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Nepal is located in what was once known as the Himalayan Goitre Belt and once had one of the highest prevalence's of iodine deficiency disorders in the world. However, through a well‐executed universal salt iodization program implemented over the past 25 years, it has achieved optimal iodine intake for its population, effectively eliminating the adverse consequences of iodine deficiency disorders. A comprehensive review of policy and legislation, surveys, and program reports was undertaken to examine the key elements contributing to the success of this program. The paper reviews the origins and maturation of salt iodization in Nepal, as well as trends in the coverage of iodized salt, the iodine content in salt, and population iodine status over the past two decades. The paper describes critical components of the program including advocacy efforts, trade issues with India, the role of the Salt Trading Corporation, monitoring, and periodic program reviews. The paper discusses the recent findings from the 2016 national micronutrient survey demonstrating the success of the salt iodization program and describes emerging challenges facing the program in the future. [ABSTRACT FROM AUTHOR]

The overall objective of the Nepal Micronutrient Status Survey (NMSS) was to assess the distribution and severity of micronutrient malnutrition, and to measure the progress achieved by different interventions. Data presented in this paper concern the prevalence of vitamin A deficiency (VAD) and the outreach and coverage of the National Vitamin A Supplementation activity. A multi-stage cluster sample design was employed that provided statistically representative data for each of thirteen eco-development strata (because of low population density, the West Mountains, Mid-west Mountains and Far-west Mountains were combined into a single stratum). The design allowed for aggregate estimates to be made at the national and ecological zone level. The survey showed a significant improvement in the status of clinical vitamin A deficiency in Nepal. The prevalence of both Bitot's spots and night-blindness among preschool children decreased from levels observed in surveys conducted in the previous twenty years. However, the prevalence of night-blindness was found to be 5% among women, and over 1% among school-aged children, which indicates that the entire population is vulnerable to VAD. These observations support findings from other surveys that have noted a high prevalence of maternal night-blindness in Nepal. Biochemical data collected as part of the survey indicated a high prevalence of low serum retinol (< 0.70 μmol/l), particularly among preschool children. Almost one of every three children (32.3%) and one of every six women (16.6%) had low serum retinol values. Low serum retinol among preschool children was associated with young age (6-11 months), rural location, wasting, presence of night-blindness and Bitot's spots, and residence in the Terai or Mountains. [ABSTRACT FROM AUTHOR]

Using national monitoring data collected between 1995 and 2009, this paper describes the change in trend with regard to the coverage of qualified iodized household salt and iodine status of the population in China since the implementation of universal salt iodization. The review indicates that the iodine content in edible salt increased from 16.2 mg/kg in 1995 to 42.3 mg/kg in 1999, then declined to 30.8 mg/kg in 2005 and has retained this level through the most recent data collection cycle, which is considered sufficient to achieve optimal iodine status. However, the median urinary iodine excretion level for children aged 8-10 at the national level has been consistently classified as "excessive iodine intake" since 1997, suggesting that although three adjustments on the standard of iodine content in edible salt have been made, the current content of salt iodization is still on the high side. The iodine content in edible salt could be lowered, and possibly adapted to local specific conditions such as water iodine content and the average daily intake of salt among the population in order to achieve a balance between preventing deficiency and reducing the risk of excessive intake. [ABSTRACT FROM AUTHOR]

Vitamin A deficiency (VAD) is a significant public health problem in many countries. While cost-effective interventions are available to control VAD, reliable information is needed to the track progress of control programmes. However, assessment of VAD is uncommon because current approaches are expensive and not feasible in low-resource settings. The present study explores the utility of retinol-binding protein (RBP), analysed by enzyme-linked immunosorbent assay from capillary blood, as an alternative measure of serum retinol concentrations in populations. The study collected matched panels of venous and capillary blood from pre-school children in Chiang Mai, Thailand. Of a total sample of 195 children, there were no differences between RBP from venous blood, RBP from capillary blood or retinol from capillary blood relative to retinol from venous blood. Receiver-operating characteristic curve analysis suggested a cut-off of RBP < 0.825 micromol l(-1) had optimal screening proficiency relative to retinol <0.70 micromol l(-1). For the purpose of population assessment, all three parameters performed well in screening for VAD relative to retinol from venous blood. There were no differences in the estimates of VAD between children stratified by inflammation status. Lower RBP concentrations were found in children in the early convalescent stage of infection than in children with no infection or in the late convalescent stage. This study provided evidence of the biological comparability between retinol and RBP estimated from venous blood and capillary blood. This is a critical observation as it provides empirical evidence that RBP from capillary blood is a surrogate measure of serum retinol concentrations.