Coverage Rate Of Iodized Salt Research Articles

Iodine status and knowledge among pregnant and lactating women in Large City in Northern China after nearly 30years of the universal salt iodization.

With the implementation of the universal salt iodization, the iodine nutrition for children and adults has been appropriate, but pregnant women are still at risk of iodine deficiency. It is of great public health significance to explore the iodine status and knowledge, and influence factors and the appropriate health education methods among pregnant and lactating women. From January 2022 to December 2023, at least 50 pregnant women and 50 lactating women were randomly selected from the resident population annually in 16 districts of Tianjin, North China. A total of 1671 pregnant women and 1658 lactating women were recruited. All participants' households salt and random urine samples were collected. A questionnaire was conducted to collect data on iodine related knowledge and behaviors as well as needs of health education from all participants. Logistic regression models were constructed to analyze the factors affecting the iodine related knowledge level. We used the Rasch model and the quadrantal graph to analyze the participants' knowledge level on different iodine-related questions and their needs for health education. The median urine iodine concentration (UIC) of pregnant and lactating women in Tianjin were 152.40 μg/L and 124.60μg/L. In some districts, the median UIC of pregnant and lactating women below the appropriate range. The iodized salt coverage rate of pregnant and lactating women in Tianjin was 76.12% and 77.40%, respectively. In pregnant and lactating women who did not actively supplement with iodine, the median UIC in those who consumed non-iodized salt were significantly lower than that in those who consumed iodized salt (139.26μg/L and 154.40μg/L, P = 0.044; 94.60μg/L and 123.80μg/L, P < 0.001). Compared with the low knowledge score group, pregnant women in the high knowledge score group had a higher proportion of iodized salt consumption (71.25% and 78.05%, P = 0.003), and pregnant and lactating women in the high knowledge score group had a higher proportion of actively supplement iodine (44.61% and 55.34%, P < 0.001; 39.26% and 49.78%, P < 0.001). Health education may be the main factor affecting the iodine related knowledge scores for pregnant and lactating women, with adjusted odds ratios (OR) and 95% confidence intervals (CI) of 2.89 (2.30, 3.62) and 2.46 (1.97, 3.07), respectively. Pregnant and lactating women are most expected to acquire knowledge through healthcare professionals (72.11%) and wechat/website (74.91%), respectively. Pregnant and lactating women in some areas of Tianjin are at risk of iodine deficiency. Iodized salt consumption is an important way to ensure iodine nutrition of the population, and the lack of iodine related knowledge is an important factor affecting the consumption of iodized salt. Health education in different ways can be carried out for different people to improve the acceptance and efficiency of health education.

Iodine Excess May Lead to Low Exam Score in Children Aged 8-10 Years.

Recent research has shown that iodine excess may damage children's intelligence. Years of monitoring results in Shanghai show the iodine status has approached the upper limit of the appropriate range for children aged 8-10years, indicating a risk of iodine excess. We used multi-stage random sampling to select children. Sixteen districts of Shanghai were divided into five units based on geographic location, and one primary school was randomly selected from each unit. In each selected school, about 40 children aged 8-10years were randomly recruited to measure their urinary iodine concentration (UIC), household salt iodine concentration (SIC), the score of the final unified exam of the last semester, and school canteen salt iodine concentration. The median UIC of 3213 children aged 8-10years in Shanghai was 195.4 (122.0, 285.8) µg/L and exceeded 200µg/L in 48.8% of the population. Household and school canteen iodized salt coverage rates were 60.3% and 82.5% respectively, and mean household and school canteen SICs were 21.51 ± 9.30mg/kg and 25.29 ± 3.40mg/kg respectively. By correcting for potential confounding factors, logistic regression demonstrated that compared to the adequate iodine status group, students in the slight iodine excess group were less likely to get "A" (score > 90) in math, Chinese, and English exams (Math: OR = 0.775, 95% CI = 0.660-0.911, P = 0.002; Chinese: OR = 0.707, 95% CI = 0.543-0.842, P < 0.001; English: OR = 0.720, 95% CI = 0.610-0.849, P < 0.001). In Shanghai, the iodine status of 8-10-year-old children is approaching the upper limit of the adequate range. Iodine excess in Shanghai may lead to low exam scores for students.

Iodine in household cooking salt no longer plays a crucial role in iodine status of residents in Tianjin, China.

The contribution of household cooking salt to population iodine status is decreasing in China, the applicability of the coverage rate of iodized salt (IS), proportion of adequately iodized salt (AIS), and salt iodine concentration (SIC) of household cooking salt used for iodine status assessment of residents requires further investigation. Through the IDD control project, 16,445 children and 4848 pregnant women were recruited from Tianjin, China and the relationship between the coverage rate of IS, proportion of AIS, SIC, and population iodine status was analyzed. Additionally, through the thyroid health survey project, 856 children with IS or noniodized salt were recruited. The effects of different household cooking salts on individual iodine status and thyroid health were analyzed. After adjusting for confounding factors, no relationship was found between the coverage rate of IS, proportion of AIS, SIC of household cooking salt, and iodine status of children and pregnant women (all P > 0.05). No differences in levels of thyroid function and structural indicators were found in children with different household cooking salts (all P > 0.05). Additionally, no relationship was found between noniodized salt exposure and goiter, overt hyperthyroidism, overt hypothyroidism, thyroid nodules, antibody single positivity, or subclinical hypothyroidism (all P > 0.05). Iodine in household cooking salt no longer plays a crucial role in iodine status in Tianjin, China. Other indicators must be identified as beneficial supplements for precise iodine status evaluation not only in Tianjin but also in other large cities in China.

Appropriate Range of Median Urinary Iodine Concentration in 8- to 10-Year-Old Children Based on Generalized Additive Model.

Background: The appropriate range of median urinary iodine concentration (MUI) in children has always been controversial. To prevent the occurrence of a goiter epidemic in Shanghai, we explored the appropriate range of MUI by integrating multiple monitoring results. Methods: This study summarized and analyzed the monitoring data from 1997, 1999, 2011, 2014, and 2017 of children living in Shanghai. In each monitoring year, the probability-proportional-to-size sampling technique was used to select 30 sampling units. In each sampling unit, one primary school was randomly selected. From each selected school, 40 children 8- to 10-year-old were randomly recruited to measure thyroid volume (Tvol) and their household salt iodine intake. Results: In 1997, 1999, 2011, 2014, and 2017, MUI of 8- to 10-year-old children was 228, 214, 182, 171, and 183 μg/L, and median Tvol (MTvol) was 2.9, 1.2, 1.0, 1.8, and 2.8 mL, respectively. There was a linear correlation between goiter rate and MTvol (r = 0.95, p = 0.014; 100 × goiter rate = 1.314 × MTvol -1.287). Generalized additive model (GAM) was used to predict MTvol as follows, MTvol = 0.60689 + 0.00302 MUI +0.999928 s (MUI) -0.05172 mean salt iodized concentrations (MSIs) +0.03481 × 100 × iodized salt coverage rate +0.00000969 per capita disposable income +0.271422 s (per capita disposable income) -0.38772 × monitoring year gap. The results revealed that the average relative error between predicted and actual value was 15.2%. GAM results showed that at 27-277 μg/L MUI, the goiter rate was <5%. Conclusions: Iodine status is appropriate in Shanghai. Under the existing economy and MSI, the optimal range of MUI should be 70-277 μg/L in 8- to 10-year-old children living in Shanghai.

The nutritional status of iodine in children and its correlation with thyroid size in Kashi, Xinjiang

Objective To investigate the nutritional status of iodine in children in Kashi and to evaluate the relationship between urinary iodine and thyroid size.Methods Twelve counties in Kashi were investigated.Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry,and iodine in water by arsenic-cerium oxidationreduction method,and iodized salt was tested by direct titration.Type B ultrasonography to determine length and thickness of thyroid gland was performed in selective counties.Result The median water iodine was ＜ 10 μg/L,but with the rise of coverage rate and qualified rate of iodized salt,the median urinary iodine became 177.05 μg/L.The frequency distribution was different among different counties,there were 6 counties (＞20％) being iodine deficient,and 5 counties (＞20％) with iodine excess.Moreover,urinau iodine showed no difference between Uygur and Han,upland and plain,city and countryside.Furthermore,urinary iodine was correlated with right lobe width and thickness (r=0.113,P=0.012; r=0.092,P=0.04).Conclusion The iodine deficient situation is basically corrected in Kashi,however a more refined iodine supplement project is needed to prevent thyroid diseases. Key words: Nutritional status of iodine ; Urinary iodine ; Thyroid size

Iodine deficiency and excess coexist in china and induce thyroid dysfunction and disease: a cross-sectional study.

BackgroundIn spite of the salt iodization, iodine deficiency disorders (IDD) have not been sustainably eliminated in China. There are coastal areas with low iodized salt coverage rates (iodine nutrition is inadequate) and other areas with excessive amounts of iodine in the drinking water.ObjectiveThis study aimed to clarify the association of iodine deficiencies resulting from a low coverage rate of iodized salt, excess iodine intake from drinking water with thyroid function and disease in adults.DesignA cross-sectional study was conducted in adults in different iodine nutrition areas in three provinces in China.ResultsThe prevalence of thyroid nodules was 15.52%, 8.66% and 22.17% in the iodine excess, sufficient and deficient groups, respectively. The prevalence of subclinical hypothyroidism was 20.09%, 10.41%, and 2.25% in the excess, sufficient and deficient iodine groups, respectively. The prevalence of subclinical hyperthyroidism and overt hyperthyroidism in the iodine deficient group was higher than that in the iodine excess group ( = 9.302, p = 0.002) and iodine sufficient group ( = 7.553, p = 0.006). Thyroid-stimulating hormone (TSH) was significantly correlated with excess iodine intake (β = 1.764,P = 0.001) and deficient iodine intake (β = −1.219, P = 0.028).ConclusionsThyroid nodules are more likely to be present in the iodine excess and deficient areas than in the iodine sufficient areas. Subclinical hyperthyroidism and overt hyperthyroidism are more likely to be prevalent in the iodine deficient areas than in the iodine excess or sufficient areas. Subclinical hypothyroidism is more likely to be prevalent in the high iodine intake areas than in the iodine deficient or sufficient areas. Median TSH may be deemed as an alternative indicator for monitoring the iodine nutrition status of the adult population in iodine excess and deficient areas.

Analysis of iodine nutrition of vulnerable population in the high risk region of iodine deficiency disorders in Qinghai province in 2009

Objective To investigate the iodine nutrition level of the vulnerable population in the high risk region of iodine deficiency disorders for providing a scientific basis for the development of effective preventive measures in Qinghai province. Methods The non-iodized salt coverage rate ＞ 5％ of Delingha city, the coverage rate of iodized salt and the rate of qualified iodized salt ≤80％ of Jiuzhi, Wulan, Nangqian, Zaduo, Geermu,Yushu, Gande, Chengduo, and Dulan counties(cities), the median of urinary iodine ＜ 100 μg/L of Huangyuan county of 11 areas were chosen as monitoring area in 2009. Five townships(towns) were selected by their location of east, west, south, north and center in each county (city), and one school was selected in each township (town),and 60 household salt samples were collected in each school, and quantitatively determined by direct titration of iodine(GB/T 13025.7-1999). Three townships(towns) were selected in each county(city), and two schools were selected in each township(town). The content of urinary iodine of 40 children aged 8 - 10 and 20 women of childbearing age aged 18 - 40 was analyzed by As3+-Ce4+ catalytic spectrophotometry (WS/T 107-2006). Results Three thousand two hundred and sixty-one edible salt samples were tested. The coverage rate of iodized salt was 79.88％.The iodized salt qualification rate was 95.16％. The qualified iodized salt consumption rate was 76.02％. The noniodized salt coverage rate was 20.12％. In Nangqian, Zaduo, Yushu and Geermu counties(cities), the non-iodized salt coverage rate was 88.89％, 45.05％, 43.00％ and 12.67％, respectively. The median of urine iodine of 2536 children aged 8 - 10 was 155.8 μg/L, with ≤50 μg/L about 13.6％ (346/2536), ＞ 100 μg/L about 67.5％(1711/2536), and it was 75.1, 94.6 μg/L in Nangqian and Zaduo counties, respectively. The median of urine iodine of 665 women of childbearing age was 129.7 μg/L, with ≤50 μg/L about 22.7％(151/665), ＞ 100 μg/L about 59.2％(394/665), and it was 21.0, 54.7, 72.7 μg/L in Zaduo, Nangqian and Chengduo counties, respectively.Conclusions Insufficient intake of iodine exits in children and women of childbearing age in high risk region of iodine deficiency disorders in Qinghai province, which should be corrected as soon as possible. Key words: Iodine; Deficiency diseases; Urine; Salts; Data collection

Analysis of iodine nutrition of people and serum thyroid hormone levels of women of childbearing age in pasturing areas of Tibet in 2009

Objective To explore the iodine nutrition level of people, prevalence of iodine deficiency disorders and the thyroid function of women of childbearing age in pasturing areas of Tibet. Methods Thirty families were selected respectively in pastoral Dangxiong county and agricultural Qushui county of Lhasa in 2009,drinking water and edible salt samples were collected to test iodine content; at least 50 people from each crowd of the following populations including children aged 8 - 10, women of childbearing age of 18 - 49 old and male adults aged 18 - 60 were randomly sampled and to measure their urinary iodine content and for thyroid palpation. Direct titrimetric method was used to test salt iodine(GB/T 13025.7-1999); As3+-Ce4+ oxidation reduction process to test water iodine (GB/T 5750.1-2006); As3+-Ce4+ catalytic spectrophotometry using ammonium persulfate digestion to test urine iodine(WS/T 107-2006), and goiter examination was based on Diagnostic and Classificatory Criteria of Endemic Goiter (WS 276-2007). Results The median of water iodine was 1.3 μg/L in pasturing area and 0.7 μg/L in agricultural areas, there was no statistical significant difference between them(Z =- 1.809, P ＞ 0.05).There was no iodized salt used in pastoral people, but iodized salt coverage rate was 90.0％(27/30) in agricultural residents. The median of urinary iodine among people of pasturing areas was 50.2 μg/L, lower than that of agricultural areas( 193.2 μg/L, Z =- 10.48, P ＜ 0.01 ). However, the goiter rate in pasturing area[1.0％(1/100)]was significantly lower than that of agricultural areas[18.0％(18/100) , x2 =16.8, P ＜ 0.01]. Serum level of FT4 and TT4 in pastoral population[(14.0 ± 2.0)pmol/L, (85.6 ± 17.5)nmol/L] was significantly lower than that of agricultural areas[(16.2 ± 6.3)pmol/L, (95.4 ± 21.1)nmoL/L, t =- 2.06, - 2.20, all P ＜ 0.05]. The thyroid dysfunction rate[5.9％ (2/34)]and subclinical hypothyroidism rate[2.9％ (1/34)]in pastoral population was significantly lower than that of agricultural areas[25.5％(12/47), 21.3％(10/47), x2 =5.328, 5.651, all P ＜ 0.05]. Conclusions Pastoral areas of iodine intake is significantly lower than the agricultural areas, urinary iodine levels reflect a serious iodine deficiency in pastoral people, but the blood biochemical and urinary iodine and goiter rate does not match,and shows hidden iodine hunger, which does not constitute a goiter epidemic. Key words: Iodine; Deficiency diseases; Urine; Thyroid hormones

Analysis of an investigation results on iodine deficiency disorders in Gansu in 2009

Objective To master the status in control of iodine deficiency disorders (IDD) in Gansu province and to provide the basis for development of control strategies. Methods One county which reached the national standardization of IDD elimination was selected randomly from each of 14 cities of Gansu province in 2009, then one town was selected respectively from five directions (east, south, west, north, and central) of the above selected counties. One village was chosen from every town which was selected for investigating household iodized salt and iodized salt sales network. At the same time the thyroid of children was examined, their urinary iodine (UI) was determined, the intelligence quotient(IQ) values of children were measured and health education was surveyed in one primary school which was chosen in each of the selected town. Results A total of 1420 edible salt samples were tested;the weighted iodized salt coverage rate and the weighted qualified iodized salt rate were 99.53% and 98.15 respectively. Urine samples were collected from 1761 children included in the study. The urinary iodine median was 225.87 μg/L. The urinary iodine medians were at optimal levels in five counties, over the optimal levels in seven counties and at excessive levels in two counties. A total of 3051 children aged 8 - 10 were randomly selected for thyroid examination. The weighted thyroid goiter rate(TGR) of children was 1.9%, and TGR was higher than 5% only in Hoaggu county. IQ of 2815 children was tested and the mean IQ was 105.3, except for the country of Zhuoni and Kangle, the mean IQ of other counties were over 100. The average score of health education was 3.2.Children of 57.08% (1229/2153) knew that iodine deficiency could lead to mental retardation, 71.76% (1544/2153) knew that iodine deficiency could cause thyroid goiter, 68.04%( 1465/2153 ) knew that eating iodized salt was the best method for IDD prevention and control and 61.82%(1331/2153) informed their families of the benefits of eating iodized salt. Each town had one agency selling iodized salt and each village had one more retail store with iodized salt, but 73.5%(75/102) of the stores without license for the sales. Conclusions Great progress has been made on the prevention and control of IDD in Gansu province. The qualified iodized salt consumption rate has reached the national standard for IDD elimination, TGR has decreased markedly, the urinary iodine levels in more counties are over the optimal levels and iodized salt distribution network is basically sound. But progress in health education is uneven. Key words: Iodine ; Deficiency disorders; Goiter, endemic ; Urine; Salts

Analysis of surveillance on iodized salt in Baotou during 2008-2010

Objective To find out the consumption situation of iodized salt in Baotou, identify problems and take appropriate intervention measures, and to provide scientific basis for further consolidating the results of control measures, strengthening and improving the sustainable elimination of iodine deficiency disorders. Methods Three batches of each quarter, 54 salt samples were sampled in Donghe wholesale division and Qingkun wholesale division in Baotou city salt company during 2008 - 2010; each place of Damaoqi, Baiyun district, and Qingshan district were divided into five sampling areas according to the direction of east, west, south, north, and central position, one school was selected in each district, 30 students aged 8 to 10 from each school were selected, and home salt samples were taken, and salt iodine was tested by direct titration(GB/T 13025.7-1999). Results Qualified rate of wholesale iodized salt was 100%(378/378) during 2008 - 2010, and mean salt iodine was 30.4 mg/kg;qualified rate of household iodized salt was 99.8%(2417/2421 ), and mean salt iodine was 30.4 mg/kg; iodized salt coverage rate was 99.6% (2421/2430) and consumption rate of qualified iodized salt was 99.4% (2417/2430).Conclusions Qualified rate of iodized salt, coverage rate of qualified iodized salt and consumption rate of qualified iodized salt are 90% or more, which has reached the standard of sustainable elimination of iodine deficiency disorders. Key words: Iodine; Deficiency diseases; Goiter, endemic; Salts

Iodine deficiency disorders in high-risk areas of Hainan province from 2007 to 2009: an analysis of survey results

Objective To know the prevalence of iodine deficiency disorders(IDD) and the implementation of control measures against the disorders in high-risk areas of Hainan province. Methods Typical sampling principle was used. Eight townships with lower coverage rate of iodized salt were chosen in IDD high-risk counties of Hainan. New cretinism cases were screened among children aged 10 years and under. Intelligence quotient (IQ)value, urinary iodine (UI) concentration and thyroid gland size (by palpation and B ultrasonic) were investigated in children aged 8 to 10 years and questionnaire was also carried out among students from grade 5 in elementary school. Edible salt and urine of women of childbearing age were collected to detect iodine levels, respectively,questionnaire was also carried out among the women of childbearing age. The UI was determined by As3-Ce4+ catalytic spectrophotometer, the salt iodine level was determined using self-quantitative kit. IQ values were measured by the Combined Raven Test in China (CRT-C2). Results Seventy-two townships were investigated in three consecutive years, 7937 children aged 8 to 10 years, 1797 women of childbearing age and 4128 students of grade 5 were included in the survey. One child was diagnosed as suspected new cretinism case. The coverage rate of iodized salt was increased from 44.6%(629/1411) in 2007 to 92.1%(1688/1832) in 2009. The goiter rate was dropped from 5.9% (269/4548), 6.0% (274/4548) in 2007 to 1.6% (24/1461), 0.1% (2/1461) in 2009 bypalpation, and by B-ultrasound, respectively, in children aged 8 to 10 years. The median urinary iodine(MUI) was found to be increased from 97.4 μg/L in 2007 to 165.0 μg/L in 2009, and the percentage of UI less than 50.0 μg/L, and 100.0 μg/L were dropped from 21.4%(973/4548), 51.2%(2329/4548) in 2007 to 7.5 %(110/1461), 23.4%(342/1461) in 2009, respectively. The MUI of women of childbearing age was found to be elevated from 73.7 μg/L in 2007 to 126.1 μg/L in 2009, and the value was also increased from 55.7 μg/L to 121.5 μg/L in pregnant women, but these values were still lower than 150.0 μg/L The pass rate of the questionnaire of IDD controlling among the students of grade 5 and the women of childbearing age was raised from 29.8% (446/1495) ,24.1% (179/742) in 2007 to 65.8%(732/1112), 72.1%(264/366) in 2009, respectively. The mean IQ of children was 90.4±16.0, and the percentage of IQ value less than 69 was 12.6% (1000/7937). Conclusions The diseased state of IDD has improved in the high-risk counties of disorders in Hainan province, but the pregnant women are still iodine deficient. Iodine supplimentation should be promoted among pregnant women. Key words: Iodine; Deficiency disorders; Goiter, Endemic; Data collection

Epidemiological investigation of the village with iodine in drinking water on Qianbian village and the adjacent villages in Xiamen city,Fujian province in 2008

Objective To investigate the current conditions of water iodine,childrens'iodine nutrition and residents'edible circumstance of iodized salt in the villages with high iodine in drinking water and the adjacent three villages in Xiamen city of Fujian province.Methods Four natural villages of Qianbian,Donglian,Dazhong and Dongshan of Xiangan county were chosen as survey spots in 2008.In each village,one running water sample and all well water samples were collected to obtain the benchmark for each location.All children aged 7-13 year in the four villages underwent thyroid palpation and were selected to measure the urine iodine and the salt iodine.The water iodine and urine iodine were determined by As3+-Ce4+ catalytic spectrophotometry digestion,salt iodine was determined by direct titration.Results In four investigated villages,iodine of four running water samples were all 1.5μg/L.The range of 237 well water iodine samples was from 0.1 μg/L to 506.0 μg/L.There were 18.6% (44/237)specimens in which the well water iodine less than 10 μg/L,73.4%(174/237)between 10 μg/L and 150 μg/L and 8%(19/237)more than 150μg/L.The median of urinary iodine was 153.3 μg/L in 79 urine samples,which was 114%(9/79)more than 200μg/L and less than 300μg/L,12.7%(10/79)equal or more than 300 μg/L and less than 500μg/L,7.6%(6/79)equal or more than 500μg/L and less than 800 μg/L in all samples.Seventy-nine students were examined by palpation and the total goiter rate of children measured was 11.4% (9/79).Seventy-one samples of iodine salt were detected and the coverage rate of iodized salt was 77.5%(55/71).Conclusions The well water iodine contents have a wide distribution in the investigated villages.We should enhance the community awareness by educating them on the damage of iodine excess and iodine deficiency. Key words: Water; Iodine; Urine; Epidemiology

Analysis on result of surveillance on edible salt at household level in Hebei province in 2008

Objective To investigate the supply of iodized salt in non-excessive iodine counties and iodine-free salt in excessive iodine counties at household level in Hebei province so as to provide a basis for the prevention and control of iodine deficiency disorders(IDD). Methods According to the national project of IDD surveillance,the county was taken as the elementary sampling unit. The towns and villages were selected by systematic and random sampling in every county and households were chosen by random sampling to collect their edible salt in Hebei province in 2008. The salt iodine content in non-and excessive iodine regions was detected by direct titrition method and semiquantitative method respectively. Results all 48 448 salt samples were collected from 167 non-excessive iodine counties. Weighed by the population of counties,the rate of non-iodized salt was 4.73%. Iodized salt accounted for 95.27%,out of which,96.13% were qualified and the consuming rate of qualified iodized salt was 91.96%. Eighty point eighty three percent(135/167) of the counties covered by iodized salt above 95%,92.81% (155/167) passing rate of iodized salt above 90% and 82.04 (137/167) consuming rate of qualified iodized salt. All 1466 salt samples were collected in 5 counties with excessive water iodine content and the coverage rate of iodine-free salt was 93.25%(1367/1466). Conclusions In a nutshell,the national targets for preliminary elimination of IDD have been achieved in regions of non-excessive iodine of Hebei province. Nevertheless,the coverage rate of iodized salt and qualified iodize salt rate in some counties are still below the national standard. Therefore the prevention and control of IDD need to be strengthened. The supply of iodized salt in excessive iodine regions should be timely stopped. Key words: Iodine; Salts; Data collection; Outcome assessment

Analysis on iodine nutrition status of the target population in areas with low coverage rate of iodized salt in Hebei Province

Objective To investigate the iodine nutrition status of the target population living in the areas with low coverage rate of iodized salt and to provide a basis to prevent and control iodine deficiency. Methods The investigation was carried out in the areas with coverage rate of iodized salt lower than 80%, including 7 counties (city, district). Three townships(sub-district office) were sampled in each county and two elementary schools in each township(sub-district office). Urinary iodine level was measured for 40 children aged from 8 to 10 years old in each elementary school. Drinking water iodine was collected and determined in their living villages. Twenty salt samples were tested for iodine in salt from 20 house which had fertile women, and urine iodine of 10 fertile women were tested in each village. Results Sixty-two water samples were determined and the water iodine was ranged from 5.8 to 272.7 μg/L, of which 3 water samples were equal and more than 150 μg/L. Eight hundred and seventy-two salt samples were collected. The coverage rate of iodized salt was 70.74%(585/827) and the coverage rates were below than 80% in 5 counties (city, district). A total of 1660 children' urine samples were collected, the content of urine iodine ranged from 10.0 to 1088.0 μg/L and the urine iodine median was 173.7 μg/L. Four hundred and thirty-seven urine samples were collected from the fertile women and the urine iodine median was 179.1 μg/L. The iodine level of children and women was the highest in Dongguang County(251.8,273.8 μg/L) while that of Hejian County (130.8,118.7 μg/L) was the lowest. Conclusions Although the iodine nutrition of children and fertile women is appropriate in areas with low coverage rate of iodized salt, we presume from the results that the possibility of iodine deficiency in pregnant and lactating women exists in Hejian and Anping. Key words: Iodine; Nutrition assessment; Salts; Urine; Children; Women

The analyze of study on the condition iodine deficiency disorders in the high risk area of Tibet to focus groups in 2007

Objective To propose prevention and control strategy against iodine deficiency disorders to prevent new cases of endemic cretinism from occurring. Methods In April and August 2007, all the suspected cretinism patients born after the first of January, 1997 were searched for in 16 counties from Lhasa, Shannan, Nyingchi, Qamdo and Xigaze. Meanwhile, 60 children aged 8-10 years were selected in each of the two rural villages of each county chosen. Goiter was examined using palpation and B-ultrasound, urinary iodine was determined, inteligence quotient(IQ) was tested; 30 women of childbearing age from each village chosen underwent urinary iodine test and household salt semi-quantitative detection. Results No new cases of endemic cretinism had been found; Palpation identified goiter at 4.5% (257/5680) in children, B-ultrasound revealed a rate of 4.7% (258/5433). Median of urinary iodine was 159.4 μg/L, the averaged IQ was 78.3±14.5; women of childbearing age had a median urinary iodine of 70.2 μg/L. The coverage rate of iodized salt was 52.8%. Conclusions Goiter rate in children, urinary iodine level meet the standard set for the elimination of iodine deficiency disorders; however, the low IQ children, low coverage of iodized salt and the level of urinary iodine in women of childbearing age are less than desirable. Iodine deficiency disorders prevention and control need to be strengthened. Key words: Iodine; Deficiency diseases; Intelligence tests; Data collection

Analysis of field survey results for iodine deficiency disorders in high-risk areas of China

Objective To investigate the occurrence of new cretinism cases and the prevalence of endemic goiter, and the reason of lower coverage rate of iodized salt in the iodine deficiency disorders(IDD) high-risk areas of China, so as to put forward target prevention measures for these areas. Methods A hundred and one counties from 11 provinces(autonomous regions, municipality), such as Tibet, Qinghai, Xinjiang, Gansu, Ningxia, Sichuan, Hainan, Chongqing, Yunnan, Guangxi, Inner Mongolia, were chosen into the survey by simple random sampling. In the counties of high risk, typical sampling principle was used. In the selected townships, searching for new cretinism cases were carried out in the children under 10 years old, the thyroid volume of children aged 8-10 years old were determined by B-ultrasonography methods and their urinary iodine (UI) were determined by As3-Ce catalytic spectrophotometry, the intelligence quotient(IQ) values of children aged 8-10 years old were measured by the combined Raven Test in China. In the household survey, the housewives were asked to fill in the questionnaire, the iodized salt coverage rates and the UI levels of child-bearing age women were investigated, the salt iodine content was determined using self-quantitative kit. Epi Info software was used to analyze the determination results. Results In the 101 high-risk counties, 249 were diagnosed as new cretinism cases from 4122 suspected cases searched. The goiter rate of children aged 8-10 years old by B-ultrasound was 8.28% (4434/53 541), 44 counties had goiter rates in the range of 5%-20%, 5 counties had goiter rates in the range of 20%-30%, and 3 counties had goiter rates of 30%. The mean IQ of children was 85.44, and the percentage of IQ value less than 70 was 16.52%(8713/52 745). The median urinary iodine(MUI) of children was 154.69 μg/L, the percentage of UI less than 50 μg/L was 17.26% (9069/52 558). Twenty-five counties had a MUI of children less than 100 μg/L. The MUI of housewives was 107.14 μg/L, the percentage of UI less than 50 μg/L was 27.50% (3722/13 534). MUI of housewives in 46 counties were less than 100.0 μg/L. The coverage rate of iodized salt at household level was 77.85%(13 150/16 891). The coverage rate of iodized salt was 52.80%(1585/3002), 44.72% (631/1411) and 72.82% (1850/2506) in Tibet, Hainan and Qinghai, respectively. More than 10% residents of Tibet, Sichuan, Hainan, Gansu and Qinghai complained that iodized salt was not convenient to buy. There were 71.39%(7652/10 719) of observed people ate crude salt. The average price of crude salt price(0.30-1.20 Yuan/kg) was lower than iodized salt(1.20-3.00 Yuan/kg). Conclusions In these IDD high-risk areas, the risk of endemic goiter and cretinism prevalence is threatening. The IDD monitoring should be carried out successively in these high-risk areas. The prevention measures, increasing iodized salt coverage rate and establishing the sustainable mechanism for eliminating IDD should be strengthened. Emergent iodine fortification measure for high risk region people should be implemented as soon as possible, a long term effective mechanism of eliminating IDD should be established. Key words: Iodine; Deficiency diseases; Goiter, Endemic; Data collection

Iodine status and thyroid function of pregnant, lactating women and infants (0-1 yr) residing in areas with an effective Universal Salt Iodization program.

To assess the iodine nutrition and thyroid function of pregnant women, lactating women and infants residing in areas where the Universal Salt Iodization program is in place. Pregnant women, lactating women and infants were selected randomly in the regions where iodized salt coverage rate is more than 90% since 2000. Urine iodine levels of pregnant woman, lactating woman and infants, milk iodine of lactating woman, thyroid-stimulating hormone (TSH) and free T4 of women were tested respectively. Median Urinary Iodine (MUI) of infants, three groups of pregnant women (first, second and third trimester) and two groups lactating women (breastfeeding less than or more than six months) were 233, 174, 180, 147, 126 and 145 microg/L, respectively. Median milk iodine of lactating women was 163 microg/L. Percentage of milk iodine < 150 microg/L of early lactating women was 40% less than that of late lactating women (p < 0.01).There was a positive correlation between urine iodine of infants and milk iodine of lactating women (r = 0.526, p = 0.000). T4 of two women were above or below the reference range. Total 15.4% women's TSH were abnormal. Most of these women's urinary iodine were lower than 150 microg/L. Iodine status of most of the target population for Universal Salt Iodization program is adequate, but iodine deficiency still existed in some. To assure every new life's brain not be damaged by iodine deficiency, iodine status of targeted populations should be monitored and supplements provided according to the monitoring outcomes.