Effect of Behaviour Change Communication on Iodised Salt Utilization and Median Urine Iodine Concentration among Children Growth Age 6 -59 Months in Central Highland of Ethiopia: Cluster Randomized Control Trial

Abstract

The most daunting challenge to control Iodine Deficiency Disorder (IDD) in Ethiopia is accessing iodised salt with adequate quantity of iodine. Fundamentally, measuring Median Urine Iodine Concentration (MUIC) is good surrogate marker of the amount of iodine found in plasma thyroxine. There was no study in Ethiopia that evaluated whether education on the iodized salt at household levels improves iodine status.Objective: This study aimed to determine the effect of behaviour change communication on the use of iodised salt on median Urinary Iodine Concentration among children age 6-59 months. Materials and Methods:A clustered Randomized Control Trial (CRCT) was carried out among children age 6-59 months and their index mothers, care givers in Arsi Zone, central highlands of Ethiopia from February 2017 to April 2019. "Kebeles" (small administration units) were taken as clusters and randomly assigned to either the intervention or control arm. There was a sufficient buffer zone between the intervention and control clusters to avoid information contamination. Mothers, Care givers and their index children were selected from both intervention and control clusters using simple systematic random sampling technique at baseline. Data on the background characteristics and Median Urinary Iodine Concentration (MUIC) were collected from mothers/ caregivers and their children age 6-59 months, respectively. Behaviour change communication was given on the intervention clusters for 15 months using explanatory poster and demonstration method. At the end line urine sample was taken from the same children and Median Urinary Iodine Concentration (MUIC) was analyzed with ammonium persulfate methods in Ethiopian Public Health Institute laboratory and iodine deficiency was stated at MUIC < 100μg/L. Descriptive statistics and a Generalized Estimating Equations (GEE) model was fitted to isolate independent predictors median Unirinary Iodine Concentration.Results: At baseline, 812 and endpoint 715 mothers/ caregivers and their paired children were enrolled in the study. Iodine deference (ID) lowered to 6% and MUIC (25th-75th percentiles [p25-p75]) higher (209.9μg/L [143-400]) μg/L at endpoint than the baseline 107.7μg/L (103, 112). Generalized Estimating Equations analys Better to Gibe P Valuees showed that being in the intervention group increased MUIC mean difference by 11.48 μg/L (β=11.48 , P <0.05) and Height for age Z-score was also positively