De Benoist Bruno, Delange François
Département de nutrition pour la santé et le développement, Organisation mondiale de la santé, CH 1211 Genève 27, Suisse.
Sante. 2002 Jan-Mar;12(1):9-17.
Iodine deficiency disorders (IDD) is a major public health problem worldwide. WHO estimates that 740 million people are currently affected by goitre. The consequences of iodine deficiency on health are the results of hypothyroidism and the main one is impaired development of foetal brain. IDD is the first cause of preventable brain damage in children. The recommended strategy to correct IDD rests upon salt iodisation. Over the last 20 years, the international community mobilised to eliminate IDD under the leadership of WHO, Unicef and ICCIDD. It resulted in remarkable progress in IDD control, especially in Africa and in South East Asia where the endemic is the most severe. It is estimated that 68% of the populations of affected countries have currently access to iodised salt. However, out of the 130 affected countries, about 30 have no programme. Besides, salt quality control and monitoring of population iodine status are still weak in many countries, thus exposing the population to an excessive iodine intake and subsequently to the risk of iodine-induced hyperthyroidism. In addition, IDD is re-emerging in some countries, especially in Eastern Europe after it had disappeared. In order to reach the goal of IDD elimination, it is important to insist on the sustainability of salt iodisation programmes, which implies an increased commitment of both health authorities and representatives of the salt industry.
碘缺乏病是全球主要的公共卫生问题。世界卫生组织估计，目前有7.4亿人受到甲状腺肿的影响。碘缺乏对健康的影响是甲状腺功能减退的结果，其中主要影响是胎儿大脑发育受损。碘缺乏病是儿童可预防脑损伤的首要原因。纠正碘缺乏病的推荐策略基于食盐碘化。在过去20年里，国际社会在世卫组织、联合国儿童基金会和国际控制碘缺乏病理事会的领导下动员起来消除碘缺乏病。这在碘缺乏病控制方面取得了显著进展，尤其是在非洲和东南亚这些地方病最为严重的地区。据估计，受影响国家68%的人口目前能够获得加碘盐。然而，在130个受影响的国家中，约有30个没有相关计划。此外，许多国家的食盐质量控制和人群碘状况监测仍然薄弱，从而使人群面临碘摄入过量以及随后发生碘致甲状腺功能亢进症的风险。此外，碘缺乏病在一些国家，尤其是在东欧消失后又重新出现。为了实现消除碘缺乏病的目标，必须强调食盐碘化计划的可持续性，这意味着卫生当局和盐业代表要做出更多的承诺。
