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India

Iodine

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EPIDEMIOLOGICAL DATA
Goiter  
Most Recent Goiter Survey

DISTRICT SURVEYS FOR TOTAL GOITER RATES ARE CONDUCTED UNDER THE NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP). THIS IS AN ON-GOING PROCESS AND OUT OF 582 DISTRICTS IN THE COUNTRY 310 HAVE BEEN SURVEYED AND 253 OF THEM FOUND TO BE ENDEMIC. SURVEYS WERE INITIALLY CONDUCTED AS EARLY AS IN THE SIXTIES AND CONTINUE TILL DATE. AS PER DESIGN, IT WAS ENVISAGED THAT RE-SURVEYS WOULD BE CONDUCTED AFTER 5 YEARS TO MEASURE THE CHANGE IN TGR.  

THESE SURVEYS ARE CONDUCTED EITHER BY THE DIRECTORATE GENERAL OF HEALTH SERVICES, GOVERNMENT OF INDIA OR THE STATE GOVERNMENT. 

THE SAMPLING METHOD (DESCRIBED UNDER 2 BELOW) FOLLOWED FOR THESE SURVEYS WILL PROVIDE DETAILS OF AREA AND POPULATION COVERAGE. 

IN ADDITION TO THE GOVERNMENT DATA, THREE NATIONAL INSTITUTIONS, VIZ., INDIAN COUNCIL OF MEDICAL RESEARCH, NATIONAL INSTITUTION OF NUTRITION AND ALL INDIA INSTITUTE OF MEDICAL SCIENCES, HAVE BEEN INVOLVED IN COLLECTING DISTRICT WISE AND STATE WISE DATA SINCE THE 1950s.  

A RECENT EFFORT BY THE INDIAN COUNCIL OF MEDICAL RESEARCH HAS PUT TOGETHER REFERENCES OF RESEARCHES AND STUDIES DONE ON IDD AS A PART OF THEIR COMPILATION “MICRONUTRIENT PROFILE IN INDIAN POPULATION”. THIS PROVIDES REFERENCES AND SUMMARY OF PUBLISHED AND UNPUBLISHED WORK ON IDD.  A DRAFT REPORT HAS BEEN PUT TOGETHER. 

CURRENTLY, EFFORTS ARE ON BY MICRONUTRIENT INITIATIVE AND INTERNATIONAL COUNCIL FOR CONTROL OF IODINE DEFICIENCY DISORDERS TO COMPILE ALL RELATED PUBLICATIONS THAT COME WITHIN THE CATEGORY OF “GREY” LITERATURE.
Date:
Groups Surveyed:
Sample Size:
Sampling Method: GOITER SURVEY IS CONDUCTED ON A RANDOM SAMPLING BASIS. FOR THE PURPOSE OF PLANNING THE SURVEY, SAMPLES ARE COLLECTED AS FOLLOWS:

5% OF ALL CATEGORIES OF SCHOOL CHILDREN, BOTH BOYS AND GIRLS IN EQUAL PROPORTION, FROM ALL SCHOOLS IN EACH BLOCK OF THE DISTRICT

1% OF THE VILLAGE POPULATION - ALL AGES AND BOTH SEXES IN EACH BLOCK OF THE DISTRICT

Estimated Goiter Prevalence:
Area Group Sample Size Prevalence Est. Pop. Affected
         
         
         
         
         
         
         
         
 

 

Urinary Iodine
Most Recent Urinary Iodine Survey - Same as goiter survey
 
Estimated IDD Prevalence:
Area Group Sample Size Prevalence Est. Pop. Affected
         
         
         
         
         
         
         
         
 
TSH - Has not been measured
 
 
 
 

POLICY AND LEGISLATION
 

Legislation on IDD
    
    
 
Government Agency to Address IDD
    
    
   
     

PROGRAM DATA
Supplementation
    
Fortification
Production and Importation of Salt
    
    
    
    
Retail
   
 
Household Consumption
    
      
  * Source: Activity report of IDD program, 2000.
 
Iodized Salt Surveys

    

In 2000, producers, retail and households were surveyed.
Survey Results

 

Survey Level

(producer/ retail/ household)

 

Date of Survey

 

Geographic area/ other grouping

 

Sample size

 

Sampling Method

%  of samples from 35 - 45 ppm

% of samples with  > 30 ppm

Average and/or Range of Iodine Content

Household

2000

National

27450

15 HH's x 30 communes x 61 provinces

81.9% (>20ppm)

    

Retail

2000

National

256

206 local stock

  

73.1 %

  

Producer

2000

National

238

4-5 x's per producer

47.5 %

  

35 - 45 ppm

(Note: good iodized salt levels at household is >20ppm, at Retail is> 30ppm, and at producers is from 35-45ppm.)
Other Programs Related to Control of IDD
Mass Media Campaigns
    

Film and video cassettes about control activities to prevent IDD are distributed to the health center network.  There is also a project on the central television.

Community-Based Programs
     There is training of local staff about IDD.
   
 
 
MONITORING
 
Salt Iodine
Current monitoring activities for iodine levels in salt
     First each producer must check and guarantee their quality control.  Second, the national program committee periodically checks the salt iodine levels at the producer, retail and household levels.
     The surveys described above are being repeated. 
     Monitoring at the community level is done with UNICEF field test kits.
    

IDD Indicators
     Lab facilities are available at academic and research institutions, e.g. Medical Research Council (MRC) and the South African Institute of Medical Research.
     There will be monitoring of the goiter rate via repeating the afore-mentioned surveys.  This depends on the availability of funds from the government and NGO's.
     
     
PROGRAM RESOURCES
 
Donor and Implementing Agencies Involved in IDD Programs
     CEMUBAC (Belgium), Australia, UNICEF, WHO are external groups involved in IDD programs.  External funds are provided from UNICEF and Australia.
     The National IDD project receives US$ 1,000,000 per year from the Vietnamese government.