Epidemic distribution of endemic cretinism in Gansu Province / 中华地方病学杂志

ABSTRACT

Objective To build a case database of endemic cretinism,investigate the distribution of existing cretinism,and provide suggestions for prevention of iodine deficiency disorders.Methods In 2011,an existing endemic cretinism case database was established in Gansu Province by verifying and registering the historical cases before 1985,and searching and diagnosing the cases between 1985-2011 in history cretinism areas and IDD high-risk areas according to endemic cretinism and endemic sub-clinical cretinism diagnosis (WS 104-104) and the IDD monitoring program of the central transfer fund at the same time,and analysis the distribution of existing cretinism.Results In 1985 and 2011,cretinism areas were 53 and 41 in Gansu Province,and the endemic cretinism cases werel9 696 and 4 715,respectively;18 cases of endemic cretinism were born between 1985 to1997,7 new cases were born after 1997;nerve cretinism,myxedematous and mixed types among existing cases were 58.8％ (2 766/4 708),9.8％ (461/4 708) and 31.4％ (1 481/4 708),males and females were 69.3％ (3 261/4 708)and 30.7％ (1 481/4 708),respectively.Cases older than 45 accounted for 73.2％ (3 444/4 708);the 7 new cases were all nerve cretinism and 5 cases distributed in ethnic minority areas.Conclusions There are potential dangers of endemic cretinism in the high-risk areas of iodine deficiency disorders due to multiple factors in Gansu Province;the nervous cretinism is the majority which is caused by insufficient iodine intake in early maternal pregnancy.To prevent new endemic cretinism,it is necessary to strengthen measures of emergency iodine supplementation for pregnant women and nursing mothers in the high-risk areas.