Murdoch D R, Harding E G, Dunn J T
Kunde Hospital, Solukhumbu District, Nepal.
N Z Med J. 1999 Jul 23;112(1092):266-8.
To assess the current status of, and understanding about iodine deficiency disorders among Sherpa residents of the Khumbu region of Nepal, 25 years after the introduction of iodised oil injections.
Several groups of Khumbu Sherpas were studied and goitre rate, urinary iodine level and cretinism prevalence were measured as indicators of iodine deficiency. Subjects were also questioned in detail about their food consumption, with particular reference to salt use, and about their understanding of the causes and treatment of iodine deficiency disorders.
The prevalences of goitre, deaf-mutism and cretinism were 21%, 1.3% and 0.5% respectively (compared to 92%, 4.7% and 5.9% in 1966). No cretins had been born since 1966. The median urine iodine concentration was 35 microg/L. Most people preferred uniodised Tibetan rock salt, although 44% regularly consumed iodised salt. All granulated salt tested from the local market contained adequate amounts of iodine. Only 11% of those surveyed knew that goitre was caused by iodine deficiency
Although prevalences of iodine deficiency disorders are much less than 30 years ago, iodine deficiency continues to be a major problem in Khumbu and demands a clear control strategy, combining ongoing iodine supplementation and education. Iodised salt is usually the best approach to control of iodine deficiency disorders for most regions of the world but the Khumbu experience shows that local cultural and commercial factors can severely limit its impact. To be successful, control programme for iodine deficiency disorders also needs assessment of the salt trade, monitoring, education and occasional targeted interventions with iodised oil or other supplements.
在引入碘油注射25年后，评估尼泊尔昆布地区夏尔巴居民碘缺乏病的现状及认知情况。
对几组昆布夏尔巴人进行了研究，测量了甲状腺肿率、尿碘水平和克汀病患病率作为碘缺乏的指标。还详细询问了受试者的食物消费情况，特别是盐的使用情况，以及他们对碘缺乏病病因和治疗的了解。
甲状腺肿、聋哑症和克汀病的患病率分别为21%、1.3%和0.5%（相比1966年的92%、4.7%和5.9%）。自1966年以来没有出生过克汀病患者。尿碘浓度中位数为35微克/升。大多数人更喜欢未加碘的藏岩盐，尽管44%的人经常食用加碘盐。从当地市场检测的所有粒状盐都含有足够的碘。只有11%的受访者知道甲状腺肿是由碘缺乏引起的。
虽然碘缺乏病的患病率比30年前低得多，但碘缺乏在昆布地区仍然是一个主要问题，需要一项明确的控制策略，将持续的碘补充和教育结合起来。加碘盐通常是世界上大多数地区控制碘缺乏病的最佳方法，但昆布地区的经验表明，当地的文化和商业因素会严重限制其影响。要取得成功，碘缺乏病控制项目还需要对盐贸易进行评估、监测、教育以及偶尔使用碘油或其他补充剂进行有针对性的干预。
