@article{fdi:010069336,
  title = {{A}dequacy assessment of a universal salt iodization program two decades after its implementation : a national cross-sectional study of iodine status among school-age children in {T}unisia},
  author = {{D}oggui, {R}. and {E}l {A}ti-{H}ellal, {M}. and {T}raissac, {P}ierre and {L}ahmar, {L}. and {E}l {A}ti, {J}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}n the framework of a worldwide policy to eliminate iodine deficiency ({ID}) disorders, universal salt iodization was adopted in {T}unisia two decades ago. {T}he present study aims to evaluate this strategy, using both performance and impact indicators. {A} total of 1560 children, aged 6-12 years, were randomly sampled using a national, two-stage, stratified, cross-sectional cluster survey in 2012. {U}rinary iodine concentration ({UIC}) of the subjects, and household salt iodine content, were analyzed. {T}he national median {UIC} was 220 mu g/{L} (95% confidence interval ({CI}): 199-241), indicating an acceptable iodine status at the population level. {O}nly 11.4% (95% {CI}: 8.6-14.9) of the children had {UIC} <100 mu g/{L}, but with large regional disparities (4.3% to 25.5%, p < 0.01); however, more than a quarter of the subjects were at risk of adverse health consequences due to iodine excess. {C}hildren from households of low socio-economic levels were more prone to inadequate {UIC}. {T}he national median iodine concentration of household salt was 22 mg/kg (95% {CI}: 21-23). {O}nly half of the households used adequately iodized salt (15-25 ppm), with large regional disparities. {N}ational {ID} rates are now well below the target criteria of {WHO} ({W}orld {H}ealth {O}rganization) certification (<20% of children with {UIC} < 50 mu g/{L} and < 50% with {UIC} < 100 mu g/{L}). {T}he coverage of adequately iodized salt fell short in meeting the goals of {USI} ({U}niversal {S}alt {I}odization), i.e., >90% of households. {R}egular monitoring of iodized salt production lines must be strengthened with involvement by producers.},
  keywords = {universal salt iodization ; iodine deficiency disorders ; iodine status ; {T}unisia ; children ; adequacy assessment ; evaluation ; {TUNISIE}},
  booktitle = {},
  journal = {{N}utrients},
  volume = {9},
  numero = {1},
  pages = {art. 6 [17 p.]},
  ISSN = {2072-6643},
  year = {2017},
  DOI = {10.3390/nu9010006},
  URL = {https://www.documentation.ird.fr/hor/fdi:010069336},
}