Bali Surya, Nayak Pritish Kumar
Department of Community and Family Medicine, All India Institute of Medical Sciences Bhopal, Madhya Pradesh, India.
Independent Public Health Consultant, Madhya Pradesh, Bhopal, India.
Asia Pac J Clin Nutr. 2019;28(2):356-361. doi: 10.6133/apjcn.201906_28(2).0018.
Iodine deficiency disorders (IDD) has been a major public health challenge for the Indian subcontinent over many years. Our study was conducted in Tikamgarh district of Madhya Pradesh, an iodine deficiency disorders-endemic district, with the objective to estimate total goitre rate and iodine nutrition status.
A cross-sectional study with 30 cluster sampling was conducted between June to July 2016 among school-going children in the age group of 6-12 years. Ninety children from each school (30x90=2700) were selected for the assessment of Goitre. Total 540 salt samples and 270 urine samples were collected to estimate salt iodine content from their house-hold and urine iodine excretion (UIE) respectively. A total of 150 households and 30 shopkeepers were interviewed to understand the awareness level for salt iodization.
Goitre rate in Tikamgarh district was 1.9% with prevalence of grade I & II was 1.7% and 0.2% respectively. The median UIE level was 200 mcg/L. The 20% the population had iodine deficiency, 28.9% population had adequate iodine nutrition and 51.1% population had either more than adequate level of iodine. The 72.4% of the population consume adequately iodized salt (>=15 ppm).
Our study concludes that Tikamgarh district is non-endemic for IDDs against the earlier classification as an IDD-endemic district. About 20% population has 'iodine deficiency' and approximately 51.1% population has 'more than adequate iodine intake'. We recommend stringent programme monitoring, undertake periodic assessment of IDD and explore manifestations of excess iodine intake (>=300 mcg/L) such as Iodine-induced hyperthyroidism in future.
多年来，碘缺乏病一直是印度次大陆面临的一项重大公共卫生挑战。我们的研究在中央邦的蒂卡姆加尔区开展，该地区是碘缺乏病流行区，旨在估算甲状腺肿总患病率和碘营养状况。
2016年6月至7月间，在6至12岁学龄儿童中开展了一项采用30个整群抽样的横断面研究。从每所学校选取90名儿童（30×90 = 2700名）进行甲状腺肿评估。共收集了540份盐样本和270份尿样，分别用于估算家庭盐碘含量和尿碘排泄量（UIE）。共采访了150户家庭和30名店主，以了解碘盐加碘知晓水平。
蒂卡姆加尔区的甲状腺肿患病率为1.9%，其中I级和II级患病率分别为1.7%和0.2%。尿碘排泄量中位数为200微克/升。20%的人口存在碘缺乏，28.9%的人口碘营养充足，51.1%的人口碘水平超量。72.4%的人口食用碘含量充足的盐（≥15 ppm）。
我们的研究得出结论，蒂卡姆加尔区并非碘缺乏病流行区，与之前被归类为碘缺乏病流行区的情况不同。约20%的人口存在“碘缺乏”，约51.1%的人口“碘摄入量超量”。我们建议加强项目监测，定期评估碘缺乏病，并在未来探索碘摄入量超量（≥300微克/升）的表现，如碘致甲状腺功能亢进症。
