Study: USI implementation brings Sarawak population’s iodine status to ideal level – Borneo Post Online

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KUCHING (June 1): Sarawak has progressed from a state of borderline iodine adequacy before the introduction of Universal Salt Iodisation (USI) to one in which the population’s iodine status is now at an ideal level, a study showed.

Titled ‘A 10-Year Impact Evaluation of the Universal Salt Iodisation (USI) Intervention in Sarawak, Malaysia, 2008–2018’, the study, aimed to evaluate the impact of the USI among school children in Sarawak after 10 years of implementation.

USI was introduced to control the iodine deficiency disorders (IDD) among the population, as it is the simplest technique to ensure optimal iodine nutrition.

According to the researchers in their article published on April 11 in the peer-reviewed open-access journal ‘Nutrients’, findings in the study revealed that the school children iodine status has greatly improved after USI was implemented in Sarawak.

“In a 2008 study, the total goitre rate (TGR) was found to be very low, indicating that IDD was not a public health issue in Sarawak. In a 2018 study, the TGR was further reduced to 0.1 per cent. This is a promising trend, indicating that the IDD is improving with time.

“The improvement of the Sarawak IDD situation in 2018 was likely attributable to the implementation of the mandatory USI programme in 2008 and was in agreement with the results of a number of studies, which revealed that the IDD status was significantly improved in the country with iodisation programme,” the researchers said.

The researchers are from the Ministry of Health (MOH)’s Institute for Public Health, MOH’s Institute for Medical Research, and Sarawak State Health Department.

For the study, data was extracted from state-wide IDD surveys conducted in 2008 and 2018.

A total of 1,104 and 988 between the ages of eight and 10 were involved in the 2008 and 2018 surveys, respectively. Sampling units for the survey were 30 primary schools under the Ministry of Education.

Visual examination and palpation were used to determine the thyroid status, and spot urine sample taken from each child. Subjects were also requested to bring 80 grammes of table salt from home to determine iodine levels.

After 10 years of USI implementation in Sarawak, the results from both surveys confirmed the effectiveness of mandatory USI in increasing the nutritional iodine status of school children in Sarawak.

However, particular attention is needed to keep IDD under control in Sarawak, such as improving the monitoring and surveillance system at all levels on the quality of iodised salt to ensure that the USI programme is effective.

In addition, future studies on the prevalence of IDD in other vulnerable groups, such as newborns, pregnant and lactating mothers, are required.

The full text of the research article is hosted on MDPI, a scholarly open-access journal publisher, and can be accessed at

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