Urinary sodium excretion and determinates among adults in Ethiopia: Findings from National STEPS survey


Abstract Background: There is strong and consistent evidence indicating high salt intake is one of the risk factors for non-communicable diseases (NCDs). The global target is to reduce population salt intake by 30% by 2025. This study was conducted with the aim of determining the level of urinary sodium excretion and determinates among adults in Ethiopia. Methods: A nation-wide cross-sectional survey on NCD risk factors was carried out using the WHO STEPS survey during April and June 2015. A total of 6761 spot urine samples representative of all the regions of the country including the cities of Addis Ababa and Dire Dawa city administration were collected. The level of sodium and creatinine excretion was determined using Cobas Integra 400 Plus. INTERSALT equation was used to calculate population salt intake. Logistic regression analysis was used to assess the independent predictors of salt intake. Results: Among 6761 study participants included in this study, 3979 (58%) were female, 2653 (39.2%) of the study participants aged between 15-29 years. The mean estimated salt intake (g/day) in Ethiopia population using random spot urine was 8.3 (95% CI 8.2-8.4) where the average salt intake among male was 9.0 (95% CI 8.9-9.1) and 7.4 (95% CI 7.3-7.4) among female. Those aged 30-34 [AOR and (95%CI)] [2.89 (1.81-4.57)] and male [AOR and (95%CI)] [2.34 (1.65-3.30)] were more likely to have high sodium intake than their counterparts. Conclusion and recommendation: Salt consumption in Ethiopia is higher than the WHO recommendations of 5 g/day. Being male and in the thirties was a strong determinant influencing the sodium intake in our study. Population based strategies to reduce salt intake must be implemented and also factors associated with high salt intake should be considered as one of the strategies used in community interventions directed to reduce salt intake to prevent death and disability from NCDs. (Ethiop. J. Health Dev. 2017;34(Special issue):370-377) Key words: Sodium excretion, Salt intake, Spot Urine, Ethiopia