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Evaluation of the effects of iodized salt on the mental development of preschool-aged children: a cluster randomized trial in northern Ethiopia.

ABSTRACT: A cluster randomized effectiveness trial was used to examine the effects on mental development of introducing iodized salt to children 4 to 6?years of age in Ethiopia, where there were reportedly high levels of iodine deficiency. Sixty district clusters were randomized to receive iodized salt early at their markets with assistance from regular salt distributors or later as introduced by market forces. At pre- and post-iodization, 1602 children were given cognitive/language tests (namely School Readiness, WPPSI verbal reasoning, WPPSI Matrix reasoning), and mothers were interviewed concerning demographics, nutrition and health. Children's weight, height, urine and a blood sample were taken. Analyses of covariance, adjusting for clustering and baseline levels were conducted. Urinary iodine concentrations were significantly higher at endline in the intervention children than controls though both medians were above threshold. Overall, less than 5% were anemic. There were no significant main effect differences between groups on the cognitive/language tests, but there were effect modifiers, namely mother's education, child's sex and diet. For example, the intervention group performed better on the school readiness test than controls if their mothers had attended school, but not otherwise. In conclusion, the data are consistent with negative findings from studies where children 6 to 12?years were supplemented with an iodine capsule, indicating that the benefits of iodine, in salt or capsule form, for brain development may be restricted to children under 3?years. Yet, benefits may be tied to those with more educational resources or may compensate for conditions of disadvantage.

SUBMITTER: Aboud FE

PROVIDER: S-EPMC6865940 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Evaluation of the effects of iodized salt on the mental development of preschool-aged children: a cluster randomized trial in northern Ethiopia.

Aboud Frances E FE Bougma Karim K Lemma Tizita T Marquis Grace S GS

Maternal & child nutrition 20160503 2

A cluster randomized effectiveness trial was used to examine the effects on mental development of introducing iodized salt to children 4 to 6 years of age in Ethiopia, where there were reportedly high levels of iodine deficiency. Sixty district clusters were randomized to receive iodized salt early at their markets with assistance from regular salt distributors or later as introduced by market forces. At pre- and post-iodization, 1602 children were given cognitive/language tests (namely School R ...[more]

PMID: 27145299

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Project description:Introduction:Adequate iodine fortified salt is the most common and effective method of preventing iodine deficiency. Studies showed households using iodized salt (15 Parts Per Million (PPM) to 80 PPM) of iodine at household level were low in Tigray region and other regions of Ethiopia. Limited studies have conducted on utilization of iodized salt at the household level and none of them did not addressed on factors affecting to proper iodized salt utilization. The aim of this study was to determine the iodine concentration in the collected salt samples, adequately iodized salt consumption coverage and identify factors affecting to proper iodized salt utilization amongst the households of Northern Ethiopia. Methods:Community based cross-sectional designs on selected 318 household food caterers were interviewed and salt samples were accordingly collected. Data was analyzed by the SAS-9.2 statistical software package. The iodine concentrations of the salt samples were determined by using the golden standard iodometric titration technique. Logistic Generalized Estimating Equation (GEE) statistical analysis method was used to assess factors affecting proper iodized salt utilization at household level. Results:Adequately iodized salt coverage among the households was only 51 (17.5%). About 42 (14.38%) had 15?ppm (ppm) - 80?ppm, 9 (3.08%) had >?80?ppm, 188 (64.4%) had 1.1?ppm to 14.9?ppm and 53 (18.2%) had no iodine in the salt (0?ppm). Only 26 (8.9%) of the households had used iodized salt properly. Family size with Adjusted Odds Ratio (AOR) (0.82) and 95%CI [0.67, 0.92], residency of the household with AOR (2.83) and 95%CI [1.48, 5.40], the availability of iodized salt with AOR (3.90) and 95% CI [1.74, 8.7] and affordability to iodized salt with AOR (3.33) and 95% CI [1.41, 7.34] was strong predictors to proper iodized salt utilization. Conclusions:Coverage of adequately iodized salt was low. Family size, residency, availability and affordability of iodized salt were the predictors of proper iodized salt utilization. To enhance USI utilization effective inspection and regulatory measures should be taken to prevent the production and distribution of under/ over iodized salt in the market.

Project description:BackgroundThe gut microbiota is recognized as a regulator of brain development and behavioral outcomes during childhood. Nonetheless, associations between the gut microbiota and behavior are often inconsistent among studies in humans, perhaps because many host-microbe relationships vary widely between individuals. This study aims to stratify children based on their gut microbiota composition (i.e., clusters) and to identify novel gut microbiome cluster-specific associations between the stool metabolomic pathways and child behavioral outcomes.MethodsStool samples were collected from a community sample of 248 typically developing children (3-5 years). The gut microbiota was analyzed using 16S sequencing while LC-MS/MS was used for untargeted metabolomics. Parent-reported behavioral outcomes (i.e., Adaptive Skills, Internalizing, Externalizing, Behavioral Symptoms, Developmental Social Disorders) were assessed using the Behavior Assessment System for Children (BASC-2). Children were grouped based on their gut microbiota composition using the Dirichlet multinomial method, after which differences in the metabolome and behavioral outcomes were investigated.ResultsFour different gut microbiota clusters were identified, where the cluster enriched in both Bacteroides and Bifidobacterium (Ba2) had the most distinct stool metabolome. The cluster characterized by high Bifidobacterium abundance (Bif), as well as cluster Ba2, were associated with lower Adaptive Skill scores and its subcomponent Social Skills. Cluster Ba2 also had significantly lower stool histidine to urocanate turnover, which in turn was associated with lower Social Skill scores in a cluster-dependent manner. Finally, cluster Ba2 had increased levels of compounds involved in Galactose metabolism (i.e., stachyose, raffinose, alpha-D-glucose), where alpha-D-glucose was associated with the Adaptive Skill subcomponent Daily Living scores (i.e., ability to perform basic everyday tasks) in a cluster-dependent manner.ConclusionsThese data show novel associations between the gut microbiota, its metabolites, and behavioral outcomes in typically developing preschool-aged children. Our results support the concept that cluster-based groupings could be used to develop more personalized interventions to support child behavioral outcomes. Video Abstract.

Project description:BackgroundIn 2019, 144 million under-five-year-old children were stunted, and 47 million were wasted globally. In Ethiopia, approximately 350,000 children are estimated to die each year. Preschool aged children need focused attention because this age group not only has special needs, but also forms the platform for growth and development of all children. Under nutrition among preschool children is the result of a complex interplay of diverse elements, such as birth weight, household access to food, availability and use of drinking water. This study aimed at determining the anthropometric failures and associated factors using composite indictors.MethodsA community-based cross-sectional study design was used among randomly selected 588 caregivers with pre-school aged children. Under-nutrition of pre-school aged children was computed by using the composite index of anthropometric failure. A multi-stage sampling technique followed by a systematic random sampling technique was used to select study participants. Structured questionnaires were used to collect data. WHO Anthro software was used to calculate height for age, weight for age and weight for height. The overall prevalence of anthropometric failure (CIAF). Both bivariable and multivariable binary logistic regressions were used to identify factors associated with under-nutrition.ResultsThe overall prevalence of under-nutrition among pre-school children was 50.8%, which was significantly associated with being a female (AOR = 1.51, CI: 1.076, 2.12), being from a large family (AOR = 1.78, CI: 1.19, 2.663), having acute respiratory infection (AOR = 1.767, CI: 1.216, 2.566), lack of improved source of drinking water (AOR = 1.484 CI: 1.056, 2.085) and poor dietary diversity score (AOR = 1.5, CI: 1.066, 2.112).ConclusionsThe study area has a high prevalence of CIAF in pre-school aged children. The CIAF was found to be significantly associated with the sex of the child, family size, ARI within the last two weeks, and dietary diversity score. To promote the use of family planning and the prevention of infectious diseases, health education is required. The government should adapt CIAF as a metric for assessing children's nutritional status.

Project description:BackgroundIodine deficiency disorder (IDD) is a global, regional, and national public health problem that is preventable. Universal salt iodization is a worldwide accepted strategy to prevent IDD. The level of iodine in the salt should be adequate at the household level (≥15ppm). Though there was fragmented evidence on the proportion of adequately iodized salt at the household level in Ethiopia, the national level proportion of adequately iodized salt at the household level was remaining unknown. Therefore, this systematic review and meta-analysis estimated the pooled proportion of adequately iodized salt at the household level in Ethiopia from 2013-2020.MethodWe systematically searched the databases: PubMed/MEDLINE, Google Scholar, and Science Direct for studies conducted in Ethiopia on the availability of adequately iodized salt at the household level since 2013. We have included observational studies, which were published between January first, 2013, and 10 August 2020. The report was compiled according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The quality of included studies was scored based on the Newcastle Ottawa quality assessment scale adapted for cross-sectional studies. The data were extracted in Microsoft excel and analyzed using Stata version 14.1 software. We employed a random-effects model to estimate the pooled proportion of adequately iodized salt at the household level in Ethiopia. The presence of statistical heterogeneity within the included studies was evaluated using the I-squared statistic. We used Egger's regression test to identify evidence of publication bias. The pooled proportion with a 95% confidence interval (CI) was presented using tables and forest plots.ResultsWe screened a total of 195 articles. Of these, 28 studies (with 15561 households) were included in the final systematic review and meta-analysis. In Ethiopia, the pooled proportion of adequately iodized salt at the household level was 37% (95% CI: 28, 46%). The subgroup analyses of 28 studies by residence revealed that the pooled proportion of adequately iodized salt at the household level was 32% (95% CI: 29, 35%) and 48% (95% CI: 31, 66%) in rural and urban areas, respectively. Based on geographic location, the highest proportion was found in Addis Ababa (81%; 95%CI: 78, 83), and the lowest proportion found in Dire Dawa (20%; 95%CI: 17, 22). Besides, the proportion of adequately iodized salt at the household level was significantly increased during 2017-2020 (42%; 95% CI: 30, 53%) as compared with 2013-2016 (27%; 95% CI: 17, 39%).ConclusionsIn Ethiopia, the pooled proportion of adequately iodized salt at the household level was very low as compared to the world health organization's recommendation. Thus, the Federal Ministry of Health of Ethiopia and different stakeholders should give more attention to improve the proportion of adequately iodized salt at the household level.

Project description:Background:Every student has the potential to do well in school. Failing to provide good nutrition puts them at risk for missing out on meeting that potential and leads to long-term irreversible damage to cognitive development. However, taking action today to provide healthier choices in schools can help set students up for a successful future full of possibilities. So, this study is aimed at assessing the effect of nutritional status on academic performance of school-aged children. Methods:A school-based cross-sectional study was conducted from Feb 05- March 30, 2017 in Lalibela town. A total of 505 primary school students were included in the study. The child anthropometric measures were calculated using AnthroPlus software version 1.0.4 WHO 2007 standards. Bivariable and multivariable ordinal logistic regression were fitted. The proportional odds ratio (POR) with a 95% CI and P value < 0.05 were considered statistically significant. Results:The overall prevalence of stunting, underweight, and thinness was 29.5%, 35.7%, and 29.5%, respectively. In this study, 14.7% of the study participants had low academic achievement in the semester. The multivariable analysis showed that rural residence (POR = 0.39; 95% CI: (0.21, 0.75)), not studying regularly (POR = 0.49; 95% CI: (0.29, 0.82)), severe underweight (POR = 0.25; 95% CI: (0.09, 0.71)), and severe stunting (POR = 0.03; 95% CI: (0.01, 0.37)) were associated with decreased odds of high average semester score achievement of school-aged children. Additionally, higher maternal educational status (POR = 2.12; 95% CI: (1.10, 4.07)) and family income from 550 to 2999 ETB (POR = 1.71; 95% CI: (1.04, 2.81)) were associated with increased odds of high semester average score achievement. Conclusion:Nearly one-third of school-aged children in Lalibela town were stunted, thin, and underweight. Rural place of residence, not studying regularly study, underweight, and stunting were associated with decreased academic achievement. While, family monthly income from 550 to 2999 ETB and higher maternal education status were associated with increased academic achievement.

Project description:IntroductionIodine is one of the crucial micronutrients required for the normal growth of humans from the fetal stage to adulthood through the synthesis of thyroxin (t3) and triiodothyronine (t4) hormones in the thyroid gland for regulation of metabolism, protein synthesis, and brain development. This study aimed to assess iodine status, the impact of knowledge and practice for adequate iodized salt utilization in household levels in North West Ethiopia.MethodA population-based cross-sectional study was carried out using multistage sampling among 1398 residents from 28 December 2021 to 30 January 2022. A systematic random sampling technique was used to select the study participants. The collected data were entered into Epi-Data version 3.1 and then exported to STATA/R version 14 for further analysis. An adjusted odds ratio with 95% CI was used to declare statistical significance at p < 0.05.ResultThe overall mean (±SD) age of participants was 34.9 (±12.8) years. About 678 (48.5%) had 15-80 ppm, 23 (1.6%) had >80 ppm, 533 (38.13%) had 1.1 ppm to 14.9 ppm, and 147 (10.5) had no iodine in salt (0 ppm) after assessed by Rapid Test Kit. Only 48.5% of the sampled household had used adequate iodized salt with ≥15 ppm. The overall burden of goiter was estimated at 11.4/1000 population. Adequate iodized salt utilization was significantly associated with having formal education (adjusted odds ratio = 1.89: 95% confidence interval: 1.4, 2.6, p = 0.001), monthly income ≥5000 ETB/month (adjusted odds ratio = 1.99: 95% confidence interval: 1.5, 2.9, p = 0.001), and good knowledge score (adjusted odds ratio = 1.6: 95% confidence interval: 1.12, 2.6, p = 0.03) were predictors for proper iodized salt utilization.ConclusionCoverage of adequately iodized salt was low and respondents' formal education, monthly income ≥5000 Ethiopian Birr/month, and good knowledge score were all significantly associated with proper iodized salt utilization. While the prevalence of goiter was not significantly identified as a public health problem as compared in the regions, however, in light of previous iodine deficiency in this region of Ethiopia, the salt iodization program should be done continually.

Dataset Information

Evaluation of the effects of iodized salt on the mental development of preschool-aged children: a cluster randomized trial in northern Ethiopia.

Publications

Evaluation of the effects of iodized salt on the mental development of preschool-aged children: a cluster randomized trial in northern Ethiopia.

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