Iodine concentration level of iodized dietary salt and its associated factors: a systematic review and meta-analysis

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Abstract

Background

Iodine deficiency disorder (IDD) is a major public health problem in Ethiopia. The availability of adequate iodized dietary salt at the household level is immensely important. Hence, this review aimed to estimate the pooled prevalence of adequate iodine concentration level of iodized dietary salt at the household level and its associated factors in Ethiopia.

Methods

We searched the literature using electronic databases (PubMed/Medline, Google Scholar, Science Direct, and Embase) and gray literature from January 9, 2022, to February 25, 2022. The rapid test kit was used to measure the adequacy of iodine level of dietary salt. The quality of studies was assessed using Joanna Briggs Institute critical appraisal tool. Heterogeneity between studies was checked using I ² test statistics and publication bias was checked using funnel plot and Egger’s statistical test at a 5% significance level. A random-effects model was employed to estimate the pooled prevalence of the outcome variable and its determinants in Ethiopia.

Results

The search identified 149 studies of which 18 studies were included with a total of 10,556 participants. The pooled prevalence of adequate iodine levels of iodized salt in Ethiopia was 44.37% (95% CI: 35.85-52.88). Women who had formal education (adjusted odds ratio (AOR) = 1.99 (95% CI: 1.47–2.48)), good knowledge of women (AOR = 2.14, 95% CI: 1.36–3.36), packed iodized salt (AOR = 3.85 (95% CI: 1.88–7.87)) and storage of iodized salt at home for less than 2 months (AOR = 2.66 (95% CI: 2.11–3.35) were the significant factors.

Conclusion

This review suggests that the pooled prevalence of adequate iodine levels was low. Our finding highlights the need for considering the educational status, knowledge, and duration of salt storage to enhance the prevalence of adequate levels of iodized salt at the national level.

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PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews

Matthew J Page (2021)

The methods and results of systematic reviews should be reported in sufficient detail to allow users to assess the trustworthiness and applicability of the review findings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was developed to facilitate transparent and complete reporting of systematic reviews and has been updated (to PRISMA 2020) to reflect recent advances in systematic review methodology and terminology. Here, we present the explanation and elaboration paper for PRISMA 2020, where we explain why reporting of each item is recommended, present bullet points that detail the reporting recommendations, and present examples from published reviews. We hope that changes to the content and structure of PRISMA 2020 will facilitate uptake of the guideline and lead to more transparent, complete, and accurate reporting of systematic reviews.

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Operationalizing dietary diversity: a review of measurement issues and research priorities.

Marie T. Ruel (2003)

Dietary diversity (DD) is universally recognized as a key component of healthy diets. There is still, however, a lack of consensus on how to measure and operationalize DD. This article reviews published literature on DD, with a focus on the conceptual and operational issues related to its measurement in developing countries. Findings from studies of the association between DD and individual nutrient adequacy, child growth and/or household socioeconomic factors are summarized. DD is usually measured using a simple count of foods or food groups over a given reference period, but a number of different groupings, classification systems and reference periods have been used. This limits comparability and generalizability of findings. The few studies that have validated DD against nutrient adequacy in developing countries confirm the well-documented positive association observed in developed countries. A consistent positive association between dietary diversity and child growth is also found in a number of countries. Evidence from a multicountry analysis suggests that household-level DD diversity is strongly associated with household per capita income and energy availability, suggesting that DD could be a useful indicator of food security. The nutritional contribution of animal foods to nutrient adequacy is indisputable, but the independent role of animal foods relative to overall dietary quality for child growth and nutrition remains poorly understood. DD is clearly a promising measurement tool, but additional research is required to improve and harmonize measurement approaches and indicators. Validation studies are also needed to test the usefulness of DD indicators for various purposes and in different contexts.