Low Urinary Iodine Concentration among Mothers and Children in Cambodia

Nutrients
Q1
Apr 2016
Citations:18
Influential Citations:1
Observational Studies (Human)
81
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Enhanced Details

Methods
Cross-sectional national survey (CNMS-2014) conducted as a subset of the 2014 Cambodian Demographic and Health Survey (CDHS). Participants: 736 mothers aged 15–49 years (mothers of children 6–59 months) and 950 children aged 6–59 months; 21% urban, 79% rural; no severe or chronic illness; informed consent obtained. Sampling: two-stage cluster design across 611 villages. Urine samples collected to measure urinary iodine concentration (UIC); salt samples tested for iodine using rapid test kits.
Results
Median UIC: mothers 63 µg/L; children 72 µg/L. >60% of both groups have UIC <100 µg/L, indicating iodine deficiency. Lower UIC associated with rural residence, poorer socioeconomic status, and lack of access to iodized salt. By wealth, median UIC is 55 µg/L in the poorest mothers vs 75 µg/L in the richest; 63.7% of children and 74.6% of mothers have UIC <100 µg/L. About 75.6% of salt tested contained iodine; 62% of salt samples in a national assessment were non-iodized. Unadjusted odds of low UIC higher for rural vs urban residents and for those without iodized salt; multivariate analysis shows rural residence and lack of iodized salt as key risk factors for both groups; age >24 months increases risk for children; equity card access shows no consistent protective effect. Authors call for stronger enforcement of iodized salt legislation and short-term iodine supplementation for at-risk groups; suggest adjusting iodization standards toward WHO-recommended levels (14–22 ppm) and enhancing monitoring with quantitative salt-iodine tests; emphasize ensuring equitable access to adequately iodized salt while considering overall salt reduction guidance.
Limitations
Large intra-individual variation in UIC; use of single spot samples limits individual-level assessment. WHO cut-offs extrapolated to women of reproductive age and younger children. Cross-sectional design precludes causal inference. Subset analysis from CDHS; may limit generalizability to the entire population. Salt iodine status assessed with rapid tests; quantitative measurements recommended for monitoring.

Abstract

A 2014 national assessment of salt iodization coverage in Cambodia found that 62% of samples were non-iodized, suggesting a significant decline in daily iodine intakes. The Cambodian Micronutrient Survey conducted in 2014 (CMNS-2014) permitted obtain...