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. 2024 Apr 19;19(4):e0299025.
doi: 10.1371/journal.pone.0299025. eCollection 2024.

Evaluation of the Universal Salt Iodization (USI) surveillance system in Tanzania, 2022

David Mahwera  1   2 , Erick Killel  3 , Ninael Jonas  1   2 , Adam Hancy  4 , Anna Zangira  3 , Aika Lekey  3 , Rose Msaki  3 , Doris Katana  5 , Rogath Kishimba  2   6 , Debora Charwe  4 , Fatma Abdallah  3 , Geofrey Chiduo  4 , Ray Masumo  3 , Germana Leyna  1   3 , Geofrey Mchau  1   2   3
Affiliations

Evaluation of the Universal Salt Iodization (USI) surveillance system in Tanzania, 2022

David Mahwera et al. PLoS One. .

Abstract

Background: The evaluation of surveillance systems has been recommended by the World Health Organization (WHO) to identify the performance and areas for improvement. Universal salt iodization (USI) as one of the surveillance systems in Tanzania needs periodic evaluation for its optimal function. This study aimed at evaluating the universal salt iodization (USI) surveillance system in Tanzania from January to December 2021 to find out if the system meets its intended objectives by evaluating its attributes as this was the first evaluation of the USI surveillance system since its establishment in 2010. The USI surveillance system is key for monitoring the performance towards the attainment of universal salt iodization (90%).

Methodology: This evaluation was guided by the Center for Disease Control Guidelines for Evaluating Public Health Surveillance Systems, (MMWR) to evaluate USI 2021 data. The study was conducted in Kigoma region in March 2022. Both Purposive and Convenient sampling was used to select the region, district, and ward for the study. The study involved reviewing documents used in the USI system and interviewing the key informants in the USI program. Data analysis was done by Microsoft Excel and presented in tables and graphs.

Results: A total of 1715 salt samples were collected in the year 2021 with 279 (16%) of non-iodized salt identified. The majority of the system attributes 66.7% had a good performance with a score of three, 22.2% had a moderate performance with a score of two and one attribute with poor performance with a score of one. Data quality, completeness and sensitivity were 100%, acceptability 91.6%, simplicity 83% were able to collect data on a single sample in < 2 minutes, the system stability in terms of performance was >75% and the usefulness of the system had poor performance.

Conclusion: Although the system attributes were found to be working overall well, for proper surveillance of the USI system, the core attributes need to be strengthened. Key variables that measure the system performance must be included from the primary data source and well-integrated with the Local Government (district and regions) to Ministry of Health information systems.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Schematic design pathway of USI surveillance system evaluation.
Fig 2
Fig 2. USI Flow of information and feedback.
Fig 3
Fig 3. Percentage of samples collected with positive and negative results at three districts in the Kigoma region from January-December 2021.
Fig 4
Fig 4. Timeliness in data entry in three councils, Kigoma region 2021.
Fig 5
Fig 5. A map of Tanzania showing the study area.
See this image and copyright information in PMC

References

    1. Menyanu E. et al., “Salt-reduction strategies may compromise salt iodization programs: Learnings from South Africa and Ghana,” Nutrition, vol. 84, p. 111065, 2021, doi: 10.1016/j.nut.2020.111065 - DOI - PubMed
    1. Pandav C. S., Yadav K., Srivastava R., Pandav R., and Karmarkar M. G., “Iodine deficiency disorders (IDD) control in India,” Indian J. Med. Res., vol. 138, no. SEP, pp. 418–433, 2013. - PMC - PubMed
    1. Sun D. et al.., “Eliminating iodine deficiency in China: Achievements, challenges and global implications,” Nutrients, vol. 9, no. 4, pp. 1–21, 2017, doi: 10.3390/nu9040361 - DOI - PMC - PubMed
    1. United Republic of Tanzania, Tanzania National Nutrition Survey 2018, no. June. 2019.
    1. Hetzel B. S., “Eliminating iodine deficiency disorders—The role of the international council in the global partnership,” Bull. World Health Organ., vol. 80, no. 5, pp. 410–413, 2002, doi: 10.1590/S0042-96862002000500014 - DOI - PMC - PubMed

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