Iodine Status After a 3-year Universal Salt Iodisation in Sarawak, Malaysia
Keywords:
universal salt iodization, iodine deficiency disorders, urinary iodine concentration, SarawakAbstract
ABSTRACT
Iodine Status After a 3-year Universal Salt Iodisation in Sarawak, Malaysia
Lim Kuang Kuay1, Jambai Endu2, Chan Ying Ying1, Teh Chien Huey3, Hasimah Ismail1, Â Lim Kuang Hock1, Kee Chee Cheong3Â
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1Institute for Public Health, Ministry of Health, Malaysia.
2Sarawak State Health Department, Ministry of Health, Malaysia.
3Institute for Medical Research, Ministry of Health, Malaysia.
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Introduction:  As the 2008 National Iodine Deficiency Disorders (IDDs) survey had revealed the borderline iodine sufficiency (median urine iodine concentration = 101.9 µg/L) among the Sarawakian, a mandatory universal salt iodization (USI) was implemented in Sarawak thereafter. This study aimed to determine the effectiveness of USI in Sarawak after a 3-year implementation of USI from 2008 to 2011 by analyzing the data from the 2011 IDD Survey in Sarawak.
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Methods: The IDD survey was conducted between Jun 2011 to July 2011 involving 6 districts in Sarawak (Sarikei, Mukah, Kapit, Sibu, Bintulu and Miri). A total of 610 children were then recruited into the survey. Thyroid size was determined by inspection and palpation while the iodine excretion level in spot morning urine was measured using in-house micro method. Â
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Results: The total goitre rate (TGR) was found to be 0.05% (n = 2). Overall the median urinary iodine concentration (UIC) level was 154.2 µg/L (IQR, 92.7 - 229.8 µg/L), with the highest median UIC been observed in Sarikei [178.0 (IQR, 117.6 - 308.9 µg/L)], followed by Mukah [174.8 (IQR, 99.0 - 224.3 µg/L)], Miri [158.6 (IQR, 92.3 - 235.4 µg/L)], Sibu [147.0 (IQR, 89.8 - 221.4 µg/L)], Bintulu [142.3 (IQR, 52.8 - 245.1 µg/L)] and Kapit [131.0 (IQR, 88.6 - 201.9 µg/L)]. One in every ten child was of iodine insufficient (UIC < 50µg/L) while a third of the child (32%) were of adequate level of UIC.
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Conclusions: The present findings indicate that the mandatory universal salt iodization was effective in improving the iodine level of children in Sarawak. However, regular and proper monitoring of the UIC level in the communities is needed to prevent excessive iodine intake.
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Keywords: universal salt iodization, iodine deficiency disorders, urinary iodine concentration, SarawakÂ
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