Date Published: April 4, 2019
Publisher: Public Library of Science
Author(s): Muzemil Muktar, Kedir Teji Roba, Bezatu Mengistie, Berhe Gebremichael, Adamu Belay Tessema, Meseret Woldeyohannes Kebede, Sun Young Lee.
Goiter is a major public health problem in Ethiopia. Even though there were studies done on goiter in Ethiopia, there was little evidence in the eastern part of the country. Therefore, the aim of this study was to assess the prevalence of goiter and its associated factors among school-age children in Anchar district of Eastern Ethiopia.
A school based cross-sectional study was conducted from February 13 to 30, 2017. Multistage sampling method was used to select 418 children aged 6–12 years. Data were collected using a questionnaire. Children were examined for the presence or absence of goiter based on the criteria of the World Health Organization (WHO). Salt samples were tested using a rapid test kit. Data were entered to EpiData version 3.1 and exported to SPSS version 22.0 for analysis. Bivariate and multivariate logistic regression models were fitted; Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were computed. Level of significance was determined at p-value less than 0.05.
The total goiter prevalence rate was 51.8% (CI: 46.9%, 56.8%). Father’s education (AOR = 1.87, CI: 1.06, 3.30), type of salt used (AOR = 2.09, CI: 1.13, 3.88), iodine level of salt (AOR = 2.77, CI: 1.11, 6.89), frequency of milk consumption (AOR = 3.65, CI: 1.63, 8.20), frequency of cabbage consumption (AOR = 7.74, CI: 4.48, 13.39), eating status of eggs (AOR = 3.16, CI: 1.54, 6.50), and eating status of dark green vegetables/fruits (AOR = 2.14, CI: 1.17, 3.93) were factors associated with goiter among school-age children.
The total goiter prevalence rate was very high. Therefore, the health and education sectors of the study area should work hand in hand to improve the awareness of the community about goiter, iodized salt and iodine rich foods.
The hormones produced by the thyroid gland need iodine, as an essential component and these hormones are crucial for sustaining human life. Deficiency of iodine results in goiter which is the abnormal growth of thyroid gland, clinically detected by physical inspection and palpation [1, 2]. The prevalence of goiter increases with the severity of iodine deficiency and becomes endemic in populations where the intake of iodine is less than 10 microgram per day .
The findings of this study assessed the prevalence and associated factors of goiter among school-age children in primary schools of Anchar district, Eastern Ethiopia. Accordingly, the prevalence of goiter in this study was 51.8% (CI: 46.9%, 56.8%). Father’s level of education, buying and/or using iodized salt, iodine level of household salt, frequency of milk and cabbage consumption, eating status of eggs and dark green vegetables/fruits were identified as independent predictors of goiter among school age children.
The strength of the study is that it was supplemented with salt iodine tests. However, since the study is cross-sectional, it might not show the temporal relation between the independent and dependent variables. There is a possibility that some of the responses might suffer from recall bias since the questions for the dietary habits were based on recall. Moreover, the result is not representative of the prevalence in the community, as it did not include children out of school.
More than half of the school-age children included in this study had goiter. Moreover, more than half of the salt samples were non-iodized. Furthermore, the father’s level of education, buying and/or using iodized salt, iodine level of household salt, frequency of milk and cabbage consumption, eating status of egg and dark green vegetables/fruits were associated factors of goiter among school age children. Therefore, Anchar district health and education sectors should work together in disseminating messages to increase the awareness of the community on how to prevent goiter through the consumption of iodized salt, and iodine rich foods.