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Objective To master the situation of iodine deficiency disorders (IDD) and the people's iodine nutritional status after implementation of the new salt iodine standard in Gansu Province in 2012.Methods Totally 30 counties (cities) were selected in Gansu Province by population proportionate to size sampling (PPS) method in 2014,and one primary school was selected in each counties (cities).In each selected school,50 children aged 8-10 years old were selected for thyroid examination by B-ultrasound,urine samples were collected for iodine determination,and salt samples were collected for iodine determination from a subset of children included in the study.Totally 20 pregnant women were selected from the towns with the sampled schools and urine samples were collected for iodine determination.Arsenic and cerium catalysis spectrophotometry (WS/T 107-2006) was used to detect urinary iodine content;direct titration (GB/T 13025.7-2012) was used to detect edible salt iodine content.Urinary iodine of children and pregnant women were compared with 2011 (before implementation of the new salt iodine standard).Results The median of salt iodine was 26.6 mg/kg,the iodized salt coverage rate was 99.5% (1 492/1 500),the qualified rate of iodized salt was 89.3% (1 333/1 492),and the consumption rate of qualified iodized salt was 88.9% (1 333/1 500).The thyroid goiter rate of children was 3.2% (48/1 500);a total of 1 499 urine samples of children were detected,the urinary iodine median was 169.8 μg/L,it was significantly lower than that in 2011 (216.0 μg/L,Z =-6.813,P < 0.05).A total of 600 urine samples of pregnant women were detected,the urinary iodine median was 161.8 μg/L,it was significantly lower than that in 2011 (168.6 μg/L,Z =-3.590,P < 0.05).Conclusion IDD has been controlled after implementation of the new standard of iodized salt and iodine nutrition condition is good.
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Objective To monitor the situation of iodine deficiency disorders (IDD) in Tibet,and to provide a background information of iodine nutritional status of residents before adjustment of iodine concentration.Methods According to the method of population proportionate sampling (PPS),27 counties were selected to carry out IDD surveillance.One primary school was selected in each county.Forty children aged 8-10 from each primary school were sampled to examine thyroid volume,and edible salt samples were collected from their home to determine salt iodine.In addition,12 of the sampled children,15 pregnant women and 15 lactating women from three townships near the selected schools were chosen to detect urinary iodine.The methods of B-ultrasonography,oxidation-reduction titration (GB/T 13025.7-1999) and arsenic cerium catalytic spectrophotometry (WS/T 107-2006) were used to determine thyroid volume,salt iodine and urinary iodine,respectively.Results One thousand and eighty-one children aged from 8 to 10 were examined,and their goiter rate was 1.9% (20/1 081).Seven hundred and fifty-eight salt samples were determined,and the median salt iodine level was 38.3 mg/kg and the consuming rate of qualified iodized salt was 88.1%(758/668).Meanwhile,urine samples of 522 children aged 8-10,267 pregnant women and 336 lactating women were also tested,and their median urinary iodine level was 166.1,132.7,138.1 μg/L,respectively.Conclusions The results show that the goiter rate and urinary iodine level of children aged from 8 to 10 have reached the national standard of IDD elimination (<5%,100-300 μg/L),while the residents consumption rate of qualified iodized salt is still lower than the national standard (90%).In particular,the iodine nutrition of pregnant women is inadequate,which is lower than the national standard (urinary iodine 150 μg/L).It is still necessary to strengthen the monitoring of salt iodine as well as iodine nutrition in special groups in the future,and strengthen health promotion at the same time.
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Objetivos: Evaluar la efectividad del “Programa de Eliminación Sostenible de Deficiencia de Yodo” mediante determinación de yoduria y prevalencia de bocio. Materiales y métodos. Se realizó un estudio transversal en el cual se incluyó a la población escolar cubana de 6 a 11 años que cursaba estudios en el periodo 2011-2012. Se empleó un muestreo estratificado polietápico. En el cual se determinaron los niveles de excreción de yodo en la orina (yoduria) y la presencia de bocio. Resultados. La mediana de yoduria fue de 176,3 µg/L; el 7,6% de los escolares presentaron alguna deficiencia de yodo, solo el 2,2% estaba por debajo de 50 µg/L (deficiencia severa) y el 15,3% tenía yodurias por encima de 300 µg/L. El porcentaje de escolares con nutrición óptima de yodo fue de 43,5%, esta categoría presentó una frecuencia significativamente mayor ( p=0,03) en el estrato montaña (52,5%). La prevalencia de bocio encontrada fue de 17,6%, que corresponde a una endemia ligera. Sin embargo, en el estrato montaña se encontró una prevalencia de 32,6 % (endemia severa). Conclusiones. El análisis integral del impacto de las acciones de control de la deficiencia de yodo evaluado a través de la excreción urinaria de yodo y la prevalencia de bocio refleja que ha dejado de ser un problema de salud poblacional en los estratos urbano y rural de Cuba, atribuible a un adecuado proceso de yodación de la sal. Sin embargo, aún se observa una alta prevalencia de bocio en la zona de montaña de Cuba.
Objectives: To assess the effectiveness of the Sustainable Elimination of Iodine Deficiency Program through determination of urinary iodine and goiter prevalence. Materials and methods. A cross-sectional study was conducted in Cuban school children aged 6 to 11 years old in 2011-2012. A stratified multistage sample was used in which the levels of iodine excretion in urine (urinary iodine) and the presence of goiter were determined. Results. The median urinary iodine was 176.3 µg/L; 7.6% of the students showed some deficiency of iodine, only 2.2% were below 50 µg/L (severe deficiency), and 15.3% had urinary iodine above 300 µg/L. The percentage of school children with optimal iodine nutrition was 43.5%, this category showed a significantly higher frequency (p=0.03) in the mountain areas (52.5%). Goiter prevalence was 17.6% which corresponds to a mild endemic. However, in the mountain area the prevalence was 32.6% (severe endemic). Conclusions. The comprehensive analysis of the impact of iodine deficiency control measures assessed by urinary iodine excretion and goiter prevalence reflects that it is no longer a population health problem in urban and rural areas of Cuba, attributable to a proper process of salt iodization. Nevertheless, high goiter prevalence is still observed in the mountain area of Cuba.
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Niño , Femenino , Humanos , Masculino , Enfermedades Carenciales/epidemiología , Enfermedades Carenciales/prevención & control , Bocio/epidemiología , Yodo/deficiencia , Estudios Transversales , Cuba/epidemiología , Yodo/orina , Programas Nacionales de Salud , Prevalencia , Evaluación de Programas y Proyectos de Salud , Salud Rural , Salud UrbanaRESUMEN
Objective To investigate the nutritional status of children and women of childbearing age in high-risk areas of iodine deficiency disorders in Tianjin in 2008-2010 and to provide a scientific basis for iodine supplementation.Methods Hangu District was selected as survey point from 2008 to 2010,Dagang District and Jingan County were increased in 2010.Hangu District was divided into five areas,one township(town) that was not high iodine was selected from each area,four administrative villages were selected from each township(town),and 15 households were selected from each administrative village.Three township(town) were selected from Dagang and Jingan County,respectively.Two administrative villages were selected from each township(town),and 20 households were selected from each administrative village.Iodine level of salt samples from each household was determined.In 2009,one primary school was selected from each survey township(town),thyroid volume of 40 8-10-year-old students was examined,and urine iodine of 20 students was tested.In 2010,three township(town) were selected from each survey point,two primary school were selected from each survey township(town),40 8-l0-year-old students were selected from each primary school,urine iodine and thyroid volume of the students were determined.150,50 and 60 women of childbearing age from Hangu District were selected from 2008 to 2010,and 60 were selected from Dagang District and Jingan County,respectively.Urine iodine of the women was tested.Iodine content of salt was tested by a semi-quantitative test kit; diagnosis of endemic goiter was based on the Diagnostic Criteria of Endemic Goiter (WS 276-2007); urinary iodine test was based on the Arsenic Cerium Catalytic Spectrophotometry (WS/T 107-2006).Results Coverage rates of iodized salt in Hangu District in the 3 years were 65.0% (195/300),70.3% (211/300) and 90.8% (274/300),respectively.Coverage rates of iodized salt in Dagang District and Jinghai County were 40.0%(48/120) and 38.3%(46/120).In 2009,the median urinary iodine of children aged 8-10 in Hangu District was 205.4 μg/L and in 2010,the medians urinary iodine of children aged 8-10 of the three survey point were 193.0,293.1 and 216.8 μg/L.Goiter rates of children aged 8-10 in Hangu District were 4.24%(9/212) and 3.59% (9/251),and in Dagang District and Jinghai County were 3.60% (9/250) and 5.44%(13/239).The medians urinary iodine in women of childbearing age in Hangu District in the 3 years were 134.9,196.1 and 229.5 μg/L,respectively.The medians urinary iodine in women of childbearing age in Dagang District and Jinghai County were 316.9 and 190.9 μg/L.Conclusions The nutritional status of high-risk areas of iodine deficiency disorders in Tianjin are better than the national limit of enhanced iodine requirements.Due to higher water iodine in the same areas,some people are iodine excess,to which we should pay more attention.
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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.
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Objective To master the condition of iodine deficiency disorders (IDD),residents iodine nutritional status and implementation of prevention measures in Gansu Province and to provide a basis for developing control strategies.Methods Thirty primary schools were selected in Gansu Province utilizing cluster sampling methodology in 2011,In each selected school,40 children aged 8-10 were randomly selected for thyroid examination and urine samples were collected from 12 children,at the same time measuring the average daily salt intake of domestic residents by 3 days weighing method.On the spot random urine samples and salt samples were collected from a subset of children included in the study.Three towns near the selected school were selected randomly and random urine samples were collected from 5 pregnant and 5 lactating women in each selected town.One drinking water sample was collected for analysis from different sources in five directions(east,south,west,north and central)in each administrative village with the sampled schools.In areas with centralized water supply,two tap water samples were collected for analysis.Results The water iodine median of 83 water samples was 2.02 μg/L,the range was 0.20-36.92 μg/L,and iodine median of 1199 salt samples was 27.4 mg/kg,iodine level in 89.2% (74/83) of the water samples was lower than 10 μg/L.The iodized salt coverage rate was 98.0% (1175/1199),the qualified rate of iodized salt was 90.3% (1061/1175) and the consumption rate of qualified iodized salt was 88.5% (1061/1199).Total of 360 salt samples intake of households were collected,per capita daily salt was 8.5 g,and the range was 2.5-17.8 g.Total of 1200 children thyroid were checked,the thyroid goiter rate(TGR)of children was 2.8%(34/1200) by B-ultrasound and 3.5% (42/1200) by palpation.Total of 359,450 and 450 urine samples of childen aged 8-10,pregnant and lactating women,the urinary iodine median were 216.0,168.6,161.9 μg/L,respectively.Conclusions Great progress has been made in the prevention and control of IDD in Gansu Province.IDD has been controlled effectively and the urinary iodine medians are at optimal levels.
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Objective To master the level of iodine nutrition among population in Jiangxi province,and to provide a scientific basis for establishing the strategy for prevention and control of iodine deficiency disorders (IDD).Methods Retrospective method was adopted to analyze the goiter rate and frequency distribution of urinary iodine of children aged 8-10,the qualified rate of iodized salt,the coverage rate of iodized salt and the consumption rate of qualified iodized salt in residents of Jiangxi province from 1995 to 2010.The method of correlation analysis was used to analyze the relationship between goiter rate of children (by palpation) and the qualified rate of iodized salt,iodized salt coverage rate and residents consumption rate of qualified iodized salt.Results The goiter rates (measured by the method of palpation) of children aged 8-10 were down from 40.17%(482/1200) in 1995 to 0.80%(16/2000) in 2010(x2 =4.864,P< 0.05).The median of urinary iodine of children was higher than 200 μg/L; the proportion of people whose urinary iodine content higher than 300 μg/L was above 25.00% and the highest propoaion was up to 58.01% (210/362) between 1995-2010.The minimum median of salt iodine was 17.77 mg/kg in 1995,and 29.30-39.10 mg/kg in other years.The qualified rates of iodized salt,the iodized salt coverage rates and the consumption rates of qualified iodized salt increased from 43.58%(452/1037),86.42%(1037/1200) and 37.67%(452/1200) in 1995 to 97.95% (1916/1956),99.95%(1956/1957) and 97.90%(1916/1957) in 2010,respectively; there was a growth trend over the years(x2 =5.240,6.118,5.631,all P < 0.05).The goiter rates of children were related to the qualified rates of iodized salt,the iodized salt coverage rates and the consumption rates of qualified iodized salt,and the correlation coefficient(r) was-0.833,-0.881 and-0.918 (all P < 0.05),respectively.Conclusions The level of iodine nutrition among residents in Jiangxi province has already gone beyond the appropriate level,and the iodine concentration in salt should be cut to ensure the appropriate iodine nutrition level among people.
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ObjectiveTo investigate the occurrence of new cretinism cases and the prevalence of endemic goiter in iodine deficiency disorders(IDD) high-risk areas of Fujian province,so as to put forward target prevention and control measures for these areas.Methods Twelve counties from Xiuyu,Xiangan,Pingtan,and Dongshan were chosen into the survey by simple random sampling,searching for new cretinism cases were carried out in children under 10 years old.Two schools were chosen in every county and the thyroid volume of forty children aged 8 - 10 were determined by B-ultrasonography methods and their urinary iodine(UI) was determined by As3--Ce4+catalytic spectrophotometry in each school.Twenty women of child-bearing age aged 18 - 40 were chosen for collecting edible salt and urine samples,and the salt iodine content was determined using self-quantitative kit and their UI was also determined by As3--Ce4+ catalytic spectrophotometry.Results In the 4 high-risk counties,no cretinism cases were found.The goiter rate of children aged 8 - 10 was 3.6%(37/1027),and that in Dongshan county was 5.4%(13/240),which was higher than the national standards for eliminating IDD( < 5%).The median urinary iodine(MUI) of children aged 8 - 10 was 175.3 μg/L,and the MUI of women aged 18 -40 was 152.7 μg/L.The coverage rate of iodized salt was 82.7%(382/462).ConclusionsNew case or suspected new case of cretinism is not discovered in the high-risk areas of IDD of Fujian province,and median urinary iodine level of people is in the adequate range.
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Objective To analysis the progress in prevention and control of iodine deficiency disorders (IDD) in Dalian and to provide a scientific basis for further prevention and control of the disease.Methods From 2006 to 2010,5 or 9 townships were randomly sampled from each county in Dalian,4 villages were sampled from each selected townships and 15 or 8 households were sampled from each selected villages for collecting salt samples and salt iodine level was determined by direct titration method.Sixty daytime urine samples from pregnant women,breast feeding women,infants and young children were collected,respectively,every year to detect urinary iodine level.From 2007 to 2009,2 to 11 counties were sampled and from each selected county one school was sampled to collect 100 daytime urine samples of children aged 8-10 and iodine content was determined.From 2006 to 2009,2 to 5 counties were sampled,from each selected county 2 to 5 schools were sampled and 100 children aged 8 to 10 in each selected school were sampled to detect intelligence quotient level and the thyroid volume.Results From 2006 to 2010,16 012 copies of households' edible salt samples were monitored; the average iodine content was ranged 29.68-31.51 mg/kg,the rate of qualified iodized salt in household ranged from 97.24% to 98.42%.A total of 1398 copies of urine samples of pregnant women,486 breast feeding women,473 infants and 502 young children were monitored,and the median value of urinary iodine was 129.3-189.6,114.6-190.6,148.5-298.5 and 144.4-187.3 μg/L,respectively.A total of 1657 urine samples were monitored,1264 intelligence quotient level and 1197 thyroid volume of school-age children were determined,the median urinary iodine,thyroid goiter rate and intelligence quotient level was 217.9-266.7 μg/L,0-3.29% and 110.4-117.2 μg/L,respectively.Conclusions From 2006 to 2010,the city's households qualified iodized salt coverage rate has reached the national standard for elimination of iodine deficiency disorders.The iodine nutrition of key population and school-age children has reached adequate level,the thyroid goiter rate is less than 5%,and the level of intelligence quotient has increased every year.But the iodine nutrition of breast feeding women in 2009 and 2010,pregnant women in 2010 is inadequate,so iodine nutrition surveillance and health education in pregnant and breast feeding women need to be strengthened in the future.
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Objective To evaluate the nutritional status of iodine of pregnant and lactating women in coastal and inland areas of Zhejiang province,and to provide scientific basis for iodine supplementation.Methods In 2009,five coastal cities,five coastal counties and three inland areas from Zhejiang province were selected by the cluster sampling method,and one sub-district(township) was randomly selected in each city (county),then one community (village) was randomly selected in each sub-district (township).Thirty pregnant women,thirty lactating women and fifty children aged 8 - 10,were randomly selected in each community(village) as the investigation objects to collect instant urine samples to detect urine iodine,and to collect thirty resident edible salt and some water samples to detect salt iodine and water iodine,if the numbers of water source were more than 5 then 1 water sample was collected by their location of east,south,west,north and center in each community(village),otherwise,the numbers of water samples collected were equal to the number of community (village).Results The medians of salt iodine of coastal city,coastal county and inland area were 28.42,25.29,and 33.24 mg/kg,respectively,and the medians of water iodine correspondingly were 5.41,11.52,and 2.80 μg/L,respectively.The medians of urinary iodine of pregnant and lactating women in Zhejiang province were 148.72 and 161.34 μg/L,respectively,which were less than that of children aged 8 - 10(231.02 μg/L,Z =8.57,8.24,all P < 0.017).The medians of urinary iodine in pregnant women from different areas were ranked in order as inland areas(211.42 μg/L),coastal counties (150.51 μg/L) and coastal cities (123.33 μg/L,Z =2.80,5.31,2.42,all P < 0.017),and in lactating women,the medians of urinary iodine in inland areas( 197.43 μg/L) was higher than that in coastal cities( 139.64 μg/L,Z =4.03,P < 0.017).Conclusions The overall levels of iodine nutrition in lactating and pregnant women in Zhejiang province are in the appropriate level,but that of the pregnant women in the coastal cities is inadequate.
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Objective To assess the iodine nutritional status of special target population in coastal saltproducing areas and coastal non-salt-producing areas in Xiamen city,and to provide a basis for take appropriate measures for prevention of iodine deficiency disorders.Methods The Xiang-An salt-producing areas and the JiMei non-salt-producing areas were chosen as research spots in 2009.One sample of produced water and 2 samples of tap water were collected to test iodine level; 600 children aged 8 to 10 were selected and thyroid palpation was performed,besides,the urine sample and household salt sample were also collected for iodine determination.Sixty pregnant women,breasffeeding women,and 0 - 2 year old infants were recruited,respectively,and urine samples and household salt samples were collected to perform the determination of iodine level.Results The iodine levels in drinking water of Xiang-An district and Ji-Mei district were 3.23 and 6.05 mg/L,respectively.The consumption rates of edible qualified iodinated salt were 84.4% (438/519) and 98.3% (392/399),respectively.The goiter rates of children aged 8 - 10 were 3.03%(19/628) and 0.67%(4/600),respectively.The medians of urinary iodine were 202.80 and 238.40 μg/L,respectively.The proportions of urinary iodine level < 50 μg/L were 3.5% (14/405) and 1.0%(2/202),respectively.The medians of urinary iodine of the pregnant women were 120.55 and 153.35 μg/L,respectively,and the proportions of urinary iodine level < 150 μg/L were 62.1% (46/74) and 46.8% (29/62),respectively.The medians of urinary iodine in three trimester were 173.10,144.75 and 101.90 μg/L,respectively,early trimester of pregnancy > second trimester and third trimester (Z =6.151,3.052,all P < 0.05),second trimester > third trimester (Z =2.016,P < 0.05 ).The medians of urinary iodine of the breastfeeding women were 131.20 and 104.35 μg/L,respectively.The proportions of urinary iodine level < 100 μg/L were 35.3% (24/68) and 46.7%(28/60),respectively.The medians of urinary iodine of the infants were 81.95 and 80.20 μg/L,respectively,the proportions of urinary iodine level < 100 μg/L were 59.7%(37/62) and 61.6%(40/65),respectively,< 50 μg/L were 32.3% (20/62) and 30.8% (20/65),respectively.Conclusions The levels of iodine nutrition in pregnant women,breastfeeding women,and 0 - 2 year old infants from Xiang-An district and Ji-Mei district in Xiamen city are still below the desired level of iodine nutrition,and the infants and pregnant women in coastal salt-producing areas are poor in iodine nutrition,we should pay close attention.We should strengthen market supervision on iodized salt,carried out iodine nutrition monitoring on pregnant women,breasffeeding women,and infants,and disseminate knowledge of iodine nutrition among high-risk population should be carried out immediately.
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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.
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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.
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Objective To investigate iodine deficiency disorders(IDD) in Chongqing and Linzhi, and to provide scientific basis for IDD control and prevention. Methods According to the national program developed in 2007, investigation was conducted in Chengkou and Wuxi county in Chongqing municipality, and Linzhi, Bomi,Milin and Langxian county in Linzhi prefecture. Five towns were sampled in Linzhi county, and 3 in other counties.In each town, one township primary school and two village primary schools were selected to inspect thyroid by B ultrasound and palpation, and urinary iodine of children aged 8 to 10 years was tested in these schools. Meanwhile,2 villages were selected in each town for test of salt iodine level and urinary iodine of childbearing age women and search cretin cases. Results Three hundred and forty families in Chongqing and 915 families in Linzhi were investigated. The coverage of iodized salt in Chongqing was 98.82%(336/340), which was significantly higher than that in Linzhi[66.34%(607/905), x2 = 139.56, P < 0.01]. Goiter rate of children in Chongqing was 9.27%(89/960) by palpation and 8.34% (61/731) by B ultrasound, while goiter rate of children in Linzhi was 7.80%(102/1308) by palpation and 5.53% (69/1248) by B ultrasound. The difference of goiter rate by palpation between Chongqing and Linzhi was not statistically significant (x2 = 1.37, P > 0.05 ). But goiter rate of children by B ultrasound in Chongqing was higher than that in Linzhi (x2= 5.51, P < 0.05). In Chongqing, the median urinary iodine was 319.15 μg/L, and 345.75 μg/L in Chengkou county and 281.39 μg/L in Wuxi county. In Linzhi prefecture, the median urinary iodine was 189.81 μg/L, and 207.81 μg/L in Linzhi county, 161.12 μg/L in Bomi county, 131.83 μg/L in Milin county and 334.60 μg/L in Langxian county. The median urinary iodine in childbearing women were 248.42 μg/L in Chongqing and 121.25 μg/L in Linzhi. The median urinary iodine in Chongqing both in children and women were higher than those in Linzhi. No new cretin case was found in these two areas. Conclusions Goiter rate in high risk areas of IDD in Chongqing and Linzhi has decreased to less than 10%.No new cretin case is found in these areas. It can be concluded that the work of control and prevention is effective.There is excess iodine in Chongqing. In Linzhi county and Langxian county, iodine is excess in children and deficient in women. Further investigation should be conducted to find out the reason. Population iodine is excess in Bomi and Milin counties. The concentration of salt iodine should be decreased in Chongqing. In Linzhi prefecture,adding iodine measures should be adjusted based on further investigation.
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Objective To evaluate the effectiveness of health education on iodine deficiency disorders (IDD) in Hebei, and to provide basic information for development of control strategies. Methods A total of 34 project counties were selected in Hebei province, and 3 townships were chosen in each project county. Heath educational activities were carried out in the classes of grade 5 in the central primary school of each selected township. In the meantime, 3 villages were chosen in each selected township where the health education for women of childbearing age in the community was carried out. Sureys on knowledge of IDD control were conducted in the 34 project counties before and after the health educational activities. Results The knowing rates of IDD control among pupils in all 34 project counties increased from 71.10%(7835/11 019) to 94.84%(10 840/11 430) after health education, with a average increase of 23.74%. The knowing rates of IDD control among housewives increased from 77.02%(4531/5883) to 95.32%(5902/6192), with a average increase of 18.30%. Of which, the knowing rates of IDD control among pupils in Hengshui city increased from 55.56% (750/1350) to 94.89% (1281/1350),with a average increase of 39.33%. The knowing rates of IDD control among housewives in Handan city increased from 65.68%(532/810) to 96.50%(909/942), with a average increase of 30.82%. Conclusions The knowing rates of IDD control among pupils and housewives are remarkably increased after implementing the health education projects. They have better life and health habits, and the project achieves desired effect.
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Objective To investigate the nutritional status of iodine among residents in Chongqing, and to facilitate scientific prevention and control of iodine deficiency disorders. Methods Select 9 towns in each of the 40 districts (counties) in Chongqing, and collect 40 resident edible salt samples in each of the selected town to detect salt iodine by direct titrimetry. Select 5 towns on the site of the east, west, south, north and middle of every district (county), select 20 children aged 8 to 10 in each of the selected town to collect urine samples and detect urinary iodine by As-Ce catalytic spectrophotometric assay. Results The median of iodine of 14 217 salt specimens by household was 292 mg/kg with a coverage rate of qualified iodized salt of 98.90%( 14 061/14 217). The consumption rate of qualified iodized salt was 95.59%( 13 590/14 217). The median of urinary iodine for 4050 children aged 8 to 10 was 247.20μg/L, of which < 50 μg/L accounted for 4.60%(186/4050), 50-99μg/L accounted for 7.28% (295/4050), 100 - 199 μg/L accounted for 26.44% (1071/4050), 200 - 299 μg/L accounted for 25.58% (1036/4050), 300 μg/L or more, accounted for 36.10% (1462/4050). However, no significant difference was observed between different age groups(x2 = 3.77, P > 0.05). At district (county) level, the median of urinary iodine in 10(25.00%) districts (counties) was 100 - 200 μg/L, that in other 23(57.50%) districts (counties) was 200 - 300 μg/L, and that in other 7(17.50%) districts/counties was greater than 300 μg/L, and statistical significance was observed between different districts/counties (x2 = 441.95, P < 0.01). Conclusions Current iodine nutrition among residents in Chongqing is adequate. While there is excess, need to reduce the amount of salt iodization.
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Objective To find out the consumption situation of iodized salt in Baotou, identify problems and take appropriate intervention measures, and to provide scientific basis for further consolidating the results of control measures, strengthening and improving the sustainable elimination of iodine deficiency disorders. Methods Three batches of each quarter, 54 salt samples were sampled in Donghe wholesale division and Qingkun wholesale division in Baotou city salt company during 2008 - 2010; each place of Damaoqi, Baiyun district, and Qingshan district were divided into five sampling areas according to the direction of east, west, south, north, and central position, one school was selected in each district, 30 students aged 8 to 10 from each school were selected, and home salt samples were taken, and salt iodine was tested by direct titration(GB/T 13025.7-1999). Results Qualified rate of wholesale iodized salt was 100%(378/378) during 2008 - 2010, and mean salt iodine was 30.4 mg/kg;qualified rate of household iodized salt was 99.8%(2417/2421 ), and mean salt iodine was 30.4 mg/kg; iodized salt coverage rate was 99.6% (2421/2430) and consumption rate of qualified iodized salt was 99.4% (2417/2430).Conclusions Qualified rate of iodized salt, coverage rate of qualified iodized salt and consumption rate of qualified iodized salt are 90% or more, which has reached the standard of sustainable elimination of iodine deficiency disorders.
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Objective To find out the iodine nutritional status of children in Xiamen island, and to provide the scientific basis for iodine supplimentation. Methods On March 2010, thyroids of all children aged 6to 12, from primary school on the Xiaodeng island of Xiamen were examined by palpation, urinary iodine, iodine content of salt athome and IQ level were tested, and were collected 20 households, iodine content of drinking water was tested randomly. Results IQ testing and thyroid palpation were carried out among a total of 156 children, the goiter rate of children was 1.28% (2/156), the mean IQ was 110; 154 urine samples were taken, the median urinary iodine was 219.1 μg/L; a total of 153 salt samples were tested, and the qualified rate of iodized salt was 87.58%(134/153), and the mean iodine content in the tap water was 4.52 μg/L Conclusions Iodine nutritional status of the island residents is better, and there are no such problems as excessive iodine.
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Objective To know the prevalence of iodine deficiency disorders(IDD) and the implementation of control measures against the disorders in high-risk areas of Hainan province. Methods Typical sampling principle was used. Eight townships with lower coverage rate of iodized salt were chosen in IDD high-risk counties of Hainan. New cretinism cases were screened among children aged 10 years and under. Intelligence quotient (IQ)value, urinary iodine (UI) concentration and thyroid gland size (by palpation and B ultrasonic) were investigated in children aged 8 to 10 years and questionnaire was also carried out among students from grade 5 in elementary school. Edible salt and urine of women of childbearing age were collected to detect iodine levels, respectively,questionnaire was also carried out among the women of childbearing age. The UI was determined by As3-Ce4+ catalytic spectrophotometer, the salt iodine level was determined using self-quantitative kit. IQ values were measured by the Combined Raven Test in China (CRT-C2). Results Seventy-two townships were investigated in three consecutive years, 7937 children aged 8 to 10 years, 1797 women of childbearing age and 4128 students of grade 5 were included in the survey. One child was diagnosed as suspected new cretinism case. The coverage rate of iodized salt was increased from 44.6%(629/1411) in 2007 to 92.1%(1688/1832) in 2009. The goiter rate was dropped from 5.9% (269/4548), 6.0% (274/4548) in 2007 to 1.6% (24/1461), 0.1% (2/1461) in 2009 bypalpation, and by B-ultrasound, respectively, in children aged 8 to 10 years. The median urinary iodine(MUI) was found to be increased from 97.4 μg/L in 2007 to 165.0 μg/L in 2009, and the percentage of UI less than 50.0 μg/L, and 100.0 μg/L were dropped from 21.4%(973/4548), 51.2%(2329/4548) in 2007 to 7.5 %(110/1461), 23.4%(342/1461) in 2009, respectively. The MUI of women of childbearing age was found to be elevated from 73.7 μg/L in 2007 to 126.1 μg/L in 2009, and the value was also increased from 55.7 μg/L to 121.5 μg/L in pregnant women, but these values were still lower than 150.0 μg/L The pass rate of the questionnaire of IDD controlling among the students of grade 5 and the women of childbearing age was raised from 29.8% (446/1495) ,24.1% (179/742) in 2007 to 65.8%(732/1112), 72.1%(264/366) in 2009, respectively. The mean IQ of children was 90.4±16.0, and the percentage of IQ value less than 69 was 12.6% (1000/7937). Conclusions The diseased state of IDD has improved in the high-risk counties of disorders in Hainan province, but the pregnant women are still iodine deficient. Iodine supplimentation should be promoted among pregnant women.
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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.