Nearly one-in-five households utilized inadequate iodized salt in Nifas Silk Sub-City, Addis Ababa, Ethiopia

Mezgebu et al. BMC Nutrition (2023) 9:96 https://doi.org/10.1186/s40795-023-00754-5 BMC Nutrition RESEARCH Open Access Nearly one-in-five households utilized inadequate iodized salt in Nifas Silk Sub-City, Addis Ababa, Ethiopia Getachew Sale Mezgebu1,2, Endalkachew Amare Enyew1, Beakal Zinab Tefera1 and Fentaw Wassie Feleke2,3* Abstract Background There is no country in the developing world where iodine deficiency is not a public health problem including Ethiopia. Therefore, this study aimed to assess inadequate utilization of iodized salt and associated factors at household level in woreda 11 Nifas Silk Sub-city, Addis Ababa, Ethiopia. Methods A community-based cross-sectional study was conducted with multistage sampling technique on 348 household respondents. The data were collected using interviewer-administered structured questionnaires and an iodine rapid test kit. The data were edited, cleaned, and entered using Epi-data version 4.6.2 and exported to SPSS version 25 for analysis. A multivariable logistic regression model was fitted to identify associated factors for inadequate utilization of iodized salt. The statistical significance was declared at a p-value of less than 0.05 with 95% confidence interval. Results A total of 348 household respondents were participated. The amount of iodine content in salt 0 ppm, < 15ppm and > 15ppm were 11.8%, 7.2% and 81.0% respectively. Total inadequate utilization of iodized salt was 19%. Using unpacked salt [AOR; 0.50 (95%CI: 0.27, 0.93)], using a container without a lid [AOR; 0.29 (95%CI: 013, 0.63)], and having insufficient knowledge [AOR; 2.10 (95%CI: 1.14, 3.86)] were all significantly connected with using inadequate iodized salt. Conclusions Iodized salt utilization was inadequate. Using containers without a lid, unpacked salt, and poor knowledge were associated factors. There should be a provision of adequate knowledge about iodized salt, a proper storage and handling. Keywords Addis Ababa, Ethiopia, Iodine deficiency disorder, Iodized salt utilization *Correspondence: Fentaw Wassie Feleke 1 Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia 2 Department of Human Nutrition, School of human nutrition and food science technology, College of agriculture, Hawassa University, P.O.BOX 05, Hawassa, Ethiopia 3 Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Woldia University, P.O.BOX 400, Woldia, Ethiopia © The Author(s) 2023. 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The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Mezgebu et al. BMC Nutrition (2023) 9:96 Introduction Iodine deficiency disorders (IDD) affect more than 50 nations and are a serious public health issue. WHO estimates that there are around 2 billion people in the world [1]. Worldwide 30% [2] of the world population suffer from insufficient iodine intake below 100 µg/L [3]. Iodine deficiency is a public health problem throughout the world [4, 5]. In Europe (57%), the Eastern Mediterranean (54%), Africa (43%), Southeast Asia (40%), the Western Pacific (24%), and the Americas (10%) are the countries most affected [6]. In Africa, about 260 million people have inadequate iodine intake resulting in iodine deficiency states, which may be related to a 10–15% lowering of average intellectual capacity [7, 8]. Mental retardation, growth retardation, reproductive failure, high childhood mortality, impairments in nervous system development, goiter, physical slowness, and economic stagnation are all connected with IDD [9]. Iodine deficiency can reduce average intellectual quotient (IQ) scores by 13.5 points [10] and a mild iodine deficiency can cause a significant loss of learning ability [11]. In Ethiopia, one out of every 1000 is a cretin and about 50,000 prenatal deaths are occurring annually due to iodine deficiency disorders [12], 26% of the total population have goiter and 62% of the population is at risk of IDD according to the national survey made by the previous Ethiopian Nutrition Institute [13]. Iodine can be found in seafood, dairy products, iodinerich soils, and minor amounts in the majority of other foods. Topsoil contains iodine naturally, but it has been damaged by deforestation, erosion, and flooding [14]. Iodine shortage in the diet results from this absence of iodine in food crops. Consequently, people need extra sources to consume the required levels [15]. Despite this, the WHO supported the Universal Salt Iodization (USI) programme, a highly cost-effective public health policy [16], and salt iodization campaigns were started in about 120 different nations worldwide. Thanks to USI [17], iodine deficiency diseases have been wiped out in 34 of these countries. Despite the fact that worldwide iodine nutrition has vastly improved, 20 to 30% of pregnancies and hence babies continue to be disadvantaged by the usage of iodized salt [18]. Iodized salt coverage varies by region, ranging from 90% in Asia and the Pacific to 40–60% in Sub-Saharan Africa [19]. Furthermore, use varies significantly between countries, ranging from 10 to 90%. Sudan, Mauritania, Guinea-Bissau, and the Gambia, for example, use less than 10% of iodized salt, whereas Burundi, Kenya, Nigeria, Tunisia, Uganda, and Zimbabwe have met the USI objective [20]. In Ethiopia, the use of adequate iodized salt increased from 15% to 2011 to 89% in 2016 [21, 22]. According to research conducted in Page 2 of 8 Ethiopia, iodized salt usage ranges from 55.2% in Tigray [23] to 8.7% in the Lalo Asabi District in west Ethiopia [24–26]. The Ethiopian government revitalized and launched universal salt iodization activities, as well as strategies for the virtual elimination of IDD. The Ethiopian quality and standards authority has set the iodine level as potassium iodate at 60–80 parts per million (PPM), after allowing for iodine losses during storage and distribution, and salt fortification with iodine has been a long-term and effective (...truncated)