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Study on Evaluations and Countermeasures of Eliminating IDD Project of Jinan

Author: WangWeiRu
Tutor: XuLingZhong; ZhangJi
School: Shandong University
Course: Public Health
Keywords: IDD Iodine nutrition level Water Iodine Urine iodine Salt iodine
CLC: R599
Type: Master's thesis
Year: 2012
Downloads: 58
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Abstract


BackgroundIDD (Iodine Deficiency Disorders, IDD) is a disease of the deficiency in trace elements, which is due to the lack of Iodine in the natural environment.It caused a group of related diseases or the floorboard of harm from embryonic development to adulthood. It includes Endemic goiter Endemic cretinism、 Subclinical cretinism、 simple deaf、 fetal abortion、 premature birth、 dead-birth、 fetus congenital defect, etc. It mainly effects development of fetal brain, leads to the obstacles of the growth of intelligence and physique of children. The intelligence of the children in iodine deficiency areas is generally lower than that of other regions,iodine is known as the "intelligence" element. IDD now has become an important global public health problem. It seriously influences the healthier births and better child rearing、 development of children’s intelligence, physics and the quality of the population.It is the most common and realistic problem, it is not only a kind of disease, but also a problem relatives to the improvement of national quality and the development of society.ObjectivesThrough surveying the level of urine iodine、 salt iodine、 water iodine and goiter rate, analysing of the current iodine nutritional status of residents in Jinan city and providing scientific basis for eliminating IDD,evaluating the effect of eliminating IDD project, providing scientific basis for the formulation of corresponding countermeasures for the prevention and control of the IDD.Materials and MethodsWith the methods of stratified random sampling,sampled144edible salt of residents,144random urine sample of the child-bearing women aged15~55in each area; selected100pupils aged8~10in a primary school with thyroid gland B ultrasonic examination; sampled drinking water in the unit of village randomly testing the content of iodine.In statistical analysis used SPSS13.0. The rate comparision used the chi-square test; the comparision of water iodine, urine iodine, salt iodine used the Kruskal-Wallis non-parameter test; the correlation of water iodine, salt iodine and urine iodine used the Spearman rank related analysis.Main Results19631edible salt of the inhabitants were collected in the10counties of Jinan, in2003-2010.18785were qualified iodized salt,401were non-iodized salt, the average rate of non-iodized salt, the coverage rate of iodized salt, the qualified rate of iodized salt, the edible rate of the qualified iodized salt were2.04%,98.73%,97.69%,95.69%, the coverage rate of iodized salt, the qualified rate of iodized salt,the edible rate of the qualified iodized salt are statistically significant differences. In2006and2007the coverage rate of iodized salt, the qualified rate of iodized salt,the edible rate of the qualified iodized salt are lowest, after many responsible departments were united, they cracked down on not qualified iodized salt strengthened the supervision on iodized salt, since2008,each index of iodized salt of Jinan has maintained at a high level.5872water samples were collected in this survey, the median water iodine is13.02u g/L,and the highest is Jiyang, the median is92.80u g/L, with the maximum of475.30u g/L; Shanghe is the second, the median is69.40u g/L, with the maximum of705.01u g/L; iodine content of water in Changqing is the lowest, with the median of6.45u g/L, and the maximum of264.48u g/L.2711urine samples were collected in this survey, the minimum of urinary iodine is1.599u g/L, the maximum of urinary iodine is2946.38u g/L, the median of urinary iodine is179.00u g/L, the median of urinary iodine of each area is from151.18u g/L to267.14u g/L. The median of urinary iodine of each area used the Kruskal-Wallis non-parameter test has significant.500urine samples of children aged8-10were collected in this survey,the minimum of urinary iodine is0.01μg/L, the maximum of urinary iodine is2290.23μg/L,the median of urinary iodine is150.88μg/L. The median of urinary iodine of Lixia and Shizhong is proper, the median of urinary iodine of Huaiyin、 Tianqiao and Changqing is at the ideal level. The content of urinay iodine of each county by multiple comparison (LSD method), have statistically significant differences.997students were touch diagnosis about thyroid, among them116students were found the problem of enlargement of the thyroid gland. The lowest rate of thyroid gland enlargement is3.55%, the highest rate is16.00%, the average rate is11.74%, among that the male is54, accounting for46.6%, the female is62, accounting for53.4%; the rate of thyroid gland enlargement of male is10.8%, the rate of thyroid gland enlargement of the female is12.5%, the rate of thyroid gland enlargement of female is higher than male, the rate of thyroid gland enlargement between the male and the female has no statistically significant difference,253students were examined by B ultrasonic diagnosis, and the results showed that the the lowest rate of thyroid gland enlargement is0.00%, the highest rate is14.00%, and the average rate is5.53%, B ultrasonic diagnosis method to is more accord with actual situation of the school students aged8~10, more accuratly response to the enlargement of the thyroid gland, the method of touch diagnosis and B ultrasonic examination detecting the rate of thyroid enlargement has no statistically significant difference.Conclusions and suggestionsMost areas of Jinan are iodine deficiency regions, there are iodine deficiency areas iodine excess areas and iodine normal areas. The current concentration of iodine in the water and salt of Jinan can satisfy the requirements of nutrients level of the residents in iodine deficiency area; each index of iodine salt has reached the national standard; the rate of thyroid gland enlargement of the children maintains a low level, iodine nutrition level of the women of child-bearing age and the children is in suitable condition; speeding up the progress of the improvement of water in iodine excess areas, prevent the damage of the residents. Adopt comprehensive prevention and control measures to prevent the harm of iodine deficiency, according to the persons and the areas, supply iodine scientificly, according to nutrition level of the residents in iodine deficiency of Jinan appropriately adjustment iodine content of the salt.

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