Department of Public Health, Mizan Tepi University, Mizan Teferi, Ethiopia.
Department of Nutrition, School of public health, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2019 Aug 13;14(8):e0221106. doi: 10.1371/journal.pone.0221106. eCollection 2019.
Despite the universal iodization of salt in Ethiopia, iodine deficiency disorder remains a major public health problem and continued to affect a large segment of the population. It is thus essential to assess factors contributing to the unacceptably high endemic goiter rate in the country and avail evidence for further additional interventions. In line with this, we examined the association of dietary pattern and iodine deficiency among school-age children in Ethiopia.
We conducted a school-based cross-sectional study among 767 children aged 6 to 12 in southwest Ethiopia. We collected socio-demographic and other important health related information using a pre-tested structured questionnaire through the interview. Dietary pattern of children was measured using modified Hellen Keller's food frequency questionnaire. We measured iodine deficiency using urinary iodine concentration level and total goiter rate, according to the World Health Organization threshold criteria. We used a multivariate linear regression model to identify dietary and sociodemographic factors that affect urinary iodine level among children.
Out of the 767 children included in the study, 12% and 4% of children have grade 1 and grade 2 goiter respectively, making the total goiter rate 16%. While the prevalence of iodine deficiency based on urinary iodine concentration is 58.8% of which 13.7% had severe, 18.6% had moderate and 26.5% had mild form. The proportion of children who consumed godere/taro root/, banana, corn, Abyssinian cabbage, and potato, respectively at daily basis 57.8%, 53.1%, 37.9%, and 31.2%, respectively. Age (β = -0.7, 95%CI = -1.1, -0.4), sex (β = -22.3, 95%CI = -33.8, -10.8), consumption of taro root (β = -27.4, 95%CI = -22.9, -31.8), cabbage (β = -11.7, 95%CI = -5.7, -17.6), Abyssinian cabbage (β = 12.4, 95%CI = 6.7, 18.2), and banana (β = 5.6, 95%CI = 0.01, 11.2) significantly associated with urinary iodine level.
Iodine deficiency remains an important public health problem in southwest Ethiopia. Over-consumption of goitrogenic foods and under-consumption of iodine-rich foods were prevalent and associated with lower urinary iodine level. Therefore, dietary counseling apart from universal salt iodization is recommended.
尽管埃塞俄比亚普遍对盐进行了碘强化，但碘缺乏症仍然是一个主要的公共卫生问题，持续影响着很大一部分人群。因此，评估导致该国地方性甲状腺肿发病率居高不下的因素并提供进一步干预的证据至关重要。有鉴于此，我们研究了埃塞俄比亚学龄儿童饮食模式与碘缺乏之间的关系。
我们在埃塞俄比亚西南部的 767 名 6 至 12 岁的儿童中进行了一项基于学校的横断面研究。我们通过访谈使用经过预测试的结构化问卷收集了社会人口统计学和其他重要健康相关信息。通过改良的 Hellen Keller 食物频率问卷测量儿童的饮食模式。我们根据世界卫生组织的阈值标准，使用尿碘浓度水平和总甲状腺肿率来衡量碘缺乏情况。我们使用多元线性回归模型来确定影响儿童尿碘水平的饮食和社会人口统计学因素。
在纳入研究的 767 名儿童中，12%和 4%的儿童分别患有 1 级和 2 级甲状腺肿，总甲状腺肿率为 16%。虽然根据尿碘浓度判断的碘缺乏患病率为 58.8%，其中 13.7%为严重碘缺乏，18.6%为中度碘缺乏，26.5%为轻度碘缺乏。每天分别食用 godere/taro 根/，香蕉，玉米，埃塞俄比亚白菜和土豆的儿童比例分别为 57.8%，53.1%，37.9%和 31.2%。年龄（β=-0.7，95%CI=-1.1，-0.4），性别（β=-22.3，95%CI=-33.8，-10.8），taroroot 的食用量（β=-27.4，95%CI=-22.9，-31.8），白菜（β=-11.7，95%CI=-5.7，-17.6），埃塞俄比亚白菜（β=12.4，95%CI=6.7，18.2）和香蕉（β=5.6，95%CI=0.01，11.2）与尿碘水平显著相关。
碘缺乏症仍然是埃塞俄比亚西南部一个重要的公共卫生问题。促甲状腺肿食物的过度消费和富含碘食物的消费不足普遍存在，并与较低的尿碘水平相关。因此，除了普遍的盐碘化之外，还建议进行饮食咨询。
