title: Comparative Validation of Five Quantitative Rapid Test Kits for the Analysis of Salt Iodine Content: Laboratory Performance, User- and Field-Friendliness.
abstract: BACKGROUND
  Iodine deficiency has important health and development consequences and the introduction of iodized salt as national programs has been a great public health success in the past decades. To render national salt iodization programs sustainable and ensure adequate iodization levels, simple methods to quantitatively assess whether salt is adequately iodized are required. Several methods claim to be simple and reliable, and are available on the market or are in development.
  
  
  OBJECTIVE
  This work has validated the currently available quantitative rapid test kits (quantRTK) in a comparative manner for both their laboratory performance and ease of use in field settings.
  
  
  METHODS
  Laboratory performance parameters (linearity, detection and quantification limit, intra- and inter-assay imprecision) were conducted on 5 quantRTK. We assessed inter-operator imprecision using salt of different quality along with the comparison of 59 salt samples from across the globe; measurements were made both in a laboratory and a field setting by technicians and non-technicians. Results from the quantRTK were compared against iodometric titration for validity. An 'ease-of-use' rating system was developed to identify the most suitable quantRTK for a given task.
  
  
  RESULTS
  Most of the devices showed acceptable laboratory performance, but for some of the devices, use by non-technicians revealed poorer performance when working in a routine manner. Of the quantRTK tested, the iCheck® and I-Reader® showed most consistent performance and ease of use, and a newly developed paper-based method (saltPAD) holds promise if further developed.
  
  
  CONCLUSIONS
  User- and field-friendly devices are now available and the most appropriate quantRTK can be selected depending on the number of samples and the budget available.
authors.affiliation: GroundWork LLC, Crans-près-Céligny, Switzerland.
authors.forename: Fabian
authors.initials: F
authors.lastname: Rohner
authors.affiliation: Laboratoire National de Santé Publique, Ouagadougou, Burkina Faso.
authors.forename: Marcelline O
authors.initials: MO
authors.lastname: Kangambèga
authors.affiliation: The Micronutrient Initiative, Ottawa, Canada.
authors.forename: Noor
authors.initials: N
authors.lastname: Khan
authors.affiliation: UNICEF, Ouagadougou, Burkina Faso.
authors.forename: Robert
authors.initials: R
authors.lastname: Kargougou
authors.affiliation: UNICEF, Ouagadougou, Burkina Faso.
authors.forename: Denis
authors.initials: D
authors.lastname: Garnier
authors.affiliation: Laboratoire National de Santé Publique, Ouagadougou, Burkina Faso.
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Sanou
authors.affiliation: Direction de la Nutrition, Ministère de Santé, Ouagadougou, Burkina Faso.
authors.forename: Bertine D
authors.initials: BD
authors.lastname: Ouaro
authors.affiliation: GroundWork LLC, Crans-près-Céligny, Switzerland.
authors.forename: Nicolai
authors.initials: N
authors.lastname: Petry
authors.affiliation: GroundWork LLC, Crans-près-Céligny, Switzerland.
authors.forename: James P
authors.initials: JP
authors.lastname: Wirth
authors.affiliation: Iodine Global Network South Africa, Cape Town, South Africa; Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa.
authors.forename: Pieter
authors.initials: P
authors.lastname: Jooste
mesh_terms: D005504:Food Analysis / Q000379:methods* / Q000592:standards*; D006801:Humans; D007455:Iodine / Q000032:analysis*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017673:Sodium Chloride, Dietary / Q000032:analysis*
chemical_list: D017673:Sodium Chloride, Dietary; C034024:iodized salt; D007455:Iodine