By Nwamarah, Joy Ugo
ABSTRACT
Recently, iodine deficiency has been recognized as the leading worldwide cause
of preventable intellectual impairment, spontaneous abortions, stillbirth, impaired
fetal development and childhood growth defects. Eliminating iodine deficiency
disorder (IDD) is a global public health priority. Sub-clinical iodine deficiency can
be detected by measuring urinary iodine or assessing thyroid function. Iodine is
an element that directly affects thyroid gland secretions, which themselves to a
great extent control heart action, nerve response to stimuli, rate of body growth
and metabolism. Intestinal disorders, parasitic infestation and nutrient
interactions can impair iodine absorption and utilization. This study was designed
to access the iodine status, growth and the parasitic infestation of primary school
children. The study also tried to ascertain knowledge, attitude and practice (KAP)
of mothers on iodine deficiency disorder and iodized salt utilization, thereby
determining their effect on iodine status growth velocities of the children.
Sampling of the three schools (Ajuona CPS, Owerre-Obukpa CPS and
AmagulUmuorua CPS) was by random sampling using balloting from five
schools in the community, while the children were selected by stratified method
using the class register in each school. Questionnaires were used to elicit basic
information from the children's parents on social and demographic characteristics
of households, health facilities and practices, health records, morbidity, health
status, knowledge, attitude and practice (KAP) of mothers on iodized salts and
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iodine deficiency disorder (IDD). The anthropometric measurements of 272
children composing of 154 boys and 146 girls aged 6-12years were taken to
assess their nutritional status using standard procedures. A sub-sample of 33
children was monitored for 12 months to assess their growth velocities; 11
children from each school were randomly selected. Their stools were collected
for assessing the parasitic load, and urine for biochemical analysis of urine iodine
levels. Salt from their homes were tested for iodine content with iodine spot-test
kit. Means, standard deviation, Student t-test, analysis of variance and
correlation coefficient were used where applicable. Anthropometric
measurements of the children revealed that 25% were stunted, 13% were
underweight while 6.3% were wasted. More girls (3.0%) than boys (2.3%) were
wasted. The weight velocities of the children were higher in the dry season
(0.57kg) than in the wet season (0.29kg). Also their height velocities were higher
in the dry season (1.98cm) than in wet season (0.62cm). There were significant
differences in the mean weight velocities of the children in wet and dry seasons
(t= 3.674, P0.05)
in the mean weight velocities of the boys (0.30kg) and girls (0.26kg), as well as in
the height velocities (t= 1.03, P>0.05) of the boys (0.95cm) and girls (1.00cm).
The weight velocities for boys according to schools attended showed differences
(Ajuona CPS, 0.36kg; Amagu/Umuorua CPS, 0.32kg; and Owerre-Obukpa CPS,
0.30kg; but were not significant, f=3.85, P>0.05) and for height (Ajuona CPS,
0.61cm; AmaguIUmuorua CPS, 1.61cm; and Owerre-Obukpa CPS, 0.65cm; but
were not significant, f=3.89, P>0.05). There were differences in the weight
velocities for girls (Ajuona CPS, 0.46kg; AmaguIUmurua CPS, 0.29kg and
Owerre-Obukpa CPS, 0.23kg; but they were not significant, f=3.77, P>0.05), and
height (Ajuona CPS, 1.14cm; AmaguIUmurua CPS, 1.41 cm and Owerre-Obukpa
CPS, 0.76cm; but were not significant, f=3.95, P>0.05). More than fifty percent
(58.33%) of the children were severely iodine deficient, boys (33.33%) and girls
(25%). The urinary iodine level ranged from about (10 to 650pgIL). The intestinal
parasitic loads were generally low. There were no significant relationships
between worm infestations of children in the various schools and their urine
iodine levels. Wasting in- ~h'ildien'~wapso sitively correlated with the worm
infestation and this was significant (r=0.467, P0.05) and
underweight (r=0.240, P>0.05) in the children, but were not significant. Low
urinary iodine excretion was more in the stunted children (60.0%) than in the
normal children (21.2%). Most of the salts consumed in the homes were
adequate in iodine. About 91% of marketed salt and 97% of salt brought from
homes were iodized above 3oppm' iodine level. However, there was generally
poor knowledge about iodized salt and iodine deficiency disorders by the
mothers.