Iodine status of non-pregnant women and availability of food vehicles for fortification with iodine in a remote community in Gulf province, Papua New Guinea

Autoři: Janny M. Goris aff001;  Victor J. Temple aff002;  Joan Sumbis aff002;  Nienke Zomerdijk aff003;  Karen Codling aff004
Působiště autorů: PNG Foundation, North Tamborine, Qld, Australia aff001;  School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea aff002;  School of Medicine, The University of Queensland, Brisbane, Qld, Australia aff003;  Iodine Global Network—Southeast Asia and the Pacific, Bangkok, Thailand aff004
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224229


Adequate iodine status of women of childbearing age is essential for optimal growth and development of their offspring. The objectives of the current study were to assess the iodine status of non-pregnant women, availability and use of commercial salt, extent to which it is iodised, and availability of other industrially processed foods suitable for fortification with iodine. This prospective cross-sectional study was carried out in 2018 in a remote area in Gulf province, Papua New Guinea. Multistage cluster sampling was used to randomly select 300 women visiting local markets. Of these, 284 met study criteria of being non-pregnant and non-lactating. Single urine samples were collected from each of them. Discretionary salt intake was assessed; salt samples were collected from a sub-sample of randomly selected households. A semi-structured, pre-tested questionnaire to assess use and availability of commercial salt and other processed foods was modified and used. Salt was available on the interview day in 51.6% of households. Mean iodine content in household salt samples was 37.8 ± 11.8 ppm. Iodine content was below 30.0 ppm in 13.1% and below 15.0 ppm in 3.3% of salt samples. Mean iodine content of salt available at markets was 39.6 ± 0.52 ppm. Mean discretionary intake of salt per capita per day was 3.9 ± 1.21 g. Median UIC was 34.0 μg/L (95% CI, 30.0–38.0 ppm), indicating moderate iodine deficiency. For women with salt in the household, median UIC was 39.5 μg/L (95% CI, 32.0–47.0 μg/L), compared to median UIC of 29.0 μg/L (95% CI, 28.0–32.0 μg/L) for those without salt. This community has low consumption of iodised salt, likely due to limited access. Investigation of other industrially processed foods indicated salt is the most widely consumed processed food in this remote community, although 39.8% of households did use salty flavourings.

Klíčová slova:

Flour – Iodine – Micronutrient deficiencies – Pregnancy – Schools – Sodium chloride – Urine – Wheat


1. WHO, UNICEF, ICCIDD. Assessment of Iodine Deficiency Disorders and monitoring their elimination: A guide for programme managers. Geneva: WHO/NHD; 2007. Available from:

2. Zimmermann M, Boelaert K. Review: Iodine deficiency and thyroid disorders Lancet Diab Endoc. 2015;3(4):286–95.

3. Eastman C, Zimmermann M. The Iodine Deficiency Disorders. Bethesda: National Center for Biotechnology Information, U.S. National Library of Medicine; 2018. Available from:

4. Pearce E, Lazarus J, Moreno-Reyes R, Zimmermann M. Consequences of iodine deficiency and excess in pregnant women: an overview of current knowns and unknowns. Am J Clin Nutr. 2016;104 (Suppl):918S–23S.

5. Vanderpump M, Lazarus J, Smyth P, Laurberg P, Holder R, Boelaert K, et al. Iodine status of UK schoolgirls: A cross-sectional survey. Lancet. 2011;377(9782):2007–12. doi: 21640375

6. Hynes K, Otahal P, Hay I, Burgess J. Mild iodine deficiency during pregnancy is associated with reduced educational outcomes in the offspring: 9-year follow-up of the gestational iodine cohort. J Clin Endocrinol Metab. 2013;98(5):1954–62. doi: 10.1210/jc.2012-4249 23633204

7. Barter P. Pure Food Act, amendment of Pure Food Standards. Port Moresby: Papua New Guinea Government National Gazette; 1995. p. G 47.

8. Papua New Guinea National Department of Health. Food Sanitation Regulation Statutory Instrument. In: Department of Health, editor. Port Moresby 2007.

9. Department of Health of Papua New Guinea, Unicef Papua New Guinea, University of Papua New Guinea, US Centres of Disease Control and Prevention. Papua New Guinea National Nutrition Survey 2005. Pac J Med Sci. 2011;8(2):54–9.

10. Temple V, Haindapa B, Turare R, Masta A, Amoa A, Ripa P. Status of Iodine Nutrition in Pregnant and Lactating Women in National Capital District, Papua New Guinea. Asia Pac J Clin Nutr. 2006;15(4):533–7. doi: 10.1111/j.1365-2265.2008.03442.x 17077071

11. Temple V, Oge R, Daphne I, Vince J, Ripa P, De Lange F, et al. Salt Iodization and Iodine Status among Infants and Lactating Mothers in Papua New Guinea. Afr J Food Agr Nutr Dev 2009;9(9):1807–23.

12. Goris J, Zomerdijk N, Temple V. Nutritional status and dietary diversity of Kamea in Gulf province, Papua New Guinea. Asia Pac J Clin Nutr. 2017;26(4):665–70. doi: 10.6133/apjcn.052016.09 28582817

13. Goris J, Temple V, Zomerdijk N, Codling K. Iodine status of children and knowledge, attitude, practice of iodised salt use in a remote community in Kerema district, Gulf province, Papua New Guinea. PLoS ONE. 2018;13(11):e0197647. doi: 30485281

14. Blake N, McLoughlin H, Nurse G. Serogenetic studies on the Kamea (Kapau) Anga of the interior of the Gulf Province of Papua. Hum Hered. 1981;31:191–6. doi: 10.1159/000153205 6943122

15. National Statistical Office of Papua New Guinea. 2011 National Population and Housing Census, ward population profile Southern Region, Papua New Guinea. Port Moresby: Government of Papua New Guinea 2014.

16. PNG National Statistics. Papuan Region: Gulf Province. Available from:, highlands-region.

17. The Worldbank Group. Climate Change Knowledge Portal For Development Practitioners and Policy Makers: The Worldbank Group; 2016 [cited 2018]. Available from:

18. Bourke R, Harwood T. Food and Agriculture in Papua New Guinea. Press AE, editor. Canberra: The Australian National University; 2011.

19. UNICEF. Guidance on the Monitoring of Salt Iodization Programmes and Determination of Population Iodine Status. New York: UNICEF; 2018. Available from:

20. Temple V, Kiagi G, Kai H, Namusoke H, Codling K, Dawa L, et al. Status of iodine nutrition among school-age children in Karimui-Nomane and Sina-Sina Yonggomugl districts in Simbu province, Papua New Guinea. Pac J Med Sci. 2018;18(1):3–20.

21. China National Salt Industry Corporation. WYD Iodine Checker Instruction manual. Tanggu: Salt Research Institute, 2012.

22. World Health Organisation. Guideline: Fortification of food-grade salt with iodine for the prevention and control of iodine deficiency disorders. Geneva: World Health Organisation; 2014. Available from:

23. Lomutopa S, Aquame C, Willie N, Temple V. Status of iodine nutrition among school-age children (6–12 y) in Morobe and Eastern Highlands Provinces. Pac J Med Sci. 2013;11(2):70–87.

24. Temple V, Mapira P, Adeniyi K, Sims P. Iodine deficiency in Papua New Guinea (Sub-clinical iodine deficiency and salt iodization in the highlands of Papua New Guinea). J Pub Health. 2005;27(1):45–8.

25. Temple V. Progress towards elimination of IDD in PNG. IDD Newsletter. 2006;22(4):11–3.

26. Amoa B, Pikire T, Tine P. Iodine content in salt in Lae city of Papua New Guinea. Asia Pac J Clin Nutr. 1998;7(2):128–30. 24393639

27. Powles J, Fahimi S, Micha R, Khatibzadeh S, Shi P, Ezzati M, et al. Global, regional and national sodium intakes in 1990 and 2010: a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide. BMJ Open. 2013;3:1–18.

28. Spohrer R, Knowles J, Jallier V, Ndiaye B, Inforf C, Guinot P, et al. Estimation of population iodine intake from iodized salt consumed through bouillon seasoning in Senegal. Ann N Y Acad Sci. 2015;1357(1):43–52. doi:

29. Knowles J, Garrett G, Gorstein J, Kupka R, Situma R, Yadav K, et al. Universal Salt Iodization Coverage Survey Team; Household Coverage with Adequately Iodized Salt Varies Greatly between Countries and by Residence Type and Socioeconomic Status within Countries: Results from 10 National Coverage Surveys. J Nutr. 2017;147(5):1004S–14S. doi: 28404840

30. Bazezew M, Yallew W, Belew A. Knowledge and practice of iodized salt utilization among reproductive women in Addis Ababa City. BMC Res Notes. 2018;16(11):734. doi:

31. Lowe N, Westaway E, Munir A, Tahir S, Dykes F, Lhussier M, et al. Increasing Awareness and Use of Iodised Salt in a Marginalised Community Setting in North-West Pakistan. Nutrients. 2015;(7):9672–82. doi: 10.3390/nu7115490 26610563

32. Ali A, Khan M, Malik Z, Charania B, Bhojani F, Baig S. Impact of the long term supply of iodized salt to the endemic goitre area. J Pak Med Assoc. 1992;42(6):138–40. 1369614

33. Ansari M, Khan Z. Impact of health education intervention on consumption of iodised salt in school children in Aligarh, India. Int J Community Med Public Health. 2016;3(6):1431–6. doi: 10.18203/2394-6040.ijcmph20161606

34. Sai Deepika P, Thirumala Rao B, Vamsi A, Valleswary K, Chandra Sekhar M. A cross sectional study on proper use of iodized salt in communities of rural areas and its relevant factors in Prakasam district, Andhra Pradesh, India. IJCMPH. 2019 6(3):1083–90. doi:

35. WHO/UNICEF. Reaching optimal iodine nutrition in pregnant and lactating women and young children. Joint statement by the WHO and UNICEF: World Health Organisation; 2007.

Článek vyšel v časopise


2019 Číslo 11