Factors associated with coverage of iodine deficiency disorders by control programs in an endemic area in West Sumatra, Indonesia.

In order to ascertain the coverage and to identify factors determining the success of an iodine deficiency disorders (IDD) control program in West Sumatra, Indonesia, a cross-sectional study among 495 school children aged 6-15 years in a subdistrict of an endemic goitre area was conducted. Coverage of iodine capsule distribution was 27%. Forty-eight percent of the households used iodized salt with an appropriate concentration (>= 40 p.p.m.). Factors associated with not taking idodine capsules among children were: mother's lack of knowledge about the iodine capsule (OR 13.3, 95% CI 7.4-24.1) and mother's education level (OR 1.89, 95% CI 1.05-3.39). For unsatisfactory use of iodized salt in a household, the only predictor was family monthly income. Odds ratios and 95% CI for moderate and high family income were 2.42 (1.39-4.21) and 2.22 (1.4-3.54), respectively. We concluded that for coverage in an IDD control program, supplementation and fortification alone were not enough. Education had an impact on coverage of the supplementation. Furthermore, iodization of salt needs further improvement in relation to quality control. Finally, the program neglected high-income groups. These pitfalls should be corrected.