Iodine deficiency in urban slums of Bhubaneswar.

OBJECTIVE: The present study aimed at assessing the population prevalence of goiter and iodine deficiency in school children of 6-12 yr living in urban slums of Bhubaneswer, the capital city of Orissa. METHODS: A cross-sectional study was performed using the 30-cluster sampling methodology and surveillance methods for iodine deficiency as recommended by WHO/ICCIDD/UNICEF. The total goitre rate (n=1248), urinary iodine concentration (UIC) (n=411) and iodine content of edible salt (n=368) were measured. RESULTS: The goitre prevalence was 23.6% (grade 1=18.9%, grade 2=4.7%) with no significant gender variation. Goitre prevalence was significantly higher in children of 10-12 yr (P=0.012) and scheduled caste and tribe (P=0.003). Median urinary iodine concentration was 50.0 microg/l with 85.7% of children having values less than 100 microg/l, indicating as biochemical iodine deficiency. Median UIC was inversely in association with gradations of goitre. Children of 10-12 yr and scheduled caste/tribe communities had significantly higher median UIC (P=0.001) than their counterpart peers. About 51% of children were consuming salt having stipulated iodine content of 15 ppm. CONCLUSION: The study indicates moderate iodine deficiency in the population, despite a mandatory salt iodization programme in Orissa that has been in force since 1989. There is a need to improve the situation through enforcing monitoring of salt iodization to ensure quality and increasing the level of awareness about the iodized salt for sustainable prevention and control of iodine deficiency.

Endemic goitre in rural South Delhi.

One thousand and seventy-five children from the schools of 4 villages of rural South Delhi were clinically assessed for anatomical enlargement of thyroid gland. Goitre was graded according to WHO classification. One hundred and seventy-two children showed various grades of goitre giving a prevalence of total goitre in school children to be 16%. The problem of visible goitre (grades 2 and 3) was minimal and overwhelming majority of goitre cases belonged to lower grades. Though previous school goitre surveys from urban school children in Delhi give a prevalence as high as 55.2%, the prevalence of 16% in the present survey still categorizes rural South Delhi as mild endemic according to WHO/International classification for control of iodine deficiency disorder (ICCIDD) criteria. In Delhi partial supply of iodised salt commenced, with effect from, 1-1-1984 and it was covered by 'Ban Notification-PFA Act' prohibiting the sale of sub-optimally iodised salt. There is a need for an area specific assessment of iodine deficiency disorder (IDD) and people's access to optimally iodised salt.