Inadequate salt iodization and poor knowledge, attitudes, and practices regarding iodine-deficiency disorders in an area of endemic goitre in south-eastern Nigeria

Abstract

Focus group discussions and interviewer-administered questionnaires assessed the knowledge, attitudes, and practices of rural dwellers relating to iodine-deficiency disorders. The iodine content of salt was measured at the household and retail levels, and the iodine nutritional status of school-aged children (6-12 years) was assessed by measuring urinary iodine concentrations. The analyses showed a high level of ignorance about the causes and consequences of iodine deficiency, iodine as a nutrient, and iodized salt and its purpose. In a goitre endemic area of south-eastern Nigeria, only 47% of the household samples and 48% of the retail salt samples were iodized to a level above 30 ppm, whereas 34% of the household samples and 19% of the retail samples had no iodine. These findings could be attributable to the methods of salt handling and storage in the area. Among children, 90% had moderate to severe iodine deficiency, 10% were mildly iodine deficient, and none had normal iodine levels according to urinary iodine excretion. The findings suggest a high level of iodine deficiency and the urgent need for information, education, and communication in the study area.