Variable iodine intake persists in the context of universal salt iodization in china

Iodine deficiency disorders were prevalent in China until the introduction of universal salt iodization in 1995. Concerns have recently arisen about possible excess iodine intake in this context. To document iodine intake and the contribution from iodized salt in China, we surveyed dietary iodine intake during China's nationally representative 2007 total diet study (TDS) and during an additional TDS in 4 coastal provinces and Beijing in 2009. Iodine intake was broken down by age and sex in 2009. Mean daily iodine and salt intake and the contribution from different food and beverage groups (and in 2009, individual items) was measured. The iodine in food cooked with iodized and noniodized salt was also assessed. The mean calculated iodine intake of a standard male in China was 425 μg/d in 2007 and 325 μg/d in coastal areas in 2009, well below the upper limit (UL) in all provinces. In 2009, iodine intake was above the UL in only 1-7% of age-sex groups, except among children (18-19%). A concerning number of individuals consumed less than the WHO-recommended daily allowance, including 31.5% of adult women. Salt contributed 63.5% of food iodine, and 24.6% of salt iodine was lost in cooking. Overall salt consumption declined between the surveys. Salt iodization assures iodine nutrition in China where environmental iodine is widely lacking. The risk of iodine excess is low, but planned decreases in salt iodization levels may increase the existing risk of inadequate intake. Regular monitoring of urinary iodine and more research on the impact of excess iodine intake is recommended.     

Short-term effectiveness of mandatory iodization of table salt, at an elevated iodine concentration, on the iodine and goiter status of schoolchildren with endemic goiter

BACKGROUND: Goiter rates and iodine deficiency usually show marked improvement in efficacy studies of mandatory iodization of salt, but little is known about the short-term effectiveness of mandatory iodization. OBJECTIVE: The aim of the study was to evaluate, after 1 y, the effectiveness of mandatory iodization of salt at an iodine concentration higher than that occurring under optional iodization on the goiter rates and iodine status of schoolchildren living in an endemically goitrous area. DESIGN: Goiters, measured by palpation, and urinary iodine concentrations of children in grades 4-7 in 4 schools in a known goitrous area in South Africa were assessed before and 1 y after the introduction of mandatory iodization at a higher iodine concentration than occurred with optional iodization. Estimates of the iodine concentration of iodized salt and the proportion of households using iodized salt were also made. RESULTS: Iodine concentration in table salt and household use of iodized salt improved within 1 y. Goiter rates, which varied at baseline from 14. 3% to 30.2% in the 4 schools, remained unchanged, with an overall mean (+/-SE) prevalence of 25.6 +/- 2.5% at baseline and of 27.5 +/- 2.7% 1 y later. The distribution of urinary iodine concentrations in the 4 schools improved substantially from the baseline deficient range. The overall median urinary iodine concentration increased from 0.17 to 1.47 micromol/L. CONCLUSIONS: Mandatory iodization of salt virtually eradicated iodine deficiency within 1 y in South African schoolchildren, but the goiter rate in these children did not decline. Measurement of goiters by palpation may not be appropriate in short-term evaluations of mandatory iodization programs.     

Intimate Partner Violence Among Adolescents in Cape Town,South Africa

This study aimed to describe potentially preventable factors in intimate partner violence (IPV) perpetration and victimization among South African 8th grade students. Data were collected during a pilot evaluation of a classroom 8th grade curriculum on gender-based violence prevention in nine public schools in Cape Town through self-completed interviews with 549 8th grade students, 238 boys and 311 girls. Structural equation models (SEM) predicting IPV were constructed with variables a priori hypothesized to be associated. The majority of students (78.5 %) had had a partner in the past 3 months, and they reported high rates of IPV during that period (e.g., over 10 % of boys reported forcing a partner to have sex, and 39 % of girls reported physical IPV victimization). A trimmed version of the hypothesized SEM (CFI?=?.966; RMSEA?=?.051) indicated that disagreement with the ideology of male superiority and violence predicted lower risk of IPV (p?<?.001), whereas the frequency of using negative conflict resolution styles (e.g., walking off angrily, sending angry text messages, or refusing to talk to them) predicted high IPV risk (p?<?.001) and mediated the impact of heavy alcohol drinking on IPV (Sobel test, z?=?3.16; p?<?.001). The model fit both girls and boys, but heavy drinking influenced negative styles of resolving conflict more strongly among girls than boys. Findings suggest that interventions to reduce IPV among South African adolescents should challenge attitudes supportive of male superiority and violence; encourage use of positive conflict resolution styles; and discourage heavy alcohol use among both boys and girls.     

2009 FIGO World Congress was held in Cape Town,South Africa

2009年10月4日～9日，第19届国际妇产科联盟（International Federation of Gynecology and Obstetrics, FIGO）在南非开普敦隆重举行。FIGO大会是全球妇产科医师的一次盛会，每隔3年在五大洲轮流举办。本次大会由南非作为主办国首次承接此项会议。2009年是消除性别歧视大会30周年纪念，本次会议很好地切合了该主题。开普敦盛情欢迎世界各地的妇产科专家，     

Microplastics in Mussels Along the Coast of Cape Town,South Africa

Bulletin of Environmental Contamination and Toxicology - Microplastic (MP) contamination in marine organisms is a growing field of research internationally. However not much is known about MP...     

Twenty-year birth prevalence of Down syndrome in Cape Town, South Africa

The 20-year birth prevalence of Down syndrome in Cape Town, South Africa, was determined. All cases delivered to mothers in Cape Town, plus terminations following prenatal diagnosis, between 1 January 1974 and 31 December 1993 were ascertained. There were 784 Down syndrome pregnancies, of which 95% were trisomies. The 32 terminations comprised 18.3% of the white, 5.8% of the coloured (mixed race) and 1.4% of the black cases. The overall prevalence rate was 1.49 per 1000 (white 1.88, coloured 1.54 and black 1.29 per 1000). Analysis for linear trends showed a significant decline in rates for the total population and for whites, a downward trend for coloureds, but no decline for blacks. Over the last 5-year period the prevalence rates in all three population groups were 1.3 per 1000. An increasing risk with advancing maternal age was confirmed, but no maternal age-specific differences in rates by race were demonstrated.     

Plasma vitamin A and zinc levels in HIV-infected adults in Cape Town,South Africa

A cross-sectional study of 132 adults attending an HIV clinic in Cape Town, South Africa, was conducted to determine predictors of low plasma vitamin A and Zn levels. No patients were on antiretroviral therapy. The possible confounding effect of the acute-phase response was controlled by including C-reactive protein levels in multivariate analysis and by excluding active opportunistic infections. Retinol levels were low (<1.05 micromol/l) in 39 % of patients with early disease (WHO clinical stages I and II) compared with 48 and 79 % of patients with WHO stage III and IV respectively (P<0.01). Plasma Zn levels were low (<10.7 micromol/l) in 20 % of patients with early disease v. 36 and 45 % with stage III and IV disease respectively (P<0.05). C-reactive protein levels were normal in 63 % of subjects. Weak, positive associations were found between CD4+ lymphocyte count and plasma levels of retinol (r 0.27; 95 % CI 0.1, 0.43) and Zn (r 0.31; 95 % CI 0.25, 0.46). Multivariate analysis showed the following independent predictors of low retinol levels: WHO stage IV (odds ratio 3.4; 95 % CI 2.1, 5.7) and body weight (odds ratio per 5 kg decrease 1.15; 95 % CI, 1.08, 1.25), while only body weight was significantly associated with low Zn levels (OR per 5 kg decrease 1.19; 95 % CI 1.09, 1.30). CD4+ lymphocyte count <200/microl was not significantly associated with either low retinol or Zn levels. In resource-poor settings, simple clinical features (advanced disease and/or weight loss) are associated with lowered blood concentrations of vitamin A and/or Zn. The clinical significance of low plasma retinol and/or Zn levels is unclear and more research is required to establish the role of multiple micronutrient intervention strategies in HIV disease.     

Healthcare experiences of lesbian and bisexual women in Cape Town,South Africa

Understanding the health needs and experiences of South African lesbian and bisexual women is imperative for implementing effective and inclusive public health strategies. Such understanding, however, is limited due to the exclusion of these women from most existing research on healthcare access in the region. This paper bridges that gap by investigating the healthcare experiences of lesbian and bisexual women in Cape Town. Data were gathered from 22 interviews with self-identified lesbian and bisexual community members and university students in the Cape Town area. Interviews explored obstacles women face in accessing affirming services, different experiences with public and private healthcare, fear of stigma/discrimination, availability of relevant sexual health information and suggestions to improve existing programmes. Findings suggest that South African lesbians and bisexual women may have a range of both positive and negative experiences in public and private health services, that they use protective strategies when ‘coming out’ and that they find that sexual health information pertinent to them is largely unavailable. These discussions contribute to a more inclusive understanding of the experiences of lesbian and bisexual women accessing healthcare and other services and help to inform providers, thereby enabling them to deliver more meaningful care to lesbian, gay, bisexual and transgender persons in South Africa.     

Respiratory health of brickworkers in Cape Town, South Africa. Radiographic abnormalities

A cross-sectional study utilizing internal controls based on dust exposure determinations was performed on 268 brickworkers. Smoking, age, and other information from a detailed respiratory questionnaire and results from a physical examination and pulmonary function tests were investigated in relation to radiographic abnormality. The prevalence of pneumoconiosis was near 4%. The roles of smoking, workplace dust exposure, and age as factors predicting radiographic abnormality are discussed.     

HIV-infected women's experiences of pregnancy and motherhood in Cape Town,South Africa

Antenatal services provide a valuable opportunity for the uptake of prevention of mother-to-child transmission (PMTCT) of HIV interventions and antiretroviral treatment (ART) for maternal health. While knowledge of HIV status during pregnancy is beneficial to both mother and child, PMTCT programmes may focus more on prevention and the physical aspects of health than the psychosocial impact of HIV on pregnancy and motherhood. The objective of this study was to examine South African women's perceptions of HIV infection in pregnancy and how they related to motherhood in the context of HIV infection. In-depth interviews were conducted with 17 HIV-positive pregnant and 11 ≤ 6-month postpartum women to elicit perspectives on HIV-positive pregnancy and motherhood. For most women who tested in pregnancy, the primary rationale for testing stemmed from a concern for their children; and anxiety around the risk of vertical transmission was highly prevalent. Women did not perceive any superficial differences between themselves and non-infected pregnant women and they compared HIV to any other chronic condition. However, they voiced anxiety about being infected and were preoccupied with keeping their children safe, both in pregnancy and postpartum. They described a diminished sense of pride about motherhood and an additional burden of guilt associated with carrying a vulnerable child, which made pregnancy different for them in comparison to uninfected women. Feeding posed a particularly difficult issue because by choosing formula feeding, women were protecting their children, yet this seemed to diminish their status as a mother, while at the same time publicising messages about being infected with HIV. While women identified externally with the social value of motherhood, the burden of HIV infection was seen as a destabilising threat to their identity as mothers.     

Inequitable access to substance abuse treatment services in Cape Town,South Africa

Background  

Despite high levels of substance use disorders in Cape Town, substance abuse treatment utilization is low among people from disadvantaged communities in Cape Town, South Africa. To improve substance abuse treatment utilization, it is important to identify any potential barriers to treatment initiation so that interventions to reduce these barriers can be implemented. To date, substance abuse research has not examined the factors associated with substance abuse treatment utilization within developing countries. Using the Behavioural Model of Health Services Utilization as an analytic framework, this study aimed to redress this gap by examining whether access to substance abuse treatment is equitable and the profile of variables associated with treatment utilization for people from poor communities in Cape Town, South Africa.     

High prevalence of tuberculosis in previously treated patients, Cape Town, South Africa

The tuberculosis (TB) notification rate is high and increasing in 2 communities in Cape Town, South Africa. In 2002, we conducted a prevalence survey among adults > or = 15 years of age to determine the TB prevalence rate; 15% of households in these communities were randomly sampled. All persons living in sampled households were eligible for chest radiography and sputum examination. Of the 3,483 adults who completed a questionnaire, 2,608 underwent chest radiography and sputum examination. We detected 26 bacteriologically confirmed TB cases and a prevalence of 10.0/1,000 (95% confidence interval [CI] 6.2-13.8 per 1,000). We found 18 patients with smear-positive TB, of whom 8 were new patients (3.1/1,000, 95% CI 0.9-5.1/1,000). More than half of patients with smear-positive TB (10, 56%) had previously been treated. Such patients may contribute to transmission of Mycobacterium tuberculosis and the high TB prevalence rate. Successful treatment of TB patients must be a priority.     

Iodine content in bread and salt in Denmark after iodization and the influence on iodine intake

Objective To measure the iodine content in bread and household salt in Denmark after mandatory iodine fortification was introduced and to estimate the increase in iodine intake due to the fortification.

Design The iodine content in rye breads, wheat breads and salt samples was assessed. The increase in iodine intake from fortification of bread and the increase in total iodine intake after fortification were estimated.

Subjects Iodine intake before and after fortification was estimated based on dietary intake data from 4,124 randomly selected Danish subjects.

Main results Approximately 98% of the rye breads and 90% of the wheat breads were iodized. The median iodine intake from bread increased by 25 (13–43) µg/day and the total median iodine intake increased by 63 (36–104) µg/day.

Conclusions The fortification of bread and salt has resulted in a desirable increase in iodine intake, and the current fortification level of salt (13 ppm) seems reasonable.     

Iodine content in bread and salt in Denmark after iodization and the influence on iodine intake

OBJECTIVE: To measure the iodine content in bread and household salt in Denmark after mandatory iodine fortification was introduced and to estimate the increase in iodine intake due to the fortification. DESIGN: The iodine content in rye breads, wheat breads and salt samples was assessed. The increase in iodine intake from fortification of bread and the increase in total iodine intake after fortification were estimated. SUBJECTS: Iodine intake before and after fortification was estimated based on dietary intake data from 4,124 randomly selected Danish subjects. MAIN RESULTS: Approximately 98% of the rye breads and 90% of the wheat breads were iodized. The median iodine intake from bread increased by 25 (13-43) microg/day and the total median iodine intake increased by 63 (36-104) microg/day. CONCLUSIONS: The fortification of bread and salt has resulted in a desirable increase in iodine intake, and the current fortification level of salt (13 ppm) seems reasonable.     

江苏省食盐加碘前后人群碘营养状况变化分析

目的：分析江苏省食盐加碘前后人群碘营养状况的变化情况,为食盐加碘防治碘缺乏病策略与措施调整提供依据。方法：采用1995年-2009年间江苏省开展的7次省级碘缺乏病病情监测调查结果进行比较。结果：8～10岁学龄儿童尿碘中位数从1995年的不足100μg／L（为85μ／L）上升至1999年的最高点（406．6μg／L）,至2005年调整回落到243．5μg／L,2009年重新上升至325．3μg／L;盐碘含量均值随着国家食盐加碘浓度的调整而变化,近年来稳定在30mg／kg左右;各次调查尿碘中位数和盐碘均数相关系数r为0．863（P〈0．05）;以20-50mg／kg计,合格碘盐食用率于2002年起始终保持在94％以上;触诊和B超法检测甲状腺肿大率分别由17．43％（1995年）、8．75％（1997年）下降至2009年的1．70％和1．00％。结论：江苏省食盐加碘后人群碘营养状况明显改善,建议保持运行监测-反馈-调整的碘缺乏病防治机制,补充完善碘缺乏病防治指标体系,增加特需人群碘营养监测。     

Survey of infections transmissible between baboons and humans, Cape Town, South Africa

Baboons on South Africa's Cape Peninsula come in frequent contact with humans. To determine potential health risks for both species, we screened 27 baboons from 5 troops for 10 infections. Most (56%) baboons had antibodies reactive or cross-reactive to human viruses. Spatial overlap between these species poses low but potential health risks.     

Predictors of early first sexual intercourse among adolescents in Cape Town, South Africa

Early coital debut is a risk factor for HIV. In this paper weinvestigate the predictors of young adolescents' transitionto first intercourse using a social cognition theoretical framework.The analyses reported here were based on a longitudinal studyof 2360 students in the schools allocated to the control armof a cluster-randomized controlled trial to investigate theeffect of a school-based HIV prevention programme among Grade8 students in Cape Town. Structural equation modelling was performedwith Mplus version 3.11. Of the 1440 students who were virginsat baseline, 1144 remained virgins 15 months later and 296 (20.6%)reported having had their first sexual intercourse. Transitionto first sexual intercourse was more likely among males thanfemales, among older students and among students with a lowersocio-economic status. Transition to first sexual intercoursewas significantly associated with intentions to have sexualintercourse, poor self-efficacy to negotiate delayed sex andintimate partner violence. The model predicted 35% of the variancein intentions and 16% of the variance in transition. These findingsindicate some of the factors that influence young adolescent'stransition to first intercourse and that need to be addressedwhen designing effective interventions. Received on June 1, 2007; accepted on October 26, 2007     

Sunscreen use and environmental awareness among beach-goers in Cape Town, South Africa.

BACKGROUND. The potential impact on health of increased exposure to sunlight has caused increased concern in recent years. In South Africa little is known of peoples' sunbathing habits, use of sunscreens, and factors influencing these practices. AIMS. The aims of the study were to determine sunscreen usage among the South African beach-going public, to determine sunbathing practices of beach-goers and to determine factors influencing peoples' sunbathing habits. METHODS. Cluster sampling at 3 popular Cape Peninsula beaches was used to select a sample of 231 white adult beach-goers. Questionnaires were administered to obtain information on the use of sunscreens, frequency of use, peoples' sunbathing activities, their susceptibility to sunburn and ability to tan, whether there was a history of severe sunburn, and knowledge and awareness of environmental issues. Information was also obtained on personal characteristics and sociodemographic factors. RESULTS. 50% of respondents were using a sunscreen on the day of the interview. More women than men, and people over 25 years of age relative to younger persons, made frequent use of sunscreen lotions. A sun protection factor (SPF) of 15 or more was being used by 5% of the population. With respect to peoples' knowledge and awareness of the environment, 90% of the population cited skin cancer as a potential consequence of over-exposure to sunlight, although, in general, knowledge of environmental issues was poor. CONCLUSIONS. A major effort is needed to improve attitudes and practices in South Africa with respect to sun-tanning activities.     

Women's reproductive decision making and abortion experiences in Cape Town,South Africa: A qualitative study

ABSTRACT

Unintended pregnancy is a significant public health issue in South Africa. Despite free services including contraception, women face structural and institutional barriers to accessing care. This qualitative study comprised interviews with 16 women aged 18 to 40 years and receiving post-abortion services at a public clinic in Cape Town. Data analysis revealed three main themes: personal journeys in seeking abortion, contraceptive experiences, and contrasting feelings of empowerment (in reproductive decision making) and disempowerment (in the health care system). Women perceived themselves as solely responsible for their reproductive health, but found it difficult to obtain adequate information or services.