IODINE DEFICIENCY DISORDERSAND CONTROL MEASUREMENT

IN WEST BENGAL , INDIA

D. Dutta Consultant (NPPCF)

M. Sc (Microbiology) , M. Sc (Nutrition) Master of Social Science (M.S.W)

Research Scholar (Food & Nutrition Science)

National Iodine Deficiency Disorders Control

Index of Today's Presentation

Part A: • About National Iodine Deficiency Disorders Control Programme.

• Part B:• Facts about Iodine and Iodized Salt.

• Part C:• West Bengal State at a Glance.

• Part -A

• About National Iodine Deficiency Disorders Control Program

National Iodine Deficiency Disorders Control Programme

National Iodine Deficiency Disorders Control Programme

GOALS :As per 11th Five Year Plan, Govt. of India• To Reduce the prevalence of Iodine Deficiency Disorders below 10% in

the entire country by 2012 • Achieve Universal Access to Iodized Salt • But now GOALS as per 12th Five Year Plan, Govt. of India . a)-To reduce the prevalence of Iodine Deficiency Disorder(IDD)below 5% in

the entire country by 2017 AD. b) 100% Coverage of consumption of iodized salt at household level.

Objective -• 1-surveys to assess the magnitude of IDD.• 2)-Supply of Iodated salt in place of common salt.• 3)-Resurvey after every 5 years to assess the

extent of IDD and The impact of iodated salt.• 4)-Laboratory monitoring of iodated salt and

urinary excretion estimation.• 5)-Health Education and publication

• Spectrum of Iodine Deficiency Disorder• Foetus:1. Abortions2. Still Births3. Congenital Anomalies4. Increased PNMR5. Neurological Cretinism 6. Myxedematous Cretinism

Spectrum of Iodine Deficiency Disorders

Neonate:-• Neonatal Goitre• Neonatal Hypothyroidism Child & Adolescent:-• Juvenile Hypothyroidism• Impaired Mental Function• Retarded Physical development Adult:-• Goitre with its complication• Hypothyroidism• Impaired Mental Function

Iodine Deficiency – A Disease of The Soil

Effect on people : HUMANS Health ,Socioeconomic impact

Effect on animals : LIVESTOCK Clinical & Reproductive disorders, decreased productivity

Low Availabilityof iodine : PLANTS Iodine poor feeds & fodders

Soil Erosion : WATER, SOIL Environmental iodine deficiency

Brain Cell Growth

Iodine Deficiency Iodine Sufficiency• Iodine Deficiency is the single most common

cause of preventable mental retardation

Iodine Deficiency & Learning Abilities

• School age children living in iodine deficient environment on an average, have 13 I.Q. points less than those living in iodine sufficient environments.

IDD

Historic ViewIodine Deficiency = Goitre =

Visible Swelling

No Pain = Not a cause of Mortality = Cosmetic problem

Cretinism rare

Current VIEW: • Mental & Physical growth retardation• Loss of Energy-hypothyroidism• Learning Disability, Poor Motivation• Child Development and Child Survival• Human Resource Development

IDD Prevalence Indicators and Criteria for classifying IDD as significant public health problem

• Indicator Mild Moderate Severe

• Goitre Grade >0 5-19.9% 20-29.9% >30%

• Urine Iodine 50-99 20-49 <20 Excretion (Microgram/L)

Part -BFacts about Iodine & Iodized SaltWhat is Iodine?• Iodine is an essential micronutrient supporting some of the most vital

functions of the human body. What is Iodated Salt.?• Iodated salt is common salt containing minute quantities of an iodine

compound• Iodated salt looks, tastes and smells exactly like ordinary salt. • The Govt. of India has issued notification banning the sale of non iodized

salt for direct human consumption with effect from 17th May, 2006. How much Iodine does a person normally need? • The average daily adult requirement is 150 micrograms• Average lifetime’s requirement of an individual less than a teaspoonful.

From where do we normally get Iodine?

• Present in its natural state in the soil and in water.

• Normal requirement comes from crops grown on iodine-rich soil.

• When the soil lacks iodine, crops grown on that soil are deficient in this essential micronutrient.

• People who live on iodine-deficient land and eat its crops regularly, do not get their daily requirement of this essential element.

How do we know if salt contains Iodine?

• A low cost testing kit is available which allows to test for the iodine content of the salt on the spot.

Part - CWest Bengal State at a Glance -Surveys to assess the magnitude of IDD— IDD survey performed(from2001to2007yr.)in7districts(Malda,Birbhum,D.Dinajpur, N.24Pgns,Howrah,Purulia, Purba Mediniupur) out of 19 districts of West Bengal

found TGR more than 10% (range 11.5% to 25.90%).From 2010 to 2011 yr survey performed in Darjeeling, CoochBehar,Jalpaiguri

districts also found TGR>10%.• After then no Survey/Resurvey done. Salt Testing Reports with the help of Salt Testing Kits -• Performed from 2005 to Oct.2010yr.• 77.45% of salt samples found standard , out of 376285 no. of salt samples

during those yrs. Now salt testing will be performed in 8(eight) endemic districts (Darjeeling,

Coochbehar, Jalpaiguri, Malda, Birbhum,U.Dinajpur, N.24Pgns,Howrah) with ASHA(S).

IEC OF NIDDCP

• Observation of GLOBAL IDD PREVENTION DAY (21st Oct) Performed.• Establishment of IDD CONTROL CELL (STATE) is under process• IDD monitoring Lab. (state level) is already established• Resurvey of IDD will start in 4 districts namely Howrah, Birbhum, Malda ,North 24

Pgns. • I.E.C. activities and Health Education are to be performed in all districts of West

Bengal with following messages- At State level Programme-1) To promote awareness of Iodine Deficiency Disorders and benefits of iodated salt

intake.2) To assess the IDD magnitude of various districts in W.B. 3) To monitor adequacy of iodization of salt & adequacy of iodine deficiency. At District level Programme-1) Co-ordination of various activities under NIDDCP with Blocks by Dy CMOH-II (Nodal

Officer of NIDDCP in district).2) Training of Health Personnels oni) Goitre Detection ii) Salt Iodine Examination by salt testing kits.

I.EC OF NIDDCP

• At block Level-1) Role of Iodine in maintenance of health.2) Source of Iodine in diet. 3) Role of Iodine in pregnancy.4) Testing of Iodine in common salt and its preservation at household level.5) Role of ASHAs in community awareness. Conclusion by giving ASHA Card to ASHAs with information on Iodine Deficiency

Disorder.ASHA CARD--

1) Take always Iodized salt in diet.2) Keep Iodized salt in safe airtight pot.

3) Take Iodized salt in diet for having healthy baby/child.4) Iodized salt helps to develop your child’s Brain & I.Q.

.

Thank you.

INTRODUCTION:• Essential micronutrient• Average daily requirement of 100-150 microgram• Environmental Iodine deficiency • Out of 321 districts surveyed in all the 28 States and 7 UTs, 260 districts are endemic ie where the prevalence of Iodine Deficiency Disorders (IDDs) is more than 10% • 71 million persons are suffering from Iodine Deficiency Disorders • Disorders include abortions, stillbirth, mental retardation, dwarfism, deaf mutism, squint, goitre and neuromotor defects

OBJECTIVES: Surveys to assess the magnitude of IDD Supply of Iodated Salt in place of common salt Resurveys to assesss IDD and impact of iodated salt after every 5 years Laboratory monitoring of iodated salt & urinary iodine excretion Health education & publicity GoI launched National Goitre Control Program (NGCP) in 1962 In August 1992, NGCP was renamed as National Iodine Deficiency Disorder Control Program (NIDDCP)