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Evaluation of Urinary Iodine Concentration for Predicting Iodine Deficiency in Sub-Saharan Africa: First Population Based Study From the Demographic and Health Surveys Data (P10-089-19).

Objectives
Approximately 2 billion individuals suffer from an insufficient iodine intake, and sub-Saharan Africa is particularly the most affected. We thus conducted a cross-sectional study to assess iodine deficiency status, among women of reproductive age 20-49 years in Tanzania and examine the factors associated with iodine deficiency.


Methods
The current analysis was based on 3057 women aged 20-49 y who participated the Tanzania Demographic and Health Surveys 2015-2016. Iodine status was assessed using urinary iodine concentration (UIC). Iodine deficiency was defined if UIC was less than 100ug/L. A stepwise multivariable logistic regression to identify the factors associated with iodine deficiency. Potential predicators included age, education level, married status, wealth index, having a prenatal doctor and prenatal nurse, currently pregnant, currently breastfeeding, place of residence, employment status, and history of terminated pregnancy.


Results
The median UIC among pregnant women (median: 129 μg/L; 25th and 75th percentile: 57.8-240), uneducated women (99.0 μg/L; 48.2-201 μg/L), and poor women (92 μg/L; 43.1 -191 μg/L) were below the recommended ranges (≥150 μg/L for pregnant women and ≥100 μg/L for non-pregnant women) by the World Health Organization. Multivariable logistic stepwise regression showed that women were more likely to be iodine deficient if they were pregnant (aOR 1.55 [95% CI 1.11, 2.15], currently breastfeeding (aOR 1.56 [95% CI 1.28, 1.92], poor (aOR 1.75 [95% CI 1.35, 2.26], uneducated (aOR 1.77 [95% CI 1.26, 2.48], and living in the rural area (aOR 1.79 [95% CI 1.37, 2.34]. Unexpectedly, currently employed women also had significantly higher odds of iodine deficient (aOR 1.41 [95% CI 1.10, 1.80], relative to those without employment.


Conclusions
There is disparity in UIC among of women of reproductive age 20-49 in Tanzania. Poverty and lack of education appeared to be the driving factors for iodine deficiency. High risk of iodine deficient among pregnant and breastfeeding women appeal for action to implement and enforce universal salt iodization among this vulnerable population in Tanzania.


Funding Sources
There was no external or internal funding to support this study.