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Excess dietary iodine intake in long-term African refugees

Published online by Cambridge University Press:  02 January 2007

Andrew J Seal*
Affiliation:
Centre for International Child Health, Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
Paul I Creeke
Affiliation:
Centre for International Child Health, Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
Daniella Gnat
Affiliation:
Department of Clinical Chemistry, Saint-Pierre Hospital, Brussels, Belgium
Fathia Abdalla
Affiliation:
United Nations High Commissioner for Refugees, Geneva, Switzerland
Zahra Mirghani
Affiliation:
United Nations High Commissioner for Refugees, Geneva, Switzerland
*
*Corresponding author: Email a.seal@ich.ucl.ac.uk
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Abstract

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Objective

To assess the iodine status of long-term refugees dependent on international food aid and humanitarian assistance.

Design

A series of cross-sectional two-stage cluster or systematic random sample surveys which assessed urinary iodine excretion and the prevalence of visible goitre. Salt samples were also collected and tested for iodine content by titration.

Setting

Six refugee camps in East, North and Southern Africa.

Subjects

Male and female adolescents aged 10–19 years.

Main results

The median urinary iodine concentration (UIC) ranged from 254 to 1200 μg l−1 and in five of the camps exceeded the recommended maximum limit of 300 μg l−1, indicating excessive iodine intake. Visible goitre was assessed in four surveys where it ranged from 0.0 to 7.1%. The camp with the highest UIC also had the highest prevalence of visible goitre. The iodine concentrations in 11 salt samples from three camps were measured by titration and six of these exceeded the production-level concentration of 20 to 40 ppm recommended by the World Health Organization (WHO), but were all less than 100 ppm.

Conclusions

Excessive consumption of iodine is occurring in most of the surveyed populations. Urgent revision of the level of salt iodisation is required to meet current WHO recommendations. However, the full cause of excessive iodine excretion remains unknown and further investigation is required urgently to identify the cause, assess any health impact and identify remedial action.

Type
Research Article
Copyright
Copyright © The Authors 2006

References

1Delange, F, De Benoist, B, Pretell, E, Dunn, JT. Iodine deficiency in the world: where do we stand at the turn of the century? Thyroid 2001; 11: 437–47.CrossRefGoogle ScholarPubMed
2International Council for the Control of Iodine Deficiency Disorders. IDD Newsletter 2003; 19: 16.Google Scholar
3Laurberg, P, Bulow Pedersen, I, Knudsen, N, Ovesen, L, Andersen, S. Environmental iodine intake affects the type of nonmalignant thyroid disease. Thyroid 2001; 11: 457–69.CrossRefGoogle ScholarPubMed
4Markou, K, Georgopoulos, N, Kyriazopoulou, V, Vagenakis, AG. Iodine-induced hypothyroidism. Thyroid 2001; 11: 501–10.CrossRefGoogle ScholarPubMed
5Stanbury, JB, Ermans, AE, Bourdoux, P, Todd, C, Oken, E, Tonglet, R, et al. Iodine-induced hyperthyroidism: occurrence and epidemiology. Thyroid 1998; 8: 83100.CrossRefGoogle ScholarPubMed
6Dunn, JT, Semigran, MJ, Delange, F. The prevention and management of iodine-induced hyperthyroidism and its cardiac features. Thyroid 1998; 8: 101–6.CrossRefGoogle ScholarPubMed
7Corvilain, B, Van Sande, J, Dumont, JE, Bourdoux, P, Ermans, AM. Autonomy in endemic goiter. Thyroid 1998; 8: 107–13.CrossRefGoogle ScholarPubMed
8Gomo, ZA, Allain, TJ, Matenga, JA, Ndemere, B, Wilson, A, Urdal, P. Urinary iodine concentrations and thyroid function in adult Zimbabweans during a period of transition in iodine status. American Journal of Clinical Nutrition 1999; 70: 888–91.CrossRefGoogle ScholarPubMed
9Institute of Child Health. NutVal 2004 – Excel Spreadsheet Application, version 1.0. London: Institute of Child Health, 2004.Google Scholar
10World Health Organization (WHO). The Management of Nutrition in Major Emergencies. Geneva: WHO, 2000.Google Scholar
11Riley, M, Gochman, N. A fully automated method for the determination of, serum protein-bound iodine. Presented at Technicon SymposiumTarrytown, NY1964.Google Scholar
12United Nations Children's Fund (UNICEF) ROSCA. The Use of Iodised Salt in the Prevention of Iodine Deficiency Disorders – A Handbook of Monitoring and Quality Control. New Delhi: UNICEF ROSCA, 1998.Google Scholar
13International Council for Control of Iodine Deficiency Disorders/United Nations Children's Fund/World Health Organization (WHO). Assessment of Iodine Deficiency Disorders and Monitoring their Elimination. A Guide for Programme Managers. WHO/NHD/01.1. Geneva: WHO, 2001.Google Scholar
14Mu, L, Chengyi, Q, Qidong, Q, Qingzhen, J, Eastman, C, Collins, J, et al. Endemic goitre in central China caused by excessive iodine intake. Lancet 1987; 330: 257–9.CrossRefGoogle Scholar
15Jooste, PL, Weight, MJ, Kriek, JA, Louw, AJ. Endemic goitre in the absence of iodine deficiency in schoolchildren of the Northern Cape Province of South Africa. European Journal of Clinical Nutrition 1999; 53: 812.CrossRefGoogle ScholarPubMed
16Delange, F, De Benoist, B, Alnwick, D. Risks of iodine-induced hyperthyroidism after correction of iodine deficiency by iodized salt. Thyroid 1999; 9: 545–56.CrossRefGoogle ScholarPubMed
17World Health Organization (WHO)/United Nations Children's Fund/International Council for Control of Iodine Deficiency Disorders. Recommended Iodine Levels in Salt and Guidelines for Monitoring their Adequacy and Effectiveness. WHO/NUT/96.13. Geneva: WHO, 1996.Google Scholar
18Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2001.Google Scholar
19Expert Group on Vitamins and Minerals. Safe Upper Levels for Vitamins and Minerals. London: Food Standards Agency, 2003.Google Scholar
20European Commission. Opinion of the Scientific Committee on Food on the Tolerable Upper Intake Level of Iodine. SCF/CS/NUT/UPPLEV/26 Final. Brussels: European Commission, 2002.Google Scholar