Journal of Health Sciences & Surveillance System

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

News

Iodine Deficiency Disorders in the South of Iran during 1989-2012: A Surveillance System Report

Document Type : Original Articles

Authors

1 Epidemiologist, Shiraz University of Medical Sciences, Shiraz, Iran;

2 Nutritionist, Shiraz University of Medical Sciences, Shiraz, Iran;

3 Nutritionist, Shiraz University of Medical Sciences, Shiraz, Iran

4 Internist, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: Iodine deficiency disorders (IDD) have been recognized as a major public health problem worldwide. Consequences of IDD include goiter, hypothyroidism, and intellectual disability followed by retarded growth and development of the brain. This report aimed to determine the state of IDD in Fars province, south of Iran.Methods: In this study, we gathered data from all scientific papers, published and unpublished reports of IDD surveillance system, results of IDD-related surveys and all data from the center for disease control (CDC) at provincial and national levels during 1989-2012. Five main IDD indices are summarized, interpreted, and then organized in graphs and tables.Resuits: After formation of national committee of IDD followed by launching of extensive iodine delivery, most of IDD indices have improved. The percentage of iodized salt intake has increased from 0 to near 100%, and that of salt with adequate amount of iodine has increased to 94.5%. Median of urinary iodine concentration (UIC) has always been higher than the acceptable value (≥100 μg/L) and 68% of people had a mean of UIC ≥100 μg/L. The percentage of TSH (Thyroid-Stimulating Hormone) >5 mU/L in the screened newborns has persistently been less than 1% during 2005-11. Prevalence of goiter has declined from 68% in 1989 to 1.3% in 2007.Conclusion: Present findings address those efforts to combat iodine deficiency which were effective. According to the small sample size and also the fact that some data have been derived at the national level, we recommend that a comprehensive populationbased survey should be carried out with sufficient sample size to achieve information with high accuracy and precision.

Keywords

References
  1. UNICEF, Sustainable Elimination Iodine Deficiency:
  2. Progress since the 1990 World Summit for Children,
  3. New York, 2008.
  4. Delange F. Iodine deficiency as a Cause of brain
  5. damage. Postgrad Med J. 2001;77(906):217-20.
  6. Kimball OP. Prevention of goitre in Michigan and Ohio.
  7. JAMA. 1937;108(11):860-4.
  8. United Nations Children’s Fund, Progress for Children:
  9. A World Fit for Children statistical review, Number 6,
  10. UNICEF, New York, December 2007, p. 8.
  11. Emami A, Shahbazi H, Sabzevari M, Gawam Z,
  12. Sarkissian N, Hamedi P, et al. Goiter in Iran. Am J
  13. Clin Nutr. 1969;22(12):1584-8.
  14. Azizi F, Kimiagar M, Nafarabadi M, Yassai M. Current
  15. status of iodine deficiency disorders in the Islamic
  16. Republic of Iran. EMR Health Survey J. 1990;8:23-7.
  17. Kimiagar M, Yassai MB, Nafarabadi MT, Samimi B,
  18. Azizi F. amadpour K. Endemic goiter in Boyer-Ahmad.
  19. MJIRI. 1989;3(1):27-9.
  20. Azizi F, Mehran L. Experiences in the prevention,
  21. control and elimination of iodine deficiency disorders:
  22. a regional perspective. East Mediterr Health J.
  23. ;10(6):761-70.
  24. World Health Organization, Promotion of iodized salt
  25. in the Eastern Mediterranean, Middle East and North
  26. Africa: Report of an inter-country meeting. 2000,
  27. -12 April, Dubai, United Arab Emirates. Alexandria:
  28. WHO; 2000.
  29. Azizi F, Delshad H, Amouzegar A, Mehran L., Mirmiran
  30. P, Sheikh Aleslam R, et al. Marked Reduction in Goiter
  31. Prevalence and Eventual Normalization of Urinary
  32. Iodine Concentrations in Iranian Schoolchildren, 10
  33. Years After Universal Salt Iodination (Third National
  34. Survey of Iodine Deficiency Disorders 2000. Int J
  35. Endocrinol Metab. 2008;10(3):191-203. (In Persian)
  36. Dunn JT. Seven deadly sins in confronting endemic
  37. iodine deficiency, and how to avoid them. J Clin
  38. Endocrinol Metab. 1996;81(4):1332-5.
  39. Zimmermann MB, Wegmuller R, Zeder C, Torresani
  40. T, Chaouki N. Rapid relapse of thyroid dysfunction and
  41. goiter in school age children after withdrawal of salt
  42. iodization. Am J Clin Nutr. 2004;79(4):642-5.
  43. Haddow JE, McClain MR, Palomaki GE, Hollowell JG.
  44. Urine iodine measurements, creatinine adjustment, and
  45. thyroid deficiency in an adult United States population.
  46. J Clin Endocrinol Metab. 2007;92(3):1019-22.
  47. Li M, Eastman CJ, Waite KV, Ma G, Zacharin MR,
  48. Topliss DJ, et al. Are Australian children iodine
  49. deficient? Results of the Australian National Iodine
  50. Nutrition Study. Med J Aust. 2006;184(4):165-9.
  51. WHO, Unicef, ICCIDD, editors. Assesment of the
  52. iodine deficiency disorders and monitornig their
  53. elimintion: A guide for programme managers. 2nd ed.
  54. Geneva:WHO;2001.
  55. Holder Y, Peden M, Krug E, Lund J, Gururaj G,
  56. Mirahmadizadeh AR, Kavoosi E, Vakili M, Shenavar R, Moghadami M
  57. J Health Sci Surveillance Sys October 2013; Vol 1; No 2
  58. Koibusingye O. Injury Surveillance Guidelines.
  59. Geneva: World Health Organisation, 2001.
  60. Klaucke DN, Buehler JW, Thacker SB, Parrish
  61. RG, Trowbridge FL, Berkelman RL. Guidelines
  62. for evaluating surveillance systems. MMWR.
  63. ;37(S-5):1-18.
  64. World Health Organization, United Nations Children’s
  65. Fund, International Council for the Control of Iodine
  66. Deficiency Disorders. Assessment of iodine deficiency
  67. disorders and monitoring their elimination, A guide
  68. for programme managers. 3rd ed. Geneva, WHO. 2007.
  69. Azizi F, Janghorbani M, Hatami H. Epidemiology
  70. and control of common disease in Iran. 3rd ed. Tehran:
  71. Khosravi Publishing Corp; 2009.
  72. Tonglet R, Bourdoux P, Dramaix M, Hennart P, Ermans
  73. A. Inter observer variation in the assessment of thyroid
  74. enlargment: a Pittfall in Surveys of the prevalence of
  75. endemic goiter. Food Nutr Bull. 1994;15:64-9.
  76. WHO/UNICEF/ICCIDD. Chapter 2: Selecting target
  77. groups and Chapter 5: Selecting appropriate indicators:
  78. Biochemical indicators. In: Indicators for Assessing
  79. Iodine Deficiency Disorders and their Control Through
  80. Salt Iodination. Geneva. World Health Organization,
  81. WHO/NUT/94.6. 1994.
  82. Zimmermann MB, Jooste PL, Pandav CS. Iodinedeficiency
  83. disorders. Lancet. 2008;372:1251–62.
  84. Sandell EB, Kolthoff IM. Micro determination of
  85. Iodine by a Catalytic method. Michrochemica Acta.
  86. ;1:25-9.
  87. Zimmermann MB, Aeberli I, Torresani T, Burgi
  88. H. Increasing the iodine concentration in the
  89. Swiss iodized salt program markedly improved iodine
  90. status in pregnant women and children: a 5-y prospective
  91. national study. Am J Clin Nutr. 2005;82(2):388–92.
  92. Amouzegar A, Delshad H, Mehraein M, Mehran L,
  93. Safarkhani M, Azizi F. Continuous Adequate Iodine
  94. Supplementation in Fars Province: The 2007 Goiter and
  95. Urinary Iodine Excretion Survey in Schoolchildren.
  96. Iran J Med Sci. 2010;35(1):16-20.
  97. Setoudehmaram E, Ravanshad SH, Soleymani SH,
  98. Mostafavi H. Prevalence study of Goiter in 6-10 year
  99. old girls of Shiraz, 1995. Journal of Kerman University
  100. of Medical Sciences. 1998;5(3):128-33.
  101. Sadegholvad AS, Dabbaghmanesh MH, Ejtehadi F,
  102. Omrani Ranjbar GH. Prevalence of goiter and iodine
  103. deficiency ten years after salt iodinezation in school
  104. children (8-13 years old) in Marvdasht. Iranian Journal
  105. of Endocrinology and Metabolism. 2006;8(1):1-7.
  106. Azizi F, Sheikholeslam R, Hedayati M, Mirmiran P,
  107. Mahdavi A, Delshad H. Goiter survey and urinary
  108. iodine concentration in 8 to 10-year-old schoolchildren
  109. from Fars Province in 1996. Iranian Journal of
  110. Endocrinology and Metabolism. 2001;3(1):37-42.
  111. Walker SP, Wachs TD, Gardner JM, Lozoff B,
  112. Wasserman GA, Pollitt E, et al. International Child
  113. Development Steering Group. Child development: risk
  114. factors for adverse outcomes in developing countries.
  115. Lancet. 2007;369(9556):145-57.
  116. United Nations Population Division. World Population
  117. Prospects, the 2004 revision. New York: United
  118. Nations. 2006.
  119. UNICEF. State of the World’s Children: Women and
  120. Children- The Double Dividend of Gender Equality.
  121. New York: UNICEF. 2007.
  122. de Benoist B, McLean E, Andersson M, Rogers L.
  123. Iodine deficiency in 2007: global progress since 2003.
  124. Food Nutr Bull. 2008;29(3):195-202.
  125. WHO Nutrition. The WHO Global Database on Iodine
  126. Deficiency, 2008. WHO website. Available from: http://
  127. www.who.int/vmnis/en/, Accessed at 17/12/2012.
  128. Kuay LK, Ying CY, Zainuddin AA, Huey TC, Selamat
  129. R, Cheong KC, et al. Inadequate Iodine Intake among
  130. School Children in Terengganu-Findings from the
  131. National Iodine Deficiency Disorder Survey 2008. Int
  132. J Public Health. 2013;3(1):198-203.
  133. Skeaff SA, Thomson CD, Wilson N, Parnell WR.
  134. A comprehensive assessment of urinary iodine
  135. concentration and thyroid hormones in New Zealand
  136. schoolchildren: a cross sectional study. Nutr J.
  137. ;11:31.
  138. Andersson M, Karumbunathan V, Zimmermann MB.
  139. Global iodine status in 2011 and trends over the past
  140. decade. J Nutr. 2012;142(4):744-50.
  141. Zimmermann MB. The role of iodine in human
  142. growth and development. Semin Cell Dev Biol.
  143. ;22(6):645-52.
  144. Charoensiriwatana W, Srijantr P, Teeyapant P,
  145. Wongvilairattana J. Consuming iodine enriched eggs
  146. to solve the iodine deficiency endemic for remote areas
  147. in Thailand. Nutr J. 2010;9:68.
  148. Clifton VL, Hodyl NA, Fogarty PA, Torpy DJ,
  149. Roberts R, Nettelbeck T, et al. The impact of iodine
  150. supplementation and bread fortification on urinary
  151. iodine concentrations in a mildly iodine deficient
  152. population of pregnant women in South Australia.
  153. Nutr J. 2013;12:32.
Journal of Health Sciences & Surveillance System
Volume 1, Issue 2 - Serial Number 2
4
October 2013
Pages 57-66
Files
Share
How to cite
Statistics