ABSTRACT
Objective To find out the iodine nutritional status and thyroid function of pregnant and lactating women in the urban areas of Wuwei City of Gansu Province,and to provide a scientific basis for iodine supplementation.Methods Blood and urine samples of pregnant (52 persons) and lactating women (59 persons) were collected in 2009.Urinary iodine content was measured with arsenic cerium catalytic spectrophotometric.Serum free three triiodothyronine(FT3),free thyroid hormone(FT4),triiodo thyronine(TT3),serum total thyroxine (TT4) and thyroid-stimulating hormone (TSH) were detected with direct chemiluminescence immunoassay.Results The medians urinary iodine of pregnant and lactating women were 274.68,217.88 μg/L.The rates of low urinary iodine (pregnant women below 150 μg/L,lactating women lower than 100 μg/L) were 9.62％ (5/52) and 6.78％ (4/59).Serum TT3,TT4 levels in pregnant women[(2.48 ± 0.59),(132.18 ± 33.36)nmoL/L] were higher than that in the lactating women[(2.16 ± 0.49),(108.79 ± 28.36)nmol/L,t =-3.123,-3.971,all P ＜ 0.05].Thyroid dysfunction incidence rates of pregnant and lactating women were 17.31％ (9/52) and 8.47％ (5/59).Thyroid dysfunction was mostly subclinical hypothyroidism.Conclusions Overall iodine nutrition of pregnant and lactating women is in good condition,some individuals have the trend of hypothyroidism.It is necessary to carry out routine monitoring of urinary iodine and thyroid function.
ABSTRACT
Objective To evaluate the effect of health education on the target population of iodine deficiency disorders (IDD) in Linxia Hui autonomous prefecture.Methods During 2006-2010,IDD health education was carried out in the target population of Linxia Hui autonomous prefecture,and IDD knowledge of 5th grade pupil and 20-50 years old child-bearing women were surveyed by stratified sampling and questionnaire survey methods to evaluate the effect of health education.Results After health education,IDD knowledge passing rate rose from 55.6％ (548/986) and 18.0％(118/657) to 90.0％(1103/1225) and 86.2％(687/797) among pupils and women,respectively.The awareness rates of iodine deficiency in causing goiter,mental retardation and birth born silly children,and the key role of iodized salt in controling IDD were increased from 79.2％ (781/986),76.5％ (754/986),51.7％ (510/986) and 82.3％ (811/986) to 88.8％ (1088/1225),85.6％ (1049/1225),68.7％ (842/1225) and 90.0％ (1103/1225) among pupils,and from 48.6％ (319/657),28.3％ (186/657),15.4％ (101/657) and 39.6％ (260/657) to 86.2％ (687/797),70.0％ (558/797),46.3％ (369/797) and 87.3％ (696/797) among women,and all the difference were significant,respectively.Belief rate held by students that health education can prevent iodine deficiency disorders was 87.3％ (1069/1225),and 52.9％ (648/1225) of the students told their parents about IDD.The rate of consciously purchase of qualified iodized salt was 87.1％ (694/797) after health education among women of childbearing age,and the consumption rate of iodized salt was 64.6％(515/797).More than 90％ of the people in relevant departments knew iodine deficiency disorders related knowledge,in particular,had a clear understanding of intellectual hazards caused by iodine deficiency,and actively supported and participated in health education in the prevention and control of iodine deficiency disorders.Conclusions Comprehensive health education measures taken through schools and religious organizations has promoted a shift in the behavior,beliefs and attitudes of its consciously purchase and consumption of iodized salt,and integrated knowledge,attitude and practice (KAP).It is a good model of health education through religious organizations in ethnic minority areas.It has promoted the health education feasibility and accessibility,and the effect is more durable.
ABSTRACT
Objective To assess the improvement of intelligence quotient through an Universal Salt Iodization Supply Program,among children.Methods 3518 and 1611 children were selected from primary schools in Linxia Hui Autonomous Prefecture of Gansu in 2006 and 2010respectively.Intelligence quotient (IQ) were measured by the revised Chinese Combined Raven Test C2 (CRT-C2).Results In 2006,the average IQ of children aged 8-10 was 85.1,including 16.7％ of them with IQ≤69.The average IQ was between 80-90 in different counties and cities,with significant differences (P＜0.05).The average IQs were 92.0,90.6 and 81.8 among 8,9 and 10 years old children respectively with 10 year old' s low than those 8 and 9 year olds (P＜0.05).The average IQs of boys and girls were 84.5 and 85.6,but with no significant difference (P ＞0.05).The average IQ of children aged 8-10 in 2010 was 97.2 and 12 points higher than in 2006 (P＜0.05),but 8 IQ points (P＜0.05) less than the average level 105 from the overall of Gansu province.4.7％ of the children having an IQ≤69.IQ of children from Linxia city and Yongjing county,were up to the theoretical level of 100,with an average IQ at around 95 in other counties.The average IQs between counties or cities showed significant differences.The IQ of 8,9 year olds and 10 year olds did not present significant difference (P＞0.05),but in boys (98.8) and in girls (95.9) the difference was significant (P＜0.05).Conclusion The average IQ was close to the theoretical level (100) with the gradual implementation of universal salt iodization program,showing that the iodized salt did play a key role on children's intelligence.However,the average IQ was still lower than the average level of the whole Gansu province in 2010.
ABSTRACT
Objective To analyze monitoring results of iodized salt and distribution characteristics of problem areas with non-iodized salt in Gansu province during 2001 - 2009 and to provide a basis to develop countermeasures to iodine deficiency disorders. Methods According to the criterion of "The National Scheme of Iodized Salt Surveillance", two levels of monitoring were carried out on production and wholesale-level(during 2001 -2007) and household-level(during 2001 - 2009). Salt iodine was determined by direct titration method (GB/T13025.7-1999), and Sichuan salt or special salt was determined with an arbitration method. Criteria for qualified iodized salt was (35 ± 15)mg/kg(20 - 50 mg/kg), and for non-iodized salt was ＜ 5 mg/kg. Results During 2001 - 2007, a total of 4900 salt samples at production and wholesale-levels were examined, with a qualification rate of 97.80% (4792/4900). Non-iodized salt rates were all below 5% in Gansu province, consumption rate of qualified iodized salt was higher than 90% after 2003. During 2001 - 2009, cities(states) with non-iodized salt problems appeared 23 times, with Linxia accounting for 39.1%(9/23), Wuwei accounting for 21.7%(5/23). During 2001 -2009, counties(districts) with non-iodized salt problem appeared 123 times, including 68 times of ethnic minorities and state poverty counties, accounting for 55.3%(68/123). During 2001 - 2005 and 2006 - 2009, ethnic minorities and state poverty counties were accounting for 49.4%(44/89) and 70.6%(24/34) in counties with non-iodized salt problem. Conclusions The quality of iodized-salt at production and wholesale level is satisfactory in Gansu province, household consumption rate of qualified iodized salt have reached national standard for eliminating iodine deficiency disorders. But ethnic minorities and state poverty counties are main regions with non-iodized salt problem,these areas will be the key areas of prevention of iodine deficiency disorders in Gansu province in the future.
ABSTRACT
Objective To master the status in control of iodine deficiency disorders (IDD) in Gansu province and to provide the basis for development of control strategies. Methods One county which reached the national standardization of IDD elimination was selected randomly from each of 14 cities of Gansu province in 2009, then one town was selected respectively from five directions (east, south, west, north, and central) of the above selected counties. One village was chosen from every town which was selected for investigating household iodized salt and iodized salt sales network. At the same time the thyroid of children was examined, their urinary iodine (UI) was determined, the intelligence quotient(IQ) values of children were measured and health education was surveyed in one primary school which was chosen in each of the selected town. Results A total of 1420 edible salt samples were tested;the weighted iodized salt coverage rate and the weighted qualified iodized salt rate were 99.53% and 98.15 respectively. Urine samples were collected from 1761 children included in the study. The urinary iodine median was 225.87 μg/L. The urinary iodine medians were at optimal levels in five counties, over the optimal levels in seven counties and at excessive levels in two counties. A total of 3051 children aged 8 - 10 were randomly selected for thyroid examination. The weighted thyroid goiter rate(TGR) of children was 1.9%, and TGR was higher than 5% only in Hoaggu county. IQ of 2815 children was tested and the mean IQ was 105.3, except for the country of Zhuoni and Kangle, the mean IQ of other counties were over 100. The average score of health education was 3.2.Children of 57.08% (1229/2153) knew that iodine deficiency could lead to mental retardation, 71.76% (1544/2153) knew that iodine deficiency could cause thyroid goiter, 68.04%( 1465/2153 ) knew that eating iodized salt was the best method for IDD prevention and control and 61.82%(1331/2153) informed their families of the benefits of eating iodized salt. Each town had one agency selling iodized salt and each village had one more retail store with iodized salt, but 73.5%(75/102) of the stores without license for the sales. Conclusions Great progress has been made on the prevention and control of IDD in Gansu province. The qualified iodized salt consumption rate has reached the national standard for IDD elimination, TGR has decreased markedly, the urinary iodine levels in more counties are over the optimal levels and iodized salt distribution network is basically sound. But progress in health education is uneven.
ABSTRACT
Objective To investigate the control status of iodine deficiency disorders (IDD) in the highrisk areas of Gansu province,and to provide a scientific basis for development of effective preventive measures.Methods Twelve counties with high-risk areas of IDD in Gansu province were selected into the survey in 2007 -2009.All patients with suspected cretinism born after the first of January,1997 were enrolled in the study from the 12 counties.Meanwhile,three townships were chosen in each of the 12 counties,two villages were taken in each township,40 children aged 8 to 10 in each village primary school were selected to carry out thyroid examination by B-ultrasonography and palpation,urinary iodine(UI) test,and intelligence quotient(IQ) test; 30 women of childbearing age were selected in each village to fill in the questionnaire,and to test their urinary and salt iodine,and the local salt-related situation was investigated.Results In the 12 high-risk counties,7 were diagnosed as new cretinism cases from a total of 120 suspected cases of cretinism.The goiter rate of children aged 8 - 10 by Bultrasound was 6.8％(290/4281 ),5 counties had goiter rates higher than 5％,of which 3 counties had goiter rates higher than 10％.The average IQ of children was 82.38.The median urinary iodine(MUI) of children was 180.34 μg/L,the ratio of UI ＜ 50 μg/L was 11.0％(482/4383).The MUI of women of childbearing age was 175.91 μg/L,the ratio of UI ＜ 50 μg/L was 16.5％(126/762).MUI of women of childbearing age was less than 100.0 μg/L in Xiahe and Dongxiang counties,which were 95.24 μg/L and 66.30 μg/L,respectively.The coverage rate of iodized salt in 8 of the 12 counties was more than 95％,and that of the remaining four counties was ＜ 85％,of which the coverage rates of iodized salt were only 39.2％ (47/120)and 66.7％ (120/180),respectively,in Guanghe and Dongxiang counties.Fourteen point nine percent (206/1380) of the residents complained that iodized salt was not convenient to buy and 87.7％ (1210/1380) complained that the current price of these salts exceeded the accepted range.Only 29.9％(413/1380)of the housewives knew how to prevent IDD.Conclusions Impact factors of IDD in high-risk areas are widespread.The monitoring of IDD in high-risk areas should be strengthened.Effective measures should be taken to ensure adequate iodine nutrition of people at risk.At the same time,iodized salt-based comprehensive prevention measures should be strengthen and a long-term effective control strategy of IDD should be established.