ABSTRACT
Objective To investigate the occurrence of new cretinism cases and the prevalence of endemic goiter, and the reason of lower coverage rate of iodized salt in the iodine deficiency disorders(IDD) high-risk areas of China, so as to put forward target prevention measures for these areas. Methods A hundred and one counties from 11 provinces(autonomous regions, municipality), such as Tibet, Qinghai, Xinjiang, Gansu, Ningxia, Sichuan, Hainan, Chongqing, Yunnan, Guangxi, Inner Mongolia, were chosen into the survey by simple random sampling. In the counties of high risk, typical sampling principle was used. In the selected townships, searching for new cretinism cases were carried out in the children under 10 years old, the thyroid volume of children aged 8-10 years old were determined by B-ultrasonography methods and their urinary iodine (UI) were determined by As3-Ce<'4+> catalytic spectrophotometry, the intelligence quotient(IQ) values of children aged 8-10 years old were measured by the combined Raven Test in China. In the household survey, the housewives were asked to fill in the questionnaire, the iodized salt coverage rates and the UI levels of child-bearing age women were investigated, the salt iodine content was determined using self-quantitative kit. Epi Info software was used to analyze the determination results. Results In the 101 high-risk counties, 249 were diagnosed as new cretinism cases from 4122 suspected cases searched. The goiter rate of children aged 8-10 years old by B-ultrasound was 8.28% (4434/53 541), 44 counties had goiter rates in the range of 5%-20%, 5 counties had goiter rates in the range of 20%-30%, and 3 counties had goiter rates of 30%. The mean IQ of children was 85.44, and the percentage of IQ value less than 70 was 16.52%(8713/52 745). The median urinary iodine(MUI) of children was 154.69 μg/L, the percentage of UI less than 50 μg/L was 17.26% (9069/52 558). Twenty-five counties had a MUI of children less than 100 μg/L. The MUI of housewives was 107.14 μg/L, the percentage of UI less than 50 μg/L was 27.50% (3722/13 534). MUI of housewives in 46 counties were less than 100.0 μg/L. The coverage rate of iodized salt at household level was 77.85%(13 150/16 891). The coverage rate of iodized salt was 52.80%(1585/3002), 44.72% (631/1411) and 72.82% (1850/2506) in Tibet, Hainan and Qinghai, respectively. More than 10% residents of Tibet, Sichuan, Hainan, Gansu and Qinghai complained that iodized salt was not convenient to buy. There were 71.39%(7652/10 719) of observed people ate crude salt. The average price of crude salt price(0.30-1.20 Yuan/kg) was lower than iodized salt(1.20-3.00 Yuan/kg). Conclusions In these IDD high-risk areas, the risk of endemic goiter and cretinism prevalence is threatening. The IDD monitoring should be carried out successively in these high-risk areas. The prevention measures, increasing iodized salt coverage rate and establishing the sustainable mechanism for eliminating IDD should be strengthened. Emergent iodine fortification measure for high risk region people should be implemented as soon as possible, a long term effective mechanism of eliminating IDD should be established.
ABSTRACT
Objectives To clarify the basic data such as prevalent range,regiohal characteristics and the population at risk of drinking brick-tea type fluorosis in China.Methods Comprehensive survey for basic information was conducted in the provinces and autonomous regions where drinking brick-tea type fluorosis Wag prevalent,ineluding Inner Mongolia Autonomous Region,Tibet Autonomous Region, Sichuan Province,Xinjiang Autonomous Region, Qinghai Province,Gansu Province,Ningxia Autonomous Region and Yunan Province.The survey included the number ot counties(cifies)and townships(towns)where the people were accustomed to drinking brick-tea,pepulation,ethnic minority composition,the production and living style,sales and the kinds of brick-tea aIn so on.Results Two hundred and forty-one counties and 3246 townships were found to haye the habit 0f drinking brick-tea,among which 87.46%(2839/3246)had the habit for more than 30 years.There were 31 684 administrative vilages(residents' committees),15 047 elementary schools and 2873 temples surveyed,coveting a total population of 31 052 398 and 122 739 monks.Fifty-three ethnic minorities were involved.Han accounted for 44.86%(12 902 710/31 052 398), Uighur ethnic for 20.98%(7 416 474/31 052 398),Tibetan ethnic for 13.34%(4 323 272/31 052 398),Muslim ethnicfor 8.15%(2 767 603/31 052 398),Mongolian ethnic for 4.61%(1 400 206/31 052 398),Kazak ethnicfor 3.45% (1 218 272/31 052 398),of the population of drinking brick-tea,farmer population accounted for 64.13%(19 912 833/ 31 052 398),herdsman population for 8.79%(2 728 418/31 052 398),farmer-herdsman population for 12.53%(3 889 678/ 31 052 398)and town population for 14.56%(4 521 169/31 052 398).There Was 3926.74 tons of brick-tea sold per year in the investigated regions,mainly of Fu brick-tea,Green brick-tea and Black brick-tea.Areas with high brick- tea consumption distributed mainly in farmer region and farmer-herdsman region.Annual per capita consumption of brick-tea for farmers was 3.77 kg,and for farmer-herdsman population was 2.05 kg.Conclusions Begions with the habit of drinking brick-tea distributes extensively in western China and cover a huge population,and the herdsmen and farmer-herdsman are the main risk population.Drinking brick-tea type fluorosis is a seriolls public health issue in western China.
ABSTRACT
<p><b>OBJECTIVE</b>To estimate the frequency of injections and proportion of unsafe injections and to analyses the critical determinants of poor injection practices in general population in China. Also, to study knowledge, attitudes, practice research in providers and general population.</p><p><b>METHODS</b>A random sample consisting residents and health care providers in a rural county was elected and interview about the frequency of received injection, as well as knowledge, attitudes and practices regarding injections were studied.</p><p><b>RESULTS</b>Overall, 1 004 village residents, and 94 providers were interviewed. Among residents, 145 persons (14.4%), with 457 times (0.46 times per person) had received at least one injection during the previous 3 months. The frequency of injection was 1.84 per year. The proportion of received injections on treatment and immunizations was significantly different among > 12 years age group and < or = 12 years age group. Ninety-four point four percent of disposable syringes/needles were used for injections. Knowledge among the population and providers regarding injection safety was limited.</p><p><b>CONCLUSION</b>Injections were moderately frequent in this rural area and the proportions of disposable syringes/needles used for injections was very high. Knowledge of safe injection and reasonable injection as well as consciousness of self-protection in the providers and residents need to be improved.</p>