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Iodine deficiency disorders (IDD) control in India.

Pandav CS, Yadav K, Srivastava R, Pandav R, Karmarkar MG - Indian J. Med. Res. (2013)

Bottom Line: However, an estimated 350 million people do not consume adequately iodized salt and, therefore, are at risk for IDD.The IDD control goal in India was to reduce the prevalence of IDD below 10 per cent in the entire country by 2012.What is required is a "mission approach" with greater coordination amongst all stakeholders of IDD control efforts in India.

View Article: PubMed Central - PubMed

Affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT
Iodine deficiency disorders (IDD) constitute the single largest cause of preventable brain damage worldwide. Majority of consequences of IDD are invisible and irreversible but at the same time these are preventable. In India, the entire population is prone to IDD due to deficiency of iodine in the soil of the subcontinent and consequently the food derived from it. To combat the risk of IDD, salt is fortified with iodine. However, an estimated 350 million people do not consume adequately iodized salt and, therefore, are at risk for IDD. Of the 325 districts surveyed in India so far, 263 are IDD-endemic. The current household level iodized salt coverage in India is 91 per cent with 71 per cent households consuming adequately iodized salt. The IDD control goal in India was to reduce the prevalence of IDD below 10 per cent in the entire country by 2012. What is required is a "mission approach" with greater coordination amongst all stakeholders of IDD control efforts in India. Mainstreaming of IDD control in policy making, devising State specific action plans to control IDD, strict implementation of Food Safety and Standards (FSS) Act, 2006, addressing inequities in iodized salt coverage (rural-urban, socio-economic), providing iodized salt in Public Distribution System, strengthening monitoring and evaluation of IDD programme and ensuring sustainability of IDD control activities are essential to achieve sustainable elimination of IDD in India.

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Related in: MedlinePlus

Decrease in goitre prevalence after salt iodization in the Kangra Valley study (1956-72)22. Prevalence of goiter in 1952 was 40 per cent in all the three zones. In zone B (Control group), intervention (iodized salt) was done in 1962.
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Figure 1: Decrease in goitre prevalence after salt iodization in the Kangra Valley study (1956-72)22. Prevalence of goiter in 1952 was 40 per cent in all the three zones. In zone B (Control group), intervention (iodized salt) was done in 1962.

Mentions: Salt-iodization as an intervention to address goiter, the then well recognized and more visible manifestation of iodine deficiency was first initiated in United States of America (USA) and Switzerland in 1920s21. India was one of the first countries in the world to start a public health programme to address iodine deficiency disorders based on salt iodization. A landmark study in Kangra Valley region, Himachal Pradesh was conducted by Ramalingaswami and his team from 1956 to 197222. This community based intervention study clearly demonstrated the effectiveness of iodized salt in reducing goitre prevalence in Kangra Valley. The study area was divided into three geographically distinct zones, Zone A, Zone B and Zone C. Salt was fortified with either potassium iodate (Zone A) or potassium iodide (Zone C), to deliver 200 micrograms of iodine to each study participants. Zone B was the control area and received non-iodized salt. A progressive and significant decline in prevalence of goiter was observed in Zone A and Zone C populations by 1962. (Fig. 1) Additionally, the pattern of iodine metabolism in this population returned to within normal limits in contrast to the “control” population that did not consume iodized salt. From 1962 onwards, iodized salt was provided to Zone B, the control population also. Subsequent checks in 1968 and 1972 demonstrated a decline in goiter-prevalence in this population as well, which was directly attributable to the introduction of iodized salt in the diet. The results of this study have been supported by evidence from other international community-based intervention programmes as well2324. These studies from United States and Switzerland clearly showed a causal link between daily consumption of iodized-salt and reduction in prevalence of goiter.


Iodine deficiency disorders (IDD) control in India.

Pandav CS, Yadav K, Srivastava R, Pandav R, Karmarkar MG - Indian J. Med. Res. (2013)

Decrease in goitre prevalence after salt iodization in the Kangra Valley study (1956-72)22. Prevalence of goiter in 1952 was 40 per cent in all the three zones. In zone B (Control group), intervention (iodized salt) was done in 1962.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3818611&req=5

Figure 1: Decrease in goitre prevalence after salt iodization in the Kangra Valley study (1956-72)22. Prevalence of goiter in 1952 was 40 per cent in all the three zones. In zone B (Control group), intervention (iodized salt) was done in 1962.
Mentions: Salt-iodization as an intervention to address goiter, the then well recognized and more visible manifestation of iodine deficiency was first initiated in United States of America (USA) and Switzerland in 1920s21. India was one of the first countries in the world to start a public health programme to address iodine deficiency disorders based on salt iodization. A landmark study in Kangra Valley region, Himachal Pradesh was conducted by Ramalingaswami and his team from 1956 to 197222. This community based intervention study clearly demonstrated the effectiveness of iodized salt in reducing goitre prevalence in Kangra Valley. The study area was divided into three geographically distinct zones, Zone A, Zone B and Zone C. Salt was fortified with either potassium iodate (Zone A) or potassium iodide (Zone C), to deliver 200 micrograms of iodine to each study participants. Zone B was the control area and received non-iodized salt. A progressive and significant decline in prevalence of goiter was observed in Zone A and Zone C populations by 1962. (Fig. 1) Additionally, the pattern of iodine metabolism in this population returned to within normal limits in contrast to the “control” population that did not consume iodized salt. From 1962 onwards, iodized salt was provided to Zone B, the control population also. Subsequent checks in 1968 and 1972 demonstrated a decline in goiter-prevalence in this population as well, which was directly attributable to the introduction of iodized salt in the diet. The results of this study have been supported by evidence from other international community-based intervention programmes as well2324. These studies from United States and Switzerland clearly showed a causal link between daily consumption of iodized-salt and reduction in prevalence of goiter.

Bottom Line: However, an estimated 350 million people do not consume adequately iodized salt and, therefore, are at risk for IDD.The IDD control goal in India was to reduce the prevalence of IDD below 10 per cent in the entire country by 2012.What is required is a "mission approach" with greater coordination amongst all stakeholders of IDD control efforts in India.

View Article: PubMed Central - PubMed

Affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT
Iodine deficiency disorders (IDD) constitute the single largest cause of preventable brain damage worldwide. Majority of consequences of IDD are invisible and irreversible but at the same time these are preventable. In India, the entire population is prone to IDD due to deficiency of iodine in the soil of the subcontinent and consequently the food derived from it. To combat the risk of IDD, salt is fortified with iodine. However, an estimated 350 million people do not consume adequately iodized salt and, therefore, are at risk for IDD. Of the 325 districts surveyed in India so far, 263 are IDD-endemic. The current household level iodized salt coverage in India is 91 per cent with 71 per cent households consuming adequately iodized salt. The IDD control goal in India was to reduce the prevalence of IDD below 10 per cent in the entire country by 2012. What is required is a "mission approach" with greater coordination amongst all stakeholders of IDD control efforts in India. Mainstreaming of IDD control in policy making, devising State specific action plans to control IDD, strict implementation of Food Safety and Standards (FSS) Act, 2006, addressing inequities in iodized salt coverage (rural-urban, socio-economic), providing iodized salt in Public Distribution System, strengthening monitoring and evaluation of IDD programme and ensuring sustainability of IDD control activities are essential to achieve sustainable elimination of IDD in India.

Show MeSH
Related in: MedlinePlus