Iodine status and fish intake of Sudanese schoolchildren living in the Red Sea and White Nile regions

Abstract

<jats:title>Abstract</jats:title><jats:sec id="S1368980012000833_abs1" sec-type="general"><jats:title>Objective</jats:title><jats:p>To investigate iodine status and fish consumption of schoolchildren living in the Red Sea and White Nile regions of Sudan.</jats:p></jats:sec><jats:sec id="S1368980012000833_abs2" sec-type="general"><jats:title>Design</jats:title><jats:p>Cross-sectional study to determine urinary iodine concentration, visible goitre rate, iodine content of salt and fish consumption.</jats:p></jats:sec><jats:sec id="S1368980012000833_abs3" sec-type="general"><jats:title>Setting</jats:title><jats:p>Port Sudan (Red Sea) and Jabal Awliya (White Nile), Sudan.</jats:p></jats:sec><jats:sec id="S1368980012000833_abs4" sec-type="subjects"><jats:title>Subjects</jats:title><jats:p>Two hundred eighty (<jats:italic>n</jats:italic>280) children aged 6–12 years (142 boys, 138 girls).</jats:p></jats:sec><jats:sec id="S1368980012000833_abs5" sec-type="results"><jats:title>Results</jats:title><jats:p>The median urinary iodine concentration in children from Port Sudan and Jabal Awliya was 553 and 160 μg/l, respectively. Goitre was detected in 17·1 % of children from Port Sudan but only in 1·4 % from Jabal Awliya, The salt samples from Port Sudan contained 150–360 mg iodine (KOI<jats:sub>3</jats:sub>)/kg salt, whereas those from Jabal Awliya had levels below the detection limit. Despite consuming salt devoid of iodine, children from Jabal Awliya had optimal iodine status. It is plausible that consumption of Nile fish from Jabal Awliya Reservoir, which is a good source of iodine and favoured by the locals, might have provided sufficient iodine. In contrast, children from Port Sudan were at higher risk of iodine-induced hyperthyroidism resulting from consumption of excessively iodised salt.</jats:p></jats:sec><jats:sec id="S1368980012000833_abs6" sec-type="conclusion"><jats:title>Conclusions</jats:title><jats:p>The findings of the study clearly demonstrated that (i) Sudan still has a problem with iodine nutrition and quality control and monitoring of salt iodisation and (ii) including fish in the diet could provide a sufficient amount of iodine for schoolchildren.</jats:p></jats:sec>

Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies

“…Twenty-three papers reported cross-sectional studies in children [41, 43–64], of which 14 papers mainly reported thyroid diseases [41, 46, 47–49, 51–55, 56–58, 60], four reported biomarkers [61–64] and five described both [43–45, 50, 59] (Tables 5 and 6). Except for Nepal et al .…”

“…Water was a cause of excess iodine status in ten papers, from China [44–48, 52, 58, 59], refugee camps in Africa [53] and Somalia [41]. USI caused excess intake in five papers, from Sudan [51], Saudi Arabia [49], Uganda [56], refugee camps in Africa [55] and Brazil [54]. Fortified food might have been a cause in two papers, from Sudan [51] and the USA [60], while seafood consumption might have been the cause in one paper from Japan [57].…”

“…USI caused excess intake in five papers, from Sudan [51], Saudi Arabia [49], Uganda [56], refugee camps in Africa [55] and Brazil [54]. Fortified food might have been a cause in two papers, from Sudan [51] and the USA [60], while seafood consumption might have been the cause in one paper from Japan [57]. The cause was not clearly described in others [43, 50] or was not assessed because median UIC was not excessive [61–64].…”

“…In the child studies (Table 5), goiter was examined by palpation in seven studies [49–51, 56, 58, 59, 60], rate of visible goiter was described in two studies [41, 55] and ultrasound was used in seven studies [46–48, 52–54, 57]. One study in Chinese children using ultrasound found that goiter rate was significantly higher in the high iodine area than in the control town [46].…”

“…In contrast, the other studies did not statistically compare goiter rate. From six studies in Africa [41, 50, 51, 53, 55, 56], goiter rate was distributed widely, from 0% for visible goiters to 86% of goiters diagnosed from thyroid volume to body surface area in ultrasonography. Bimenya et al .…”