Potassium iodate levels in processed edible salts available in retail shops throughout Kenya, 2013.

OBJECTIVE: Iodine-deficiency disorders, due to insufficiency of iodine in the diet, are a global public health problem. The Kenyan Food, Drugs and Chemical Substances Act stipulates that processed retail-available edible salts contain 50-84 mg of potassium iodate (KIO3) per kilogram of salt. The present study determined the status of KIO3 levels in commercial salts, for public health action.Design/Setting/SubjectsAs part of the Kenya Demographic and Health Survey 2013, field workers collected salt samples from seven different local manufacturers/packers across eight regions of the country and sent them to the National Public Health Laboratory (NPHL) for KIO3 titration analysis. RESULTS: A total of 539 samples were collected and analysed at NPHL. The samples had a mean KIO3 of 62 mg/kg. Thirty-three (6 %) samples had KIO3 of 84 mg/kg. CONCLUSIONS: The study found that 62 % of salts sampled met the Kenyan standards, 24 % were below the required limits and 13 % were above the recommended range. Continuous monitoring of edible salts at the retail level is important to detect brands not adhering to standards and trace them for remedy. However, governmental efforts should be directed to the quality control and quality assurance of the salt-manufacturing industries.

Use of Premixed Parenteral Nutrition During a Phosphate Shortage in a Non-Critically Ill Population.

BACKGROUND: Drug shortages pose prescribing problems to clinicians. During fiscal year (FY) 2014, an acute shortage of intravenous potassium phosphate (K-Phos IV), a common supplement in parenteral nutrition (PN), prompted the use of premixed instead of individualized PN to conserve K-Phos IV. Here we quantify the K-Phos IV conserved by using premixed PN and the associated cost differences. MATERIALS AND METHODS: Costs of preparing premixed PN vs individualized PN of equivalent composition were calculated for FY 2014 at a single-center tertiary care facility. Quantity and cost of K-Phos IV saved were calculated based on the number of premixed PN prescriptions. Costs for FY 2015 were projected based on drug costs from July 2014. RESULTS: During FY 2014, prescribing premixed in lieu of individualized PN conserved 16,440 mmol K-Phos IV but increased the cost of PN by $4080.45. However, increases in K-Phos IV cost at the end of FY 2014 resulted in premixed PN as a relatively less expensive therapy than individualized PN for our institution. Cost savings of $7092.20 due to use of premixed PN is projected for FY 2015. CONCLUSIONS: Prescribing premixed PN conserves K-Phos IV during shortages, but it increased direct drug spending in non-critically ill patients at our institution during FY 2014. Persistent shortages can drive market costs of K-Phos IV, however, necessitating frequent reconsideration of resource utilization.

Evaluation of a scheme for the pre-distribution of stable iodine (potassium iodate) to the civilian population residing within the immediate countermeasures zone of a nuclear submarine construction facility.

BACKGROUND: The Barrow-in-Furness stable iodine (potassium iodate) tablet pre-distribution scheme was the first of its kind to be introduced to protect the population living around a fixed site nuclear facility in the United Kingdom. Pre-distribution schemes have attracted critical comment principally because the certainty of availability of potassium iodate tablets was unknown. This study aimed to establish the reliability of such a scheme. METHOD: A structured interviewer-administered survey of a random sample of households served by the pre-distribution scheme was carried out using a standardized questionnaire. RESULTS: The ability of this scheme to provide stable iodine protection declined from 100 per cent to 60 per cent coverage over a period of two years for the designed worst-case demand (the ability to supply stable iodine tablets to all household residents normally living within the pre-distribution scheme zone). CONCLUSIONS: Pre-distribution has value in areas where evacuation to a centre where stable iodine tablets are available or post-accident distribution to sheltering households is difficult. The value of such a scheme must be calculated against a predictable decline in its effectiveness. In implementing such a scheme it should be noted that this decline in coverage can be reduced by calculating the frequency with which tablet packs are redistributed to take account of this factor.