Iodine deficiency disorders in Car Nicobar (Andaman and Nicobar Islands).

BACKGROUND: The term 'Iodine deficiency disorders' (IDDs) reflects the spectrum of health effects due to iodine deficiency at all ages. So far, no survey for IDD has been carried out in the Andaman and Nicobar Islands (A&N). Therefore, we aimed to determine the status of IDDs at Car Nicobar Island and to assess the iodine content of salt available for consumption on the island. METHODS: The study population comprised tribal school children between 7 and 18 years of age in government schools of Car Nicobar, A&N. Children were selected from each school by the simple random sampling method using the random number table. The same sampling method was used for each school till completion of the desired sample size for that school. Casual urine samples (in screw-capped plastic bottles for iodine estimation) and blood samples (on No. 3 Whatman filter paper for TSH estimation) were collected from a randomly selected sub-sample of students. Salt samples for iodine estimation were collected from 'captains' (village headman) of each village and the headmasters of the schools and 'canteens' in government retail outlets in the villages. RESULTS: Of the 969 children surveyed, 160 (16.5%) had goitre. The prevalence was significantly more among females (23.6%) than males (9.7%). Analysis of 105 urine samples showed that the median urinary iodine excretion level was 7.0 micrograms/dl. The median TSH values in subjects was 5.7 mU/L. Fifty (82.5%) of the 54 salt samples had adequate iodine (> or = 15 parts per million). CONCLUSIONS: IDDs pose a mild-to-moderate public health problem in Car Nicobar Island. The supply of iodized salt and its iodine content was found to be satisfactory at the time of the study.

Knowledge beliefs and practices regarding iodine deficiency disorders among the tribals in Car Nicobar.

It is estimated that 1,570 million people are at risk of iodine deficiency. Because of the wide spectrum of disorders that IDD includes, and lack of any obvious association between iodine deficiency and its health effects, IDD is not perceived as a major public health problem. For any disease to be effectively controlled, awareness at all levels from community to policy makers is necessary. This study was conducted to assess knowledge, beliefs and practices regarding iodine deficiency Disorders in Car Nicobar districts of Andaman and Nicobar Islands. The population is predominantly tribals involved in coconut plantations. All the village heads of the sixteen villages and parents of 10% of the school children examined for goiter were interviewed. Initial focus group discussions were conducted as no prior knowledge about local names for goitre or other related IDD information was available. The interview schedule was designed in English which was then translated into Hindi and Nicobarese and back translated into Hindi and English. A total of 114 persons were interviewed 60 males, 54 females. The local name for goiter was "Rulo" and 44% felt that it only affected females. No one had correct knowledge of the cause of goiter. About half of the respondents believed that these swellings caused problems. Sixty three (55.3%) of respondents believed that there was treatment, of which 33 said there was medical treatment, 18 respondents said traditional treatment by "LAM-EEN" and 12 felt that both therapies are required. Majority (85%) brought salt samples from the Government canteen. They did not now whether this salt was iodised. Salt was not washed before use and storage practice was satisfactory. The awareness about IDD needs reinforcement. At present the community is a passive participant in the I.D.D. Control Programme.

NATIONAL TUBERCULOSIS CONTROL STRATEGY IN THE POST HIV PERIOD.

The tuberculosis situation in the country is a matter of great concern since the disease has not been contained. The problem has been further compounded by the emerging problem of HIV infection in the country together with development of multi-resistant tubercle bacilli. There is, therefore, a need to change our National Tuberculosis Control Strategy without disturbing the basic infrastructure of the National Tuberculosis Programme. Changes such as reinforcement of the District Tuberculosis Centre, HIV and drug sensitivity testing, giving up of long term chemotherapy, BCG vaccination policy, chemoprophylaxis policy and involvement of Non-Governmental Organisations and general practitioners are suggested.

Health and welfare of the child, mother and the family.

PIP: Women and their male partners may choose to bear fewer children if they expect their offspring to survive into adulthood. Great need therefore exists to reduce levels of perinatal and infant mortality. Maternal-child health (MCH) services are said to be integrated from the highest to the most peripheral level, but pregnant and sick mothers are really the concern of only obstetricians and gynecologists, while sick children are treated by pediatricians. The success of the Integrated Child Development Services has, however, demonstrated that integration can work. Educating mothers is important in India, but MCH care should not be delayed until systems of universal education are established. Instead, support should be given to the implementation of a system of education limited to the key problem of reproduction and MCH established within the framework of supervised maternity. The impact of education under such circumstances will be relatively greater due to the immediacy of having to treat a sick child or the pregnant mother. The author notes the improved status of women in India and considers the future of MCH and family welfare.^ieng

A study of major causes of mortality and their trend from 1921 to 1971 in Pune Cantonment.

PIP: The authors present a study of mortality in Pune cantonment, India, which had a population of around 78,000 in 1971. Data are from death registration records. Changes in mortality by sex and cause are analyzed over time^ieng