Assessment of iodine status among children and women of reproductive age in the Republic of Tajikistan

Objective: to assess the iodine status of children under six years old and women of reproductive age in the Republic of Tajikistan. Material and methods : the study was conducted across five regions of Tajikistan. Households were eligible for inclusion if they had at least one non-pregnant woman aged 15–49 years and/or a child aged 6–59 months. Data collection involved administering an updated questionnaire and collecting urine and salt samples. A two-stage random cluster sampling method was employed, consistent with national surveys conducted in 2003, 2009 and 2016. The study surveyed a total of 2,358 households, resulting in the collection of 2,358 salt samples and 4,474 urine samples from women and children. Results: analysis of 2,358 salt samples revealed that, while 36.6% of households used iodised salt, only 12.8% of these had an adequate iodine content (15–40 mg/kg). Coverage was higher in urban areas (45.1%) than in rural settings (34.2%). Dushanbe had the highest coverage (50.5%, with 19.3% adequately iodised), while the Districts of Republican Subordination (DRS) had the lowest (26.3%, with just 7.3% adequately iodised). The lowest iodine levels were found in loose salt (3.8%) and unmarked packages (3.6%). Only 14% of households that reported having iodised salt actually had adequately iodised salt. The median urinary iodine concentration (MUIC) among women (n = 2,236) was 121.7 µg/L, indicating sufficient iodine intake. By contrast, children aged 6–59 months (2,238 samples) had a MUIC of 48.1 µg/L, reflecting iodine deficiency. While the iodine status of women has improved since 2003, the situation for children remains concerning. The highest MUIC levels among children were observed in Dushanbe and Sughd Region (65.5 and 56.3 µg/L, respectively), while the lowest level was observed in Gorno-Badakhshan Autonomous Region (GBAO) (31.6 µg/L). There was no correlation between household MUIC levels and the degree of salt iodisation. Conclusion : although the median urinary iodine concentration among women of reproductive age suggests adequate iodine intake, children aged 6–59 months continue to be iodine deficient. Despite legislation mandating universal salt iodisation, household consumption of iodised salt remains low. Salt producers and inspection personnel should undergo training to ensure that salt is properly iodised in accordance with established standards.