First national iodine survey in Madagascar demonstrates iodine deficiency

Abstract

Universal salt iodization (USI) was adopted in Madagascar in 1995 within the framework of a worldwide policy to eliminate iodine deficiency disorders. Despite early USI adoption, there are no representative data on the iodine status of the Malagasy population.The aims of this study were to determine the iodine status of the Malagasy population and to assess the use of adequately iodized salt among households. We randomly sampled women of reproductive age (WRA) using a national, two-stage, stratified crosssectional survey in 2014. Casual urine from WRA and salt samples from the household containing WRA were collected to measure urinary iodine concentration (UIC) and to assess household salt iodine content. Data from 1,721 WRA in 1,128 households were collected and analysed. The national median UIC was 46 μg L −1 (interquartile range [IQR]: 13-98 μg L −1 ), indicating a moderate iodine deficiency. The median UIC was 53 μg L −1 (IQR: 9-89 μg L −1 ) in pregnant women and 46 μg L −1 (IQR: 13-98 μg L −1 ) in non-pregnant women. The national median iodine concentration of household salt was 10 mg kg −1 (IQR: 6.3-15.8 mg kg −1 ) and 26.2% (95% CI [22.1, 31.0]) of households containing WRA used adequately iodized salt (≥15 mg kg −1 ). Women living in households with adequately iodized salt had higher median UIC (72 vs. 50 μg L −1 ). Iodine status was significantly lower among women from low socioeconomic households. Madagascar's USI program needs to be revitalized. Implementing strategies to provide adequately iodized salt and enhancing iodized salt legislation to prevent severe complications resulting from iodine deficiency in the Malagasy population are essential.

Factors Associated with Stunted Growth in Children Under Five Years in Antananarivo, Madagascar and Bangui, Central African Republic

“…Our urinary iodine measurements in Antananarivo align with a previous report, which showed moderate iodine deficiency across the country. Madagascar is currently reviving a saltbased iodine supplementation program (Randremanana et al, 2019). We did not find any association between food diversity and stunting in the two study sites.…”

Seasonal trends of nutrient intake in rainforest communities of north-eastern Madagascar

“…Vitamin A supplementation, with visits twice per year, is already successfully operating in these two communities and across the nation of Madagascar. This is important as even commonly managed nutrient deficiencies, such as iodine, continue to plague the Malagasy population ( 36 ) . Aside from single nutrient solutions, poultry interventions in this region have begun to prove effective, increasing the productivity of chickens and the consumption of poultry, providing necessary fats and vitamins A and B 12 ( 7 ) .…”

The prevalence of insufficient iodine intake in pregnancy in Africa: a systematic review and meta-analysis

“…Eleven of the studies were national surveys from 10 countries. These national surveys revealed more than adequate intake in Djibouti and Somalia [34,65]; adequate iodine intake in Ghana, Sierra Leone, and Tanzania [46,58,61]; mild inadequate intake in Egypt, Gambia, and Tanzania [35,60], and moderate insufficient iodine intake in Burkina Faso, Burundi, and Madagascar [31,32,50]. The remaining studies [30, 33, 36-44, 47-49, 51-57, 59, 62, 66, 67] were subnational studies.…”