Short Communication
Volume 2 Issue 3 - 2016
Throwback on Surveys of Household Iodized Salt Utilization in Benishangul- Gumuz Region, West Ethiopia: Outstanding Works of Ethiopian Demographic and Health Survey (EDHS)
Sahilu Assegid*
Associate Professor of Epidemiology, Jimma University, Ethiopia
*Corresponding Author: Sahilu Assegid, Associate Professor of Epidemiology, Jimma University, Ethiopia.
Received: May 16, 2016; Published: July 21, 2016
Citation: Sahilu Assegid. “Throwback on Surveys of Household Iodized Salt Utilization in Benishangul-Gumuz Region, West Ethiopia: Outstanding Works of Ethiopian Demographic and Health Survey (EDHS)”. EC Paediatrics 2.3 (2016): 173-177.
Background
Between December 27/2010 and May 20/2012, two surveys on household iodized salt utilization were conducted in Benishangul-Gumuz Region, West Ethiopia: EDHS 2011 and Cross-sectional Survey of Goiter Prevalence among 6-12 and Household Salt Iodization Levels in Assosa Town, Beni-Shangul-Gumuz Region, West Ethiopia the following year.
Objective
To review the report of regional Household Iodized Salt Utilization conducted by EDHS 201, and the Cross-sectional Survey of Goiter Prevalence and Household Salt Iodization Levels in Assosa Town conducted the following year.
Chronology of significant events
The 2011 EDHS [1]
The training of interviewers, editors and supervisors was conducted from 24 November to 23 December 2010. Pre-test: 20 September to 8 October 2010
127

ASK RESPONDENT FOR


A TEASPOONFUL OF IODINE


TEST SALT FOR IODINE.

Iodine Present----------------------1


No Iodine----------------------------2


No Salt in household--------------3


Salt not tested_______________6


(Specify Reason)

• Data collection:27 December 2010 - 3 June 2011.
• The preliminary report: October 2011
• Final report: March 2012
• Number of households included in Benishangul-Gumuz Region:
Urban: 26314
Rural: 119446
Result
National
•Ninety-four percent of households had salt tested for iodine at the time of the interview.
•Of these households, 15 percent were using iodized salt.Urban households are more likely to use iodized salt (23 percent) than rural households (13 percent).
•Urban households are more likely to use iodized salt (23 percent) than rural households (13 percent). Households in the highest wealth quintile are twice as likely to use iodized salt as households in the lowest two wealth quintiles.
Regional
•At the regional level Benishangul-Gumuz and Addis Ababa have the highest proportions of households using iodized salt (40 percent and 30 percent, respectively), whereas the Dire Dawa and Harari regions have the lowest (6 percent).
1. The Proclamation [2]
“No person shall process, import, store, transport, distribute or sale non iodized salt for human consumption” Salt Iodization Council of Ministers Regulation No. 204/2011, Done Addis Ababa March 20.
2. Research [3]
•Topic: is of national interest
•Purpose: academic- for partial fulfillment of MPH degree from Jimma University
•Problem: real, Benishangul-Gumuz Region is well known iodine deficient and goiter prevalent
•Study area: Assosa town, capital of Benishangul-Gumuz Regional government
•Target: Households in which at least one child aged 6-12 was living
•Opportunity: Rapid Iodine Test Kits provided by Regional Health Bureau
•Scale for salt iodine level: Nil, 1-15, > 15PPM
•Principal investigator: Regional Health Bureau staff member
•Sponsor: Benishangul-Gumuz Region
•Data collection: From May 10 - May 20/2012
vNumber of households: 395
Result
•The overall prevalence of goiter was 104 (26.3%). •The prevalence of households with adequately iodized salt, inadequately iodized salt, and non-iodized salt were 103 (26.1%), 219 (55.4%) and 73 (18.5.0%) respectively.
•During data analysis, 37 (35.9%) of households with non-iodized salt samples had also child having goiter, 50 (22.8%) of households with salt iodine < 15PPM also contained child having goiter, and 7 (9.6%) of households having ≥ 15 PPM salt iodine also had child having goiter.
EMDHS 2014 [4]
“The EMDHS provides updated information on key health indicators since 2011 when the third Ethiopia Demographic and Health (2011 EDHS) survey was conducted. The sample design, sample selection and survey methodology employed in the EMDHS is identical to that of the three previous EDHS surveys in order to ensure comparability [5].”
Facts
A cross-section community based study was conducted during February to May 2005 in 10998 women in child bearing age of 15 to 49 years. Goiter prevalence in four regional states namely Southern Nation Nationalities and People (SNNP), Oromia, Benishangul-Gumuz and Tigray was greater than 30%, an indication of severe iodine deficiency [6].
A study 2008 Dec; 5(3): 163-8. Showed: Cassava consumption and living in high altitude were found to be risk factors for IDD. In the two regions (SNNP and Benishangul-Gumuz) among three where cassava is cultivated, those who consume cassava frequently were significantly (p < 0.001) affected by goiter than those consuming rarely or not [7].
A study published in 2015, stated: “According to the Ethiopian Demographic and Health Survey (EDHS) report of 2011, only 15.4% of the Ethiopian population use iodized salt and the percentage is higher in urban areas (23.2%) than in rural areas (13.3%). At the regional level, Benishangul-Gumuz (40%) and Addis Ababa (30%) had the highestproportions of households using iodized salt and Dire Dawa and Harari regions had the lowest (6%) whereas, in Tigray region 22.3% of households were using iodized salt [15] however, as per WHO to eliminate IDD salt iodization needs to achieve 90% [8].
The severity of ID in the general population is clearly indicated by its appearance among school-age children. The national cross-sectional study from before iodization (2007) demonstrated a high prevalence of ID among 10,965 children aged 6-12 years as indicated by both low UIC and high TGR. Based on UIC values, nearly 46% of children had severe ID (2 μg/dL or less), 23% were moderately iodine deficient (2.01-5.00 μg/dL), 15% were mildly deficient (5.01-10.00 μg/dL) and only 17% were within the normal range (>100 μg/dL). Using the prevalence of goiter as an indicator, the survey recorded the highest TGR in the SNNPR region (56.2%), followed by Oromia (42.0%), Benishangul-Gumuz (40.5%), Amhara (29.1%), and Tigray (21.9%). These results showed severe ID with over 30% of TGR in three regional states, whereas two other regions had moderate ID with between 20.0 and 29.9%. The TGR in the rest of the regional states ranged from about 5 - 20 %, indicating mild ID. Harari had the lowest TGR (4.7%), and is considered the only normal region. Overall, Ethiopia had 39.9% TGR with rates of 27.7% for palpable and 12.2% for visible goiter, with about 4 million children affected by goiter throughout the country except for Gambela regional state [9].
Map of Benishangul-Gumuz Region
Key Findings
1. EDHS 2011
A. The issue of iodized salt survey was not raised in the following sections of EDHS 2011 report:
•OBJECTIVES OF THE 2011 EDHS SURVEY
•QUESTIONNAIRES
•LISTING, PRETEST, MAIN TRAINING, FIELDWORK, AND DATA PROCESSING
•ANTHROPOMETRY, ANAEMIA, AND HIV TESTING
•Yet, itcropped in CHAPTER 11 NUTRITION OF CHILDREN AND ADULTS in jarred and curious manner. Rapid test kit also emerged in the CHAPTER 11
NUTRITION OF CHILDREN AND ADULTS
B. In sampling errors part Issue of iodized salt not included
C. Result of salt iodine using Rapid test kit was presented as:
•With salt
•Without salt
•Not as Nil, 1-15PPM, and >15 PPM
D. In Report there was no explanation about the achievement of Benishangul-Gumuz Region:
•Ninety-four percent of households had salt tested for iodine at the time of the interview.
•Of these households, 15 percent were using iodized salt. Urban households are more likely to use iodized salt (23 percent) than rural households (13 percent).
•At the regional level Benishangul-Gumuz and Addis Ababa have the highest proportions of households using iodized salt (40 percent and 30 percent, respectively), whereas the Dire Dawa and Harari regions have the lowest (6 percent).
•Urban households are more likely to use iodized salt (23 percent) than rural households (13 percent). Households in the highest wealth quintile are twice as likely to use iodized salt as households in the lowest two wealth quintiles.
•No urban rural stratification
The proclamations: Data collection of DHS 2014 was conducted at around or even before the proclamation was done
•The proclamation:Addis Ababa this 251h day of March 2011.
•Data collection took place over a five-month period from 27 December 2010 to 3 June 2011.
2. Research [3]
•The overall prevalence of goiter was 104 (26.3%).
•The prevalence of HH with adequately iodized salt, 103 (26.1%), of whom 7 (6.8%) had goiter
•Inadequately iodized salt219 (55.4%), of whom 50 (22.8%) had goiter
•Non 73 (18.5%), of whom 37 (50.7%) had goiter
3. EMDHS 2014
• No mention about iodine or goiter
Conclusion
Research vs. report
The research finding specifically the prevalence of goiter (visible/palpable/) among 6-12 (children of reproductive age group in Assosa town, from where iodized salt arrives and then distributed to other areas at least partially) indicates the enduring and pervasiveness of the problem and is distasteful and demeaning to the EDHS report on the matter.
The notion that the proportion of households with iodized salt surpassed other reason, as reported in DHS 2011, was unexplained and is unsupported by the geophysical, locational, locational, and socioeconomic background of the Benishangul-Gumuz Region [10].
Never the less, the subject of iodized salt that cropped in the CHAPTER 11 NUTRITION OF CHILDREN AND ADULTS in DHS 2011 report vanished from DMHS 2014 with whimper.
Other researches continued making references to the EDHS
Recommendation
Equip each household with iodine test kit that correctly indicates level of iodine in salt thus changing their ability to perceive and measure it.
Bibliography
  1. Ethiopia Demographic and Health Survey 2011. Central Statistical Agency Addis Ababa, Ethiopia ICF International, Calverton, Maryland, USA, March (2012).
  2. COUNCIL OF MINISTERS REGULATION No. 204/2011, Council of Ministers Regulation to Provide for Salt Iodization: This Regulation is issued by the Council of Ministers pursuant to Article 5 of the Definition of Powers and Duties of the Executive Organs of the Federal Democratic Republic of Ethiopia Proclamation No. 6’9112010 and Article 9(4) of the Food, Medicine and Health Care Administration and Control Proclamation No. 66 112009.
  3. Done at Addis I Ababa this 251th day of March 2011. Meles Zenawi, Prime Minister of the Federal Democratic Republic of Ethiopia.
  4. Gebriel TW., et al. “Cross-sectional Survey of Goiter Prevalence and Household Salt Iodization Levels in Assosa Town, Beni Shangul-Gumuz Region, West Ethiopia”. Pregnancy & Child Health journal 1 (2014): 119.
  5. 5. Ethiopia Mini Demographic and Health Survey 2014 Central Statistical Agency Addis Ababa, Ethiopia August 2014.
  6. Abuye C and Berhane Y. “The goitre rate, its association with reproductive failure, and the knowledge of iodine deficiency disorders (IDD) among women in Ethiopia: Cross-section community based study”. BMC Public Health 8 (2007): 316.
  7. TameneFiteDuressa., et al. “Comparative Analysis of Iodine Concentration in Water, Soil, Cereals and Table Salt of Horaboka, Mio and Besaso Towns of Bale Robe, South East Ethiopia”. Journal of Environment Pollution and Human Health 2.1 (2014): 27-33.
  8. CherinetAbuye., et al. “The role of changing diet and altitude on goitre prevalence in five regional states in Ethiopia”. East African Journal of Public Health 5.3 (2008): 163-168.
  9. Gidey B., et al. “Availability of Adequate Iodized Salt at Household Level and Associated Factors in Rural Communities in LaelayMaychew District, Northern Ethiopia: A Cross Sectional Study”. Journal of Nutrition and Health Sciences2.1 (2015): 103.
Copyright: © 2016 Sahilu Assegid. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PubMed Indexed Article

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


News and Events

November Issue Release

Happy to notify you all that we have successfully released November issue for the respective journals and can be viewed in the current issue pages of the journals.

Submission Timeline for December Issue

E-Cronicon delightfully welcomes the authors for submission of novel research towards December issue of respective journals. Submissions are accepted on/before November 25, 2019.

Certification for each Publication

Corresponding Authors will be issued a "Publication Certificate" with all the Co-Authors included as a token of appreciation for publishing their work with respective journals.

Researcher's Column Special Issue

Editorial office of E-Cronicon (EC) is here with a great initiation to plan a Researcher's Column special issue. The vision of this Researcher's Column is to provide an Awareness among the society with the novel information that you will be contributing. I hope to have the participation of every author who are in association with E-Cronicon to this special issue by making it a successful initiation. Best Column article will be picked by the Editorial office and will be provided with an "Appreciation Certificate". Take a smallest step by dropping your opinions to editor@ecronicon.uk for a biggest success.

Best Article of the Issue

The Editors of respective journals will elect one Best Article after each issue release and the authors of the selected article will be provided with a certificate of "Best Article of the Issue".

Certifying for Review

E-Cronicon certify the Editors for their first review done towards respective journals.

Latest Articles

Recently published articles will be updated immediately in the articles in press page of the respective journals.