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Efficacy of oral iodised oil is associated with anthropometric status in severely iodine-deficient schoolchildren in rural Malawi

  • Carina A. Furnée, Clive E. West (a1), Frits van der Haar and Joseph G. A. J. Hautvast (a1)

Abstract

The effect of anthropometric status on the efficacy of an oral supplement of iodised oil (1 ml Lipiodol Ultrafluide, 490 mg I; Laboratoire Guerbet, Aulnay-sous-Bois, France) was examined in 8–10-year-old schoolchildren (n 197) of Ntcheu, a severely I-deficient district of Malawi. The study was a controlled trial using the I concentration of casual urine samples to monitor the I status. The median urinary I concentration increased from 0·15 μmol/l at baseline (51·3 % of children < 0·16 μmol/l, 89·7 % < 0·40 μmol/l, 95·7 % 0·79 μmol/l) to 0·32 μmol/l at 40 weeks (29·1 % of the children < 0·16 μmol/l, 71·0 % < 0·40 μmol/l, 96·1 % < 0·79 μmol/l) while the total goitre prevalence fell from 63 % to 21 %. Variables of efficacy were estimated from a hyperbolic function describing the longitudinal pattern of urinary I excretion after the dose. The I retention and I elimination rate, and the periods of protection from mild (< 0·79 μmol/l) or moderate (< 0·40 μmol/l) I deficiency were obtained for groups of children with differing anthropometric status at baseline. Initial height-for-age and mid upper-arm circumference were not significantly related to efficacy. However, both the I retention and I elimination rate were reduced in children with lower initial weight-for-height. Children with lower skinfold thickness at baseline also had reduced I retention, which resulted in shorter protection periods from recurrent moderate and mild I deficiency. The efficacy of the oral iodised-oil supplement was not related to changes in anthropometric status during follow-up, nor was it related to the consumption of a food supplement of 1610 kJ immediately before the iodised-oil dose. Very low (< 0·16 μmol/l) urinary I concentration, and the presence of goitre at baseline were both associated with higher I retention and elimination rate. Children with goitre at baseline were found to have a prolonged duration of protection against recurrent moderate I deficiency. We conclude that in apparently healthy schoolchildren in I-deficient areas, general anthropometric status has a little influence on the efficacy of oral iodised oil for correcting I deficiency.

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Copyright

Corresponding author

*Corresponding author: Dr Carina Furnée, present address Chapin Hall Center for Children, University of Chicago, 1313 East 60th Street, Chicago, IL 60637, USA, fax +1(773)532 5940, email cfurnee@hotmail.com

References

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