Indicators to monitor progress of National Iodine Deficiency Disorders Control Programme (NIDDCP) and some observations on iodised salt in west Bengal
Kumar, S.
Indian Journal of Public Health 39(4): 141-147
1995
ISSN/ISBN: 0019-557X PMID: 8690501 Document Number: 302263
In India, the goal of the National Iodine Deficiency Disorder Control Programme (NIDDCP) is elimination of iodine deficiency disorders (IDD) by 2000. It aims to supply iodized salt to all of India and to assess the impact of the supply of iodized salt. Quantifiable indicators used to monitor its progress include the prevalence of IDD, iodine content of salt, and knowledge, attitudes, and practices (KAP) regarding iodized salt. The program targets school children 8-10 years old for assessing IDD prevalence. It prefers the community-based survey to the school-based survey, since the former includes children not enrolled in school. The indicators health workers use to assess IDD prevalence are thyroid size (palpation and ultrasonography), urinary iodine, and level of thyroid-stimulating hormones in serum. Spot testing kits and iodometric titration method are used to measure iodine content in salt. Salt with at least 15 ppm iodine is classified as satisfactory. A goiter survey requires a minimum of 5 salt samples (about 20 g). The KAP survey needs a minimum of 5 different households in each cluster site. Issues related to salt addressed in the KAP survey include existence of iodized salt, importance of iodized salt consumption, consequences of IDD (e.g., poor physical and mental growth of children, still births, cretinism), packaging of iodized salt, price, storage of iodized salt, use of bagara salt, prior washing of salt, and source of iodized salt. In West Bengal, only iodized salt can be sold. In 1994, West Bengal met its annual requirement of edible salt. A survey at rake unloading points in West Bengal in 1994 revealed that most salt from Gujarat had adequate iodine levels, while all but 5.3% of the salt from Rajasthan had insufficient iodine levels. Health workers and food inspectors in West Bengal routinely monitor different districts at various levels (household, retailers, and wholesalers). In 1995, 84.3% of samples at wholesalers, 74.3% at retailers, and 71.2% at households had satisfactory levels of iodine. The Goitre Cell of the West Bengal government has an IDD educational program involving teachers and panchayats.