ABSTRACT
Introduction: Iodine deficiency disorders (IDD) have remained an unresolved public health problem in India. In this survey, we have estimated the prevalence of IDD among 6-12 years of school children in rural areas of north Karnataka, India and estimated the prevalence of low iodine content (<15 ppm) in salt at the household level and urine iodine excretion in this population. Material and Methods: In this cross-sectional survey, we recruited 16,827 children between 6 and 12 years of age through multistage sampling from six districts. Goitre was examined clinically for all children. Household-level salt iodine estimation and urinary iodine estimation were carried out among a subset of the participants. Results: Overall prevalence of goitre was 17.1% (95% CI: 16.5, 17.7). Out of this, 76.7% (n = 2116) had Grade-1 goitre, and 23.7% (n = 656) had Grade-2 goitre. The prevalence of goitre was higher among females (17.9%, vs. male 16.4%, P < 0.05). The prevalence of low iodine content (<15 ppm) in salt was 48.5% (95%CI: 46.7, 50.3). The overall median iodine excretion in urine was 85 µg/L (IQR: 60-150 µg/L). In total, 37.2% (n = 601) had mild iodine deficiency, 5.2% (n = 84) had moderate deficiency, and 10.1% (n = 163) had severe deficiency. All parameters showed high inter- and intradistrict variations. Conclusion: North Karnataka has a high goitre prevalence. Low use of iodized salt can be a major reason for the high prevalence of the condition. Ensuring the availability of iodized salt in this region and periodic surveillance to measure the impact of the programme should be the priority in this region.
ABSTRACT
BACKGROUND: In India, 800,000-900,000 people will die annually due to diseases attributable to tobacco. The government of India has taken several measures, including legislation to control tobacco intake. Display of pictorial warnings on tobacco products was one of the legislative measures taken under The Cigarettes and Other Tobacco Products Act (COTPA) enacted in 2003, intended to discourage the consumption of tobacco. OBJECTIVES: 1) To study the factors influencing awareness among tobacco consumers about the pictorial warnings used on tobacco products; 2) To study the impact of the current pictorial warnings on tobacco consumers. MATERIALS AND METHODS: A cross sectional study was conducted from January 2011 to June 2011 at Bellary city, Karnataka. Data were collected with pre-tested and pre-designed semi-structured proforma. Univariate and multivariate analyses were conducted using Epi-info version 3.4.3. RESULTS: In our study out of 600 subjects 435 (72.5%) had seen the pictorial warnings. Among them 111 (25.5%) had interpreted correctly and 63 (14.5%) had given a thought/ tried to reduce or quit tobacco consumption. Younger age group, better educational status, people from urban area, upper socio economic class, lesser duration (< 5 years) of tobacco usage were found to have significant association with awareness about pictorial warnings on tobacco products. However, the impact of pictures on reducing/quitting tobacco consumption was very low. CONCLUSION: Awareness and its impact on tobacco consumption are poor among our study subjects. There is an urgent need for reconsideration for more effective pictorial warnings.
