Clinical Assessment of Goiter and Low Urinary Iodine Concentration Depict Presence of Severe Iodine Deficiency in Pregnant Ethiopian Women: A Cross-sectional Study in Rural Sidama, Southern Ethiopia.

Objectives: To determine iodine status and knowledge of iodine deficiency disorders (IDD) of pregnant women in rural Sidama, southern Ethiopia. Methods: A cross-sectional community-based study was conducted in three kebeles which were selected randomly from the eight kebeles in the study area using probability proportional to size methods. Data were collected in January, 2009, from 172 pregnant women. Main outcome measures were urinary iodine concentration (UIC), % of population with UIC < 20 µg/L, % of households using iodized salt, iodine content of salt and total goiter rate (TGR). Results: Median UIC was only 15 µg/L compared to the 150 µg/L minimum recommendation from WHO/UNICEF/ICCIDD for pregnant women. The UIC of 60% of the women was < 20 µg/L. More than 90% of households were not using iodized salt and median salt iodine content was almost zero compared to the recommended 15-40 mg/kg. TGR was 49% (95% CI: 42, 56) which is much higher than the 5% TGR cut-off signifying a problem of public health significance. In addition, > 90% of participants didn't know about IDD, about the cause of goiter or why iodized salt is important. Conclusions: Results indicated the presence of severe iodine deficiency in the study population; urgent intervention, through universal salt iodization, and iodine supplementation to high risk groups is required.