Persistence of severe iodine-deficiency disorders despite universal salt iodization in an iodine-deficient area in northern India (original) (raw)
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Public Health Nutrition, 2014
ObjectiveTo compare the iodine status of pregnant women and their children who were sharing all meals in Bangalore, India.DesignA cross-sectional study evaluating demographic characteristics, household salt iodine concentration and salt usage patterns, urinary iodine concentrations (UIC) in women and children, and maternal thyroid volume (ultrasound).SettingAntenatal clinic of an urban tertiary-care hospital, which serves a low-income population.SubjectsHealthy pregnant women in all trimesters, aged 18–35 years, who had healthy children aged 3–15 years.ResultsMedian (range) iodine concentrations of household powdered and crystal salt were 55·9 (17·2–65·9) ppm and 18·9 (2·2–68·2) ppm, respectively. The contribution of iodine-containing supplements and multi-micronutrient powders to iodine intake in the families was negligible. Adequately iodized salt, together with small amounts of iodine in local foods, were providing adequate iodine during pregnancy: (i) the overall median (range) ...
Asia Pacific journal of clinical nutrition, 2008
In Rajasthan, an Indian State with significant salt production, the sale of non-iodized salt for human consumption was banned in 1992. This study explored the relationships between the use of iodized salt in Rajasthan and the iodine status of children and pregnant women living in the area. In a State-wide survey, 30 clusters were selected proportionate-to-population-size and 40 school children, 6-12 years old, were enrolled by random house-to-house visits in each cluster. Twelve pregnant women from the same households were also sampled. Salt used for cooking and a casual urine sample from each child and pregnant woman were collected. The salt iodine content was measured by titration and the urinary iodine concentration (UIC) by a quality-assured colorimetric method. Salt iodine content was >or=15 mg/kg in 41.9% of the households, and 23.0% used non-iodized salt. Median UIC was 139 microg/L in children and 127 microg/L in pregnant women. In households using non-iodized salt, the m...
Indian Journal of Endocrinology and Metabolism, 2013
Introduction: Normal pregnancy results in a number of important physiological and hormonal changes that alter thyroid function. In pregnancy, the thyroid gland being subjected to physiological stress undergoes several adaptations to maintain sufficient output of thyroid hormones for both mother and fetus. Consequently, pregnant women have been found to be particularly vulnerable to iodine deficiency disorders (IDD), and compromised iodine status during pregnancy has been found to affect the thyroid function and cognition in the neonates. Objectives: Two decades after successful universal salt iodization (USI) in the country, there is scarce data on the iodine status of the pregnant women and their neonates. This is more relevant in areas like Kashmir valley part of sub-Himalayan belt, an endemic region for IDD in the past.The objective was to estimate Urinary Iodine status in pregnant women, the most vulnerable population. Materials and Methods: We studied thyroid function [free T3 (FT3), T3, free T4 (FT4), T4, thyroid stimulating hormone (TSH)] and urinary iodine excretion (UIE) in the 1 st , 2 nd , and 3 rd trimesters and at early neonatal period in neonates in 81 mother-infant pairs (hypothyroid women on replacement) and compared them with 51 control mother-infant pairs (euthyroid). Results: Mean age of cases (29.42 + 3.56 years) was comparable to that of controls (29.87 + 3.37 years). The thyroid function evaluation done at baseline revealed the following: FT3 2.92 ± 0.76 versus 3.71 ± 0.54 pg/ml, T3 1.38 ± 0.37 versus 1.70 ± 0.35 ng/dl, FT4 1.22 ± 0.33 versus 1.52 ± 0.21 ng/dl, T4 9.54 ± 2.34 versus 13.55 ± 2.16 µg/dl, and TSH 7.92 ± 2.88 versus 4.14 ± 1.06 µIU/ml in cases versus controls (P < 0.01), respectively. The 2 nd to 6 th day thyroid function of neonates born to case and control mothers revealed T3 of 1.46 ± 0.44 versus 1.48 ± 0.36 ng/dl, T4 of 12.92 ± 2.57 versus 11.76 ± 1.78 µg/dl, and TSH of 3.64 ± 1.92 versus 3.82 ± 1.45 µIU/ml, respectively. Discussion: UIE was similar (139.12 ± 20.75 vs. 143.78 ± 17.65 µg/l; P = 0.8), but TSH values were higher in cases (7.92 ± 2.88) as compared to controls (4.14 ± 1.06). Although UIE gradually declined from 1 st trimester to term, it remained in the sufficient range in both cases and controls. Thyroid function and UIE was similar in both case and control neonates. Conclusion: We conclude that pregnant Kashmiri women and their neonates are iodine sufficient, indicating successful salt iodization in the community. Large community-based studies on thyroid function, autoimmunity, malignancies, etc., are needed to see the long-term impact of iodization.
When we see about the awareness of the people in the world it is low due to that the peoples are suffered from goiter disease and other problems related to iodized and this problem are also faced in our country especially in Tigray Mekelle city. Despite numerous educational programmers to create awareness about iodized salt and iodine deficiency disorders (IDD), a survey conducted in the in Mekelle in 2012 revealed that the goiter rate stood at 18.8%; and 78.1% of households consumed iodized salt, which is below the goal of the IDD programme in Ethiopia which aimed at 90% household consumption of iodized salt by the end of 2015 and sustaining the gains by 2012. It was therefore, considered timely to investigate the knowledge levels and the extent of utilization of iodized salt among the people living in Mekelle, and with the lowest intake (76.4%) of iodized salt based on findings of the 2012 survey. This was a descriptive cross-sectional study. It was conducted among a total of 280 household members, mainly in charge of meal preparation, who were interviewed using a structured interview guide. A combination of cluster and simple random sampling techniques was used to select the respondents from all the respondents' The study revealed that 75.6% of households in the district consumed iodized salt (including households described as occasional users of iodized salt), and knowledge of iodized salt was quite high, as 72% of the respondents knew that not every salt contained iodine. In addition, 69.3% indicated that an inadequate intake of iodized salt can lead to the development of goiter. Despite the high awareness level, only 64.6% of respondents indicated that they exclusively used iodized salt for cooking. The main reason given by exclusive users of common salt was that the price of iodized salt is a little higher than that of common salt. Although majority of the respondents are aware of the importance of iodized salt and iodine deficiency disorders, only 64.6% exclusively used iodized salt, suggesting that respondents' high knowledge levels did not necessarily translate into an increase in the number of households who used iodized salt. Existing laws and policies on universal salt iodization and quality assurance of iodized salt from the production stage to the distribution/selling stage should be enforced.
Nutrients, 2016
In the framework of a worldwide policy to eliminate iodine deficiency (ID) disorders, universal salt iodization was adopted in Tunisia two decades ago. The present study aims to evaluate this strategy, using both performance and impact indicators. A total of 1560 children, aged 6-12 years, were randomly sampled using a national, two-stage, stratified, cross-sectional cluster survey in 2012. Urinary iodine concentration (UIC) of the subjects, and household salt iodine content, were analyzed. The national median UIC was 220 µg/L (95% confidence interval (CI): 199-241), indicating an acceptable iodine status at the population level. Only 11.4% (95% CI: 8.6-14.9) of the children had UIC <100 µg/L, but with large regional disparities (4.3% to 25.5%, p < 0.01); however, more than a quarter of the subjects were at risk of adverse health consequences due to iodine excess. Children from households of low socioeconomic levels were more prone to inadequate UIC. The national median iodine concentration of household salt was 22 mg/kg (95% CI: 21-23). Only half of the households used adequately iodized salt (15-25 ppm), with large regional disparities. National ID rates are now well below the target criteria of WHO (World Health Organization) certification (<20% of children with UIC <50 µg/L and <50% with UIC <100 µg/L). The coverage of adequately iodized salt fell short in meeting the goals of USI (Universal Salt Iodization), i.e., >90% of households. Regular monitoring of iodized salt production lines must be strengthened with involvement by producers.
International Journal of Community Medicine and Public Health, 2016
INTRODUCTION Globally, iodine deficiency disorders (IDD) continues to be a major public health problem which affect large segment of population. 1 IDD constitute the single largest cause of preventable brain damage which leads to learning difficulties and psychomotor impairment. 2 Iodine deficiency disorder impact 'refers' to all ill effects caused by iodine deficiency in a population, which can be prevented by ensuring adequate intake of iodine. 3 By ABSTRACT Background: Iodine deficiency disorder constitute the largest cause of preventable brain damage. Majority of the consequences of IDD are invisible and irreversible and as well preventable. World Health Organization (WHO) and United Nations Children's Fund (UNICEF) joint Committee on Health Policy recommended Universal Salt Iodization (USI) as a safe, cost effective and sustainable strategy to ensure sufficient intake of iodine by all individuals. Chhattisgarh Government made efforts to achieve wider coverage of population by iodized salt through Public Distribution System, but lack of recent baseline data to know the impact of this effort has been a major constraints. Keeping this in mind, a survey was proposed to assess the impact of NIDDCP in four districts of Chhattisgarh. (Rajnandgaon, Mahasamund, Koriya and Kanker). Objective of the study was: 1. To ascertain the prevalence of clinical forms of IDD among 6-12 years children in 4 selected districts of Chhattisgarh. 2. To document iodine uptake status reflected by random urinary excretion levels in a sample of 6-12 year children covered for clinical examination and 3. To evaluate the coverage of iodized salt at the community level (i-e at household) by on the spot testing by Rapid Salt Testing Kit. Methods: Cross sectional Observational study was done based on IDD survey guidelines by Government of India during July-Oct 2015 Results: Present study results showed Goiter prevalence among 6-12 years children was in the range of 3.37-17.56% (Highest in Rajnandgaon). Iodine deficiency reflected by urinary iodine excretion (UIE) was found unacceptable limit maximum (87%) in Rajnandgaon. Half of the surveyed districts had subnormal (<100 mcg/L), median urinary iodine excretion (MUIE). Our Study reveals that iodized salt coverage was in the range of 70-82 % in all the surveyed Districts. Conclusions: Among the 4 surveyed district, Goiter is a public health problem in 3 districts (prevalence >5%). The adequately Iodized salt coverage which should have been more than 90 % is not fulfilled in all the 4 districts.
Asia Pacific journal of clinical nutrition, 2019
BACKGROUND AND OBJECTIVES Iodine deficiency disorders (IDD) has been a major public health challenge for the Indian subcontinent over many years. Our study was conducted in Tikamgarh district of Madhya Pradesh, an iodine deficiency disorders-endemic district, with the objective to estimate total goitre rate and iodine nutrition status. METHODS AND STUDY DESIGN A cross-sectional study with 30 cluster sampling was conducted between June to July 2016 among school-going children in the age group of 6-12 years. Ninety children from each school (30x90=2700) were selected for the assessment of Goitre. Total 540 salt samples and 270 urine samples were collected to estimate salt iodine content from their house-hold and urine iodine excretion (UIE) respectively. A total of 150 households and 30 shopkeepers were interviewed to understand the awareness level for salt iodization. RESULTS Goitre rate in Tikamgarh district was 1.9% with prevalence of grade I & II was 1.7% and 0.2% respectively. Th...