Chapter 132 - Nutritional, Endocrine and Pathological Aspects of Iodine Deficiency Disorders in India

Abstract

Iodine deficiency disorders (IDD) continue to be a public health problem in India. It is estimated that more than 200 million people are at risk of IDD. The introduction of iodized salt in India has resulted in a significant decline in the prevalence of goiter, cretinism and neonatal hypothyroidism, underscoring the benefit of the universal salt iodization initiative. The problem of residual goiter needs more attention, because only a proportion of it can be explained by thyroid autoimmunity and identifiable environmental goitrogens. India has an annual production capacity of more than 12400000 MT against the current requirement of 5000000 MT for the entire country. The annual production of iodized salt was raised from 500000 MT in 1985–1986 to 4980000 MT in 2005–2006. To ensure usage of iodized salt, a central ban on the production of noniodized salt meant for human consumption has been reinstated with effect from May 2006. The NIDDCP is included in the 20-point program of the prime minister. For effective monitoring and proper implementation of the NIDDCP, the states and union territories have been advised to establish an IDD control cell in their State Health Directorates. Presently, 31 states and UTs have established such cells. Four regional IDD monitoring laboratories have been established at the National Institute of Nutrition (NIN) in Hyderabad for the south, All India Institute of Hygiene and Public Health, in Kolkata for the east and northeast, AIIMS, in New Delhi for the west, and NICD, in Delhi for the north. Severely endemic areas have a high prevalence of cretinism, other neurological dysfunctions and intellectual impairment. The prevalence of these manifestations declines sharply after implementation of an iodization program. While goiter rates also decline with iodine supplementation, several reports suggest the persistence of endemic prevalence of goiter several years after iodine supplementation.