Iodine content of dietary salt at household level and associated factors using Iodometric titration methods in Dera District, Northwest Ethiopia

Background: In developing countries most of the edible salts have insufficient iodine content; the problem is worse in Africa. Only 15.4% of the Ethiopian population was using adequately iodized salt. Several factors affect iodine content of edible salt including poor handling practices. The existing evidence isn't sufficient to detail the specific factors at the household level. Therefore, the aim of this study was to determine the iodine content of edible salt and identify factors associated with salt iodine content in Dera District, Northwest Ethiopia. Methods: A community-based cross-sectional study was conducted among 1194 households. A multi-stage sampling technique was used to select the households, and data were collected using the interview. A 50 g salt sample was collected from each selected household and was shipped to the Ethiopian Food, Medicine and Health Care administration and Control Authority (EFMHACA) laboratory center for iodine level analysis. The samples were analyzed using titration method. Data were entered into EPI-INFO and analyzed in SPSS. Results: Out of 1194 salt samples collected, 57.4% had iodine content in the range 15 ppm to 59.42 ppm. Salt stored in closed containers was more likely to have better iodine content compared to salt stored with open containers (AOR = 1.7, 95% CI: 1.24-2.42). Salt samples stored in dry places were 1.5 times more likely to retain iodine compared to samples stored near to heat/fire or in a moist area (AOR = 1.5, 95% CI: 1.03-2.14). Similarly, salt samples stored for less than 2 months were more likely to have adequate iodine level compared to samples stored for over 2 months (AOR = 1.6, 95% CI: 1.12-2.29). Salt samples obtained from household heads attended primary education (AOR = 1.5, 95% CI: 1.05-2.26), high school (AOR = 1.7, 95% CI: 1.05-2.64), and University (AOR = 2.8, 95% CI: 1.06-5.62) were more likely to have adequate iodine content in edible salt compared to whose didn't attend formal education. Conclusions: Nearly three out of five salt samples had enough iodine content. However, this level is low compared to the WHO recommendation (90%). The age, educational status of head of the household, duration of salt storage, use of cover to store salt and knowledge of household heads were associated with an iodine content of salt. Therefore, use of cover and proper storage of edible salt should be encouraged; improving the educational status of the community is essential the edible salt to retain its iodine content at the household level. © 2017 The Author(s).