Das D K, Chakraborty I, Biswas A B, Sarkar G N, Shrivastava P, Sen S
Department of Community Medicine, R.G.Kar Medical College and Hospital, Kolkata.
Indian J Public Health. 2005 Apr-Jun;49(2):68-72.
Iodine deficiency disorders (IDD) are major public health problems in India, including West Bengal. Existing programme to control IDD needs to be continuously monitored through recommended methods and indicators. Thus we undertook the study to assess the prevalence of goiter, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level in Dakshin Dinajpur district, West Bengal. We conducted a community-based, cross-sectional study in 2004; among 2250 school children, aged 8-10 years. The '30 cluster' sampling methodology and indicators for assessment of IDD, as recommended by the joint WHO/UNICEF/ICCIDD consultation, were used for the study. Goitre was assessed by standard palpation technique, UIE was analyzed by wet digestion method and salt samples were tested by spot iodine testing kit. Of the 2250 children, 419 (18.6%) had goitre (95% CI = 17.0 - 20.2%). Total goitre rate (TGR) was not significantly different in respect of gender, age and religion. Visible goitre rate was 2.5%. Median urinary iodine excretion level was 16 mcg/dL (normal: > or = 10 mcg/dl.) and 16.5% children had value less than 5 mcg/dL. Only 67.4% of the salt samples tested had adequate iodine content of > or = 15 ppm, with significant difference between Hindus and Muslims (chi2 = 12.68, d.f. = 1, p < 0.01). TGR of 18.6% indicate the district is still endemic for IDD, but median urinary iodine within normal range reflects no current iodine deficiency. The district is in the transition phase from iodine-deficient to iodine-sufficient. Measures are to be sustained for successful transition towards elimination.
碘缺乏病(IDD)是包括西孟加拉邦在内的印度主要公共卫生问题。现有的控制碘缺乏病计划需要通过推荐的方法和指标进行持续监测。因此,我们开展了这项研究,以评估甲状腺肿的患病率、尿碘排泄(UIE)水平状况,并估计西孟加拉邦达克辛迪纳杰布尔地区家庭层面盐的碘含量。2004年,我们在2250名8至10岁的学童中进行了一项基于社区的横断面研究。采用了世界卫生组织/联合国儿童基金会/国际控制碘缺乏病理事会联合磋商推荐的“30个群组”抽样方法和碘缺乏病评估指标进行研究。通过标准触诊技术评估甲状腺肿,采用湿消化法分析尿碘排泄,并用碘快速检测试剂盒检测盐样本。在2250名儿童中,419名(18.6%)患有甲状腺肿(95%置信区间 = 17.0 - 20.2%)。甲状腺肿总患病率(TGR)在性别、年龄和宗教方面无显著差异。可见甲状腺肿患病率为2.5%。尿碘排泄中位数水平为16微克/分升(正常:≥10微克/分升),16.5%的儿童数值低于5微克/分升。所检测的盐样本中只有67.4%的碘含量充足,≥15 ppm,印度教徒和穆斯林之间存在显著差异(卡方 = 12.68,自由度 = 1,p < 0.01)。18.6%的甲状腺肿总患病率表明该地区碘缺乏病仍为地方性流行,但尿碘中位数在正常范围内反映目前不存在碘缺乏。该地区正处于从碘缺乏向碘充足的过渡阶段。为成功过渡到消除碘缺乏病,各项措施需持续实施。