|
|
Continued
…
Table
XVIII
Iodine content of
salt samples collected
at beneficiaries level
in different districts in Tamil Nadu
(n=3889)
|
Name of the district |
Iodine content in ppm |
|||
|
N |
<5 |
5-<15 |
15 & more |
|
|
Nagapattinam |
150 |
67(44.7) |
82(54.7) |
1(0.7) |
|
Thiruvarur |
150 |
61(40.7) |
87(58.0) |
2(1.3) |
|
Villupuram |
181 |
85(47.0) |
92(50.8) |
4(2.2) |
|
Virudhunagar |
160 |
88(55.0) |
68(42.5) |
4(2.5) |
|
Tiruvanamalai |
162 |
58(35.8) |
99(61.1) |
5(3.1) |
|
|
150 |
23(15.3) |
122(81.3) |
5(3.3) |
|
Cuddalore |
149 |
71(47.7) |
72(48.3) |
6(4.0) |
|
Thanjavur |
202 |
148(73.3) |
35(17.3) |
9(9.4) |
|
Ramanathapuram |
140 |
13(9.3) |
113(80.7) |
14(10.0) |
|
Perambalour |
150 |
7(4.7) |
126(84.0) |
17(11.3) |
|
Dindigul |
150 |
67(44.7) |
65(43.3) |
18(12.0) |
|
|
130 |
89(68.5) |
24(18.5) |
17(13.1) |
|
Kancheepuram |
200 |
99(49.5) |
70(35.0) |
31(15.5) |
|
|
150 |
39(26.0) |
87(58.0) |
24(16.0) |
|
|
200 |
94(47.0) |
73(36.5) |
33(16.5) |
|
Pudukkottai |
151 |
35(23.2) |
87(57.6) |
29(19.2) |
|
Dharmapuri |
100 |
41(41.0) |
39(39.0) |
20(20.0) |
|
Erode |
150 |
45(30.0) |
69(46.0) |
36(24.0) |
|
Nilgiris |
150 |
22(14.7) |
91(60.7) |
37(24.7) |
|
Trichi |
157 |
48(30.6) |
62(39.5) |
47(29.9) |
|
Namakkal |
207 |
98(47.3) |
47(22.7) |
62(30.0) |
|
Karur |
200 |
57(28.5) |
81(40.5) |
62(31.0) |
|
Thiruvellore |
170 |
88(51.8) |
16(9.4) |
66(38.8) |
|
Sivaganga |
180 |
24(13.3) |
84(46.7) |
72(40.0) |
|
TOTAL |
3889 |
1467(37.7) |
1791(46.1) |
631(16.2) |
Figures in parenthesis denote percentages
INA= Information not available
*
Done by STK
Table
XIX
Iodine content of
salt samples collected
at traders level in different districts in Tamil Nadu (n=256)
|
Name of the district |
Iodine content in ppm |
|||||
|
Village market |
District market |
|||||
|
N |
<15 |
≥15 |
N |
<15 |
≥15 |
|
|
Nagapattinam |
3 |
2 |
1 |
9 |
7 |
2 |
|
Thiruvarur |
3 |
2 |
1 |
6 |
3 |
3 |
|
Villupuram |
6 |
5 |
1 |
12 |
11 |
1
|
|
Virudhunagar |
6 |
5 |
1 |
12 |
10 |
2
|
|
Tiruvanamalai |
6 |
5 |
1 |
8 |
6 |
2 |
|
Madurai |
22 |
11 |
11 |
28 |
10 |
18 |
|
Cuddalore |
6 |
3 |
3 |
12 |
7 |
5 |
|
Thanjavur |
INA |
INA |
INA |
2 |
1 |
1 |
|
Ramanathapuram |
INA |
INA |
INA |
INA |
INA |
INA
|
|
Perambalour |
INA |
INA |
INA |
INA |
INA |
INA
|
|
Dindigul |
INA |
INA |
INA |
INA |
INA |
INA
|
|
Vellore |
6 |
5 |
1 |
12 |
8 |
4 |
|
Kancheepuram |
INA |
INA |
INA |
INA |
INA |
INA
|
|
Coimbatore |
INA |
INA |
INA |
INA |
INA |
INA
|
|
Salem |
INA |
INA |
INA |
INA |
INA |
INA
|
|
Pudukkottai |
INA |
INA |
INA |
INA |
INA |
INA
|
|
Dharmapuri |
6 |
6 |
0 |
12 |
11 |
1 |
|
Erode |
INA |
INA |
INA |
INA |
INA |
INA
|
|
Nilgiris |
INA |
INA |
INA |
INA |
INA |
INA
|
|
Trichi |
12 |
1 |
11 |
17 |
7 |
10 |
|
Namakkal |
INA |
INA |
INA |
INA |
INA |
INA
|
|
Karur |
16 |
12 |
4 |
14 |
7 |
7
|
|
Thiruvellore |
6 |
3 |
3 |
14 |
5 |
9
|
|
Sivaganga |
INA |
INA |
INA |
INA |
INA |
INA
|
|
TOTAL |
98 |
60(61.2) |
38(38.8) |
158 |
93(58.9)
|
65(41.4) |
Figures in
parenthesis denote percentages
INA= Information not available
Iodine content of salt was estimated by
STK
Table
XX
Details of districts in Tamil
Nadu in which study was conducted
|
District from which sample was collected |
Name
of the block |
Approximate no. of village |
Month
& year of survey |
DLM held Y/N |
|
Nagapattinam |
Kallidam |
INA |
Aug,01 |
Y |
|
Thiruvarur |
Nannilam |
28 |
Aug,01 |
Y |
|
Villupuram |
Kanai |
19 |
Aug,01 |
Y |
|
Virudhunagar |
Arruppu Kkattai |
20 |
July,01 |
Y |
|
Tiruvanamalai |
Cheyyar |
>30 |
Aug,01 |
Y |
|
Madurai |
Madurai East |
INA |
Aug,01 |
Y |
|
Cuddalore |
Kattumannar
Kail |
>30 |
July,01 |
Y |
|
Thanjavur |
Kumba Kanam |
INA |
Aug,01 |
INA |
|
Ramanathapuram |
Paramakkudi |
INA |
Sep,01 |
Y |
|
Perambalour |
INA |
INA |
Sep,01 |
INA |
|
Dindigul |
Kodai Kanal |
23 |
Aug,01 |
INA |
|
Vellore |
Thirurvalam |
INA |
Aug,01 |
Y |
|
Kancheepuram |
Thiruparur |
28 |
July,01 |
INA |
|
Coimbatore |
Karadinadai |
>30 |
Aug,01 |
INA |
|
Salem |
Veerapandi |
>30 |
July,01 |
INA |
|
Pudukkottai |
Thirumayam |
INA |
Aug,01 |
INA |
|
Dharmapuri |
Dharmapuri |
INA |
Aug,01 |
Y |
|
Erode |
Uthukuli |
26 |
Sep,01 |
INA |
|
Nilgiris |
Coonur |
>30 |
Oct,01 |
INA |
|
Trichi |
Andanallur |
INA |
Aug,01 |
Y |
|
Namakkal |
Maltasa Mudhram |
>30 |
July,01 |
INA |
|
Karur |
Aravakuruchi |
>30 |
July,01 |
Y |
|
Thiruvellore |
Villivakkam |
>30 |
Aug,01 |
N |
|
Sivaganga |
Manamadurai |
INA |
Sep,01 |
Y |
DLM = District level
meeting
Y = Yes
N = No
INA = Information not
available
Table XXI
Urinary iodine excretion levels in the study subjects in
different districts in Tamil Nadu
(n= 1974)
|
Name of the district |
|
UIE levels
(μg/l) |
Comments |
||||||
|
N |
Median (μg/l) |
<20.0 |
20.0- <50.0 |
50.0- <100.0 |
³100.0 |
D/N |
|||
|
Nagapattinam |
100 |
150.0 |
0(0.0) |
4(4.0) |
2(2.0) |
94(94.0) |
N |
|
|
Thiruvarur |
94 |
>200.0 |
0(0.0) |
1(1.0) |
15(16.0) |
78(83.0) |
N |
|
|
Villupuram |
67 |
100.0 |
1(1.5) |
1(1.5) |
21(31.3) |
44(65.7) |
N |
|
|
Tiruvanamalai |
72 |
120.0 |
0(0.0) |
4(5.6) |
22(30.6) |
46(63.9) |
N |
|
|
Madurai |
107 |
>200.0 |
2(1.9) |
0(0.0) |
3(2.8) |
102(95.3) |
N |
|
|
Cuddalore |
100 |
>200.0 |
0(0.0) |
0(0.0) |
3(3.0) |
97(97.0) |
N |
|
|
Thanjavur |
89 |
150.0 |
0(0.0) |
2(2.2) |
10(11.2) |
77(86.5) |
N |
|
|
Perambalour |
157 |
85.0 |
13(8.3) |
31(19.7) |
35(22.3) |
78(49.7) |
D |
|
|
Dindigul |
90 |
150.0 |
0(0.0) |
9(10.0) |
21(23.3) |
60(66.7) |
N |
|
|
Vellore |
80 |
150.0 |
0(0.0) |
0(0.0) |
14(17.5) |
66(82.5) |
N |
|
|
Kancheepuram |
88 |
>200.0 |
3(3.4) |
0(0.0) |
1(1.1) |
84(95.5) |
N |
|
|
Coimbatore |
90 |
130.0 |
0(0.0) |
2(2.2) |
14(15.6) |
74(82.2) |
N |
|
|
Salem |
98 |
180.0 |
0(0.0) |
2(2.0) |
14(14.3) |
82(83.7) |
N |
|
|
Pudukkottai |
56 |
>200.0 |
0(0.0) |
1(1.8) |
3(5.4) |
52(92.9) |
N |
|
|
Dharmapuri |
70 |
195.0 |
1(1.4) |
1(1.4) |
6(8.6) |
62(88.6) |
N |
|
|
Erode |
85 |
155.0 |
0(0.0) |
0(0.0) |
10(11.8) |
75(88.2) |
N |
|
|
Nilgiris |
56 |
180.0 |
0(0.0) |
4(7.1) |
6(10.7) |
46(82.1) |
N |
|
|
Trichi |
112 |
>200.0 |
1(0.9) |
0(0.0) |
2(1.8) |
109(97.3) |
N |
|
|
Namakkal |
98 |
>200.0 |
0(0.0) |
0(0.0) |
4(4.1) |
94(95.9) |
N |
|
|
Karur |
110 |
180.0 |
0(0.0) |
1(0.9) |
7(6.4) |
102(92.7) |
N |
|
|
Thiruvellore |
92 |
>200.0 |
0(0.0) |
0(0.0) |
2(2.2) |
90(97.8) |
N |
|
|
Sivaganga |
63 |
155.5 |
0(0.0) |
0(0.0) |
8(12.7) |
55(87.3) |
N |
|
|
TOTAL |
1974 |
|
21(1.1) |
63(3.2) |
223(11.3) |
1667(84.4) |
|
|
Figures in
parenthesis denote percentages
D= Deficient
iodine nutriture
N= Normal iodine
nutriture
7.
Recommendations
1. The
percentage of population consuming salt with less than 15 ppm of iodine was
81.5, 84.2, 56.3, 82.8 and 83.3 in the
states of Andhra Pradesh, Karnataka, Kerala, Pondicherry and Tamil Nadu,,
respectively. These findings indicate that there is a need of strict
enforcement of ban on the sale of non iodised salt for edible purposes. Also,
intensive IEC activities are required amongst the beneficiaries so that they
demand and consume iodised salt only.
2. It
was found that in states of Andhra Pradesh, Karnataka, Kerala, Pondicherry and
Tamil Nadu, only 41.7%, 41.7%, 58.1%, 45.8% and 40.2% of salt samples at
traders level had iodine content of stipulated level ie. 15ppm and more,
respectively. These findings indicate that there is a need of strict enforcement of ban on the
sale of salt with inadequate iodine
content through PFA system.
3. The
present pilot study on status of iodine nutriture revealed that the following
districts were iodine deficient as per the UIE levels in the casual urine
samples collected during the survey.
Andhra Pradesh :
Rangareddy and Cuddapah
Karnataka : Gulbarga, Bellary, Davangeree, Kolar,
Bijapur,
Dakshina Kannada, Kodagu and Shimoga
Kerala : Kasargod, Idukki and Kottayam
Pondicherry : Yanam
Tamil Nadu : Perambalour
There is an urgent need to undertake detailed survey of IDD
in these districts. The data on neonatal chemical hypothyroidism may be
collected specifically so that the health managers and programme administrators
can be convinced with the hard laboratory findings about existence of iodine
deficiency in the district (it is known that new born with neonatal chemical
hypothyroidism have compromised IQ development).
4. There
is a need for establishment of one laboratory in each state in consultation
with the respective state governments in one of the medical colleges who
participated in the study. The faculty-in-charge of this laboratory in the
medical college may be given the responsibility of cyclic monitoring of UIE levels and iodine content of salt
every 4 years in each district by rotation. Each medical college can be
allocated 4-5 districts. The data obtained can be utilised for initiating
corrective action.
5. In
Andhra Pradesh, there is a ban on the sale of non iodised salt in 7 districts viz.,
Vizayanagarm, Visakhapatnam, East Godavari, Khammam, Warangal and Adilabad as they were found to be endemic according
to the earlier surveys conducted by DGHS. In the present study, it was found
that the median UIE level in all these 7 districts was more than 100 mg/l indicating adequate iodine nutriture. Also, these 7
districts had comparatively lower percentage of population consuming salt with
iodine content of less than 15 ppm. These findings indicate the impact of
implementation of ban on sale of non iodised salt for edible purposes in these
districts. It also supports that the ban should be extended to other districts.
6. In
Kerala, in 3 out of 8 districts from which urine samples were collected, the
median UIE level was less than 100 mg/l indicating deficient iodine nutriture. Earlier survey
conducted in Kerala had shown that 11
out of 14 districts were endemic to iodine deficiency. In view of this, there
is an urgent need of issuing a ban notification on sale of non iodised salt for
edible purposes in the state.
7. In
the present study, a total of 14,285 and 1239 salt samples were collected from
beneficiary and traders level, respectively. Urine samples were collected from 6944 subjects. A total of 49
district level sensitization meetings were conducted. Utilisation the existing
infrastructure of academic institutions (Medical Colleges) was found to be a
cost effective strategy for rapid assessment of status of salt iodisation and
iodine nutriture and increasing awareness amongst community (through child to
family approach). In view of this, the
medical colleges should be utilised for strengthening the activities
of NIDDCP programme.
8. Appendices
Appendix
I
|
State |
Total no. of
districts |
No. of district surveyed |
No.
of district endemic |
|
Andhra Pradesh |
23 |
7 |
6 |
|
Arunachal Pradesh |
10 |
10 |
10 |
|
Assam |
18 |
18 |
18 |
|
Bihar |
38 |
22 |
21 |
|
Goa |
2 |
2 |
2 |
|
Gujarat |
19 |
16 |
8 |
|
Haryana |
16 |
8 |
8 |
|
Himachal Pradesh |
12 |
10 |
10 |
|
Jammu & Kashmir |
15 |
14 |
11 |
|
Karnataka |
20 |
17 |
6 |
|
Kerala |
14 |
14 |
11 |
|
Madhya Pradesh |
45 |
16 |
16 |
|
Maharashtra |
31 |
29 |
21 |
|
Mizoram |
4 |
4 |
4 |
|
Manipur |
8 |
8 |
8 |
|
Meghalaya |
5 |
2 |
2 |
|
Nagaland |
7 |
7 |
7 |
|
Orissa |
30 |
2 |
2 |
|
Punjab |
12 |
3 |
3 |
|
Rajasthan |
27 |
3 |
3 |
|
Sikkim |
4 |
4 |
4 |
|
Tamilnadu |
21 |
12 |
12 |
|
Tirpura |
3 |
3 |
3 |
|
Uttar Pradesh |
67 |
34 |
29 |
|
West Bengal |
18 |
5 |
5 |
|
Andman & Nicobar Islands |
2 |
Survey not done |
Survey not done |
|
Chandigarh |
1 |
1 |
1 |
|
Dadar & Nagar Haveli |
1 |
1 |
1 |
|
Delhi |
1 |
1 |
1 |
|
Daman & Diu |
1 |
1 |
1 |
|
Lakshwadeep |
1 |
Survey not done |
Survey not done |
|
Pondicherry |
4 |
Survey
not done |
Survey not done |
|
Total No. of District |
480 |
282 |
241 |
Appendix II
Relationship between iodine intake and IDD
________________________________________________________
Nutritional
status daily
(micrograms) Iodine intake
________________________________________________________
Associated with cretinism 20 or less
Associated with goiter 20 - 50
Marginal 50 -
100
Normal 100 - 300
More than normal 300 and above
________________________________________________________
Appendix
III
The Spectrum of iodine deficiency disorders
________________________________________________________________
Stage in Life Health Effects
________________________________________________________________
Foetus Abortions
Stillbirths
Congenital anomalies
Increased perinatal mortality
Increased infant mortality
Neurological cretinism :
·
mental deficiency
·
deaf-mutism
·
spastic diplegia
·
squint
Myxedematous
cretinism :
·
mental deficiency
·
dwarfism
Psychomotor
defects
Neonate Neonatal goiter
Neonatal hypothyroidism
Child and adolescent goiter
Juvenile hypothyroidism
Impaired mental function
Retarded physical development
Adult Goiter with complications
Hypothyroidism
Impaired mental function
____________________________________________________________________
STATUS OF SALT IODISATION IN
INDIA (1998-99 NFHS - 2)
|
Percent distribution of households by degree of iodization of
salt, according to state, India, 1998–99 |
||||||
|
State |
Not iodized |
7 ppm |
15 ppm |
30 ppm |
Missing |
Total percent |
|
North Haryana Himachal Pradesh Jammu & Kashmir Rajasthan Central Madhya Pradesh Uttar Pradesh East Orissa Northeast Arunachal Pradesh Manipur Meghalaya Mizoram Nagaland West South Andhra Pradesh Karnataka Kerala Tamil Nadu |
28.4 21.6 16.8 32.6 0.7 100.0 6.1 4.5 13.5 75.7 0.1 100.0 19.5 9.2 13.9 57.1 0.2 100.0 3.2 6.2 14.9 75.6 0.1 100.0 24.8 22.3 27.5 25.4 0.0 100.0 16.7 7.8 13.7 61.6 0.3 100.0 37.1 15.3 21.9 24.4 1.3 100.0 25.0 16.3 14.4 42.3 2.1 100.0 22.7 26.9 19.6 29.2 1.6 100.0 22.9 30.1 26.6 20.4 0.0 100.0 29.6 35.1 18.2 16.8 0.4 100.0 11.3 26.5 25.8 36.0 0.5 100.0 0.8 15.0 46.9 37.2 0.1 100.0 1.8 18.2 32.7 46.9 0.3 100.0 2.3 9.7 15.4 72.5 0.1 100.0 6.7 30.0 24.9 38.1 0.3 100.0 0.7 8.0 27.9 63.3 0.0 100.0 10.9 21.2 25.5 41.7 0.7 100.0 3.1 17.5 31.8 47.3 0.3 100.0 37.3 20.2 4.0 37.9 0.6 100.0 29.5 14.2 14.9 41.2 0.2 100.0 32.0 6.9 11.0 49.1 1.0 100.0 36.8 35.7 10.2 17.2 0.1 100.0 24.1 32.4 12.9 30.5 0.1 100.0 47.6 13.2 5.6 33.7 0.0 100.0 62.7 15.8 8.1 13.1 0.3 100.0 |
|||||
|
ppm: Parts per million |
||||||