 75 ) iodine concentration in household drinking water was 108 (77-297) mg/l. None of the children had UIC below 100 mg/l, 16 % had UIC between 100 and 299 mg/l, and 84 % had UIC above 300 mg/l. There was a positive association between Tvol and whether the household possessed livestock. Conclusions: The children are suffering from endemic goitre and high UIC caused probably by an excessive intake of iodine. The excessive iodine intakes probably originate from drinking water and milk.

“…The refugees live in a harsh desert environment, which makes it difficult to cultivate food crops and with limited water supply. Previous surveys have revealed poor water quality in these refugee camps, such as high levels of fluoride [ 10 ], together with high levels of iodine [ 11 , 12 ] and nitrate [ 13 ]. High intake of iodine and fluoride may be a health risk, as excessive iodine intake may lead to thyroid disorders [ 14 ], and excessive fluoride intake may lead to fluorosis [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Trace Element Concentrations in Drinking Water and Urine among Saharawi Women and Young Children

Aakre

Gjengedal

et al. 2018

Toxics

Poor water quality has been reported along with a variety of negative health outcomes in the Saharawi refugee camps in Algeria. We assessed the concentration of elements in drinking water and urine in refugee women and children. Twenty-four samples of distributed public drinking water were collected, along with urine samples from 77 women and 296 children. Using inductively coupled plasma mass spectrometry, we analyzed water and urine for 31 and 10 elements, respectively. In addition, the water samples were analyzed for five anions by ion-exchange chromatography. Data were described according to two areas: zone 1 with purified water and water with naturally better quality, and zone 2 with only partially purified water. Most elements in drinking water had significantly higher concentration in zone 2 compared with zone 1. Sodium, chloride, nitrite, and nitrate were the parameters that exceeded the WHO Guidelines for Drinking Water Quality. Among both women and children, urinary concentration of vanadium, arsenic, selenium, lead, iodine, and uranium exceeded reference values, and most of the elements were significantly higher in zone 2 compared to zone 1. Even though water purification in the Saharawi refugee camps has increased during the last years, some elements are still exceeding the WHO guidelines for drinking water quality. Moreover, urinary exposure of some elements exceeded reference values from the literature. Further effort should be made to improve the water quality among the Saharawi refugees.