Status of Iodine Deficiency Disorders, Salt Iodisation

1
Status of Iodine Deficiency Disorders, Salt
Iodisation its Awareness in Urban Population of
Udaipur District, Rajasthan

• Study was funded by Indian Council of Medical
  Research, New Delhi
• Pradhan R. Lecturer, Govt. Home Science College,
  Sector 10, Chandigarh
• Choudhury M. Dean, College of Home Science,
  Udaipur, Rajasthan

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Introduction

• Iodine Deficiency Disorders (IDDs) are a global
  public health problem including India.
• Iodine deficiency is the worlds most preventable
  cause of brain damage and main cause of impaired
  cognitive development in children.
• In India, 200 million live at the risk of IDD,
  more than 71 million suffer from Goiter and other
  IDDs
• Spectrum of IDDs affect all ages- the fetus, the
  neonate, the child, adolescents and adults.

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Rationale

• In view of its widespread prevalence, its ill
  effects at various stages of life cycle and lack
  of availability of recent scientific data
• 1993, Goiter prevalence was reported to be 10.2
• According to WHO - lt5 of school children
• (6-12yrs) suffer from goiter the area is
  classified as endemic.

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Objectives

• To assess current prevalence of IDD in Urban
  area of Udaipur district.
• To find out the iodine nutriture of the target
  population.
• To assess the status of salt iodisation at the
  beneficiary level.
• To find out awareness regarding IDD, iodised salt
  and its importance.

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Methodology

• Locale Urban area of Udaipur District.
• Sampling Design - Stratified Multistage
• Sample selection
• Udaipur city- East, West, North, South, Center
• Exhaustive list of all the schools was prepared
• Two coeducational schools from each zone were
  selected
• Consent from the Principals of selected school
  was taken
• Children in the age group of 6-12years were
  selected
• Children were briefed about the importance of the
  study and consent of the children was taken

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Methodology

• Sample size
• Presumption about the prevalence of the goiter -
  15
• Relative precision -10
• Confidence level - 95
• Sample calculated- 2190
• Assessment of IDD was done using both clinical
  and biochemical methods
• Thyroid palpation
• Urinary Iodine excretion method
• Estimation of iodine content of salt samples at
  household level

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Assessment of IDD

• Clinical examination
• Goiter traditional , recommended thyroid
  palpation method after obtaining training from
  an expert endocrinologist.
• Goiter graded according to WHO (1994)
  classification
• Classification
• Grade 0-Not palpable or visible Goiter
• Grade 1-A mass in the neck that is consistent
  with an enlarged thyroid that is palpable but
  not visible (PNV).It moves upward in the neck
  as the subject swallows.
• Grade 2-A swelling in the neck that is visible
  (V) when the neck is in a normal position and is
  consistent with an enlarged thyroid when the
  neck is palpated.

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Biochemical estimation

• Casual on the spot urine samples in small
  plastic bottles
• Wet digestion method(Dunn et al,1993) at Human
  Nutrition Unit, All India Institute of Medical
  Sciences, New Delhi.
• Classified using (WHO,1994)Classification

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Salt iodisation

• Estimation of iodine content of salt samples at
  household level.
• 20 g of salt (auto seal, polythene pouches)
• Iodometric titration method(Tyabji et al,1990).
• Awareness-Questionnaire - IDD, iodised salt and
  its importance .

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Prevalence of Goiter in children
TGR 8.4
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Age wise prevalence of Goiter
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Prevalence of IDD by Median UIE levels
Severe
Moderate
Mild
Normal
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Distribution of salt samples by iodine content
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Awareness regarding IDD and iodised salt
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Conclusion

• Transition of population from iodine deficient to
  iodine sufficient.
• Effective implementation of National Iodine
  Deficiency Disorders Control Programme.
• High awareness about IDD and iodised salt due to
  large scale , intensive mass media education
  programme.

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Dr. Ritu PradhanLecturer,Government Home
Science College, Sector 10, Chandigarh E mail
sharmapritu_at_yahoo.com