To assess iodine status among women of reproductive age in Sierra Leone and to identify factors associated with iodine status, including the availability of adequately iodized salt at the household level.
In a nationally representative cross-sectional survey in Sierra Leone, household salt samples and women’s urine samples were quantitatively analyzed for iodine content. Salt was collected from 1,123 households, and urine samples from 817 non-pregnant women. Other information, such as socio-economic status, residence, age, and consumption of iodine supplements, was collected.
Household coverage with adequately iodized salt (=15 mg/kg iodine) was 80.7%. The median urinary iodine concentration (UIC) of non-pregnant women was 190.8 µg/L. Women living in households with adequately iodized salt had higher median UIC (211.3 µg/L vs. 97.8 µg/L, respectively, p<0.001). In women without access to iodized salt, urban residents had much higher UIC (143.3 µg/L ) than rural residents (83.4 µg/L). In contrast, this difference was much less in women with access to iodized salt (228.7 µg/L vs. 189.5 µg/L, respectively). For several other factors, the range of UIC among subgroups was much greater in women without iodized salt than women with iodized salt: ranges for regions = 131.0 µg/L for non-consumers of iodized salt vs. 23.7 µg/L in consumers, ranges for women's education = 146.4 µg/L vs. 25.2 µg/L; for wealth quintiles = 230.4 µg/L vs. 67.2 µg/L.
Salt iodization has the potential for increasing equity in iodine status even with the persistence of other risk factors for deficiency in Sierra Leonean women of reproductive age.