Universal Salt Iodinization is not that Universal - A study among school age children in Mandla District, Madhya Pradesh.





Iodine, Salt, Goiter, Deficiency, School, India


Background: Iodine deficiency is a preventable cause of brain damage. Aims &Objectives: The present study was conducted to determine the prevalence of goiter in school going children clinically, to assess the iodine status (urinary iodine excretion) of school children, and to assess the iodine content of the salt consumed by the population. Materials and Methods: It is school based cross-sectional study, conducted in Mandla district of Madhya Pradesh state in central India in 2016. The study participants were school children in 6-12 years of age. Probability-proportional-to-size cluster sampling was used. Palpation method was used to identify the presence of goiter. Urine samples were collected and median urinary iodine excretion was found. The salt samples were also collected from the households and local market to determine the iodinization status. Results: A total of 2700 school children were studied. The total goitre rate was 0.74%. Among those clinically palpable goiter 15(75%) were girls. The prevalence of goitre higher among girls was statically significant with p=0.025. All the cases of clinically palpable goiter belonged to caste other than general with p<0.001. The median urinary iodine excretion of 270 urine samples of school children was 184 µg/l. The prevalence of iodine deficiency disorders using urinary iodine excretion as indicator in the present study was 22.9% Seven percent of the samples had median urinary iodine The normal iodine content i.e more than the 15 ppm iodine was present in 84% of samples collected from households. Conclusion: The children of Mandla district of Madhya Pradesh had low prevalence of goiter. However, there is significant burden of goiter among backward classes.


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Iodine deficiency disorders - World Health Organization. Available from http://www.who.int/nutrition/topics/idd/en/ [Last accessed on 1 June 2018]

Iodine status worldwide WHO Global Database on Iodine Deficiency. Available from http://apps.who.int/iris/bitstream/handle/10665/43010/9241592001.pdf ;jsessionid=3861E7270BDD5759E5B35F69E78FDDC8?sequence=1 [Last accessed on 12 June 2018]

UNICEF. Coverage Evaluation Survey 2009, All India Report. Ministry of Health and Family Welfare, Government of India, New Delhi. 2010. Available from: http://www.unicef.org/india/health.html [Last accessed on 2017 May 27].

Pandav CS, Yadav K, Srivastava R, Pandav R, Karmarkar MG. Iodine deficiency disorders (IDD) control in India. Indian J Med Res. 2013;138:418–33

Sen TK, Biswas AB, Chakrabarty I, Das DK, Ramakrishnan R, Manickam P, Hutin Y. Persistence of iodine deficiency in Gangetic flood-prone area, West Bengal, India. Asia Pac J Clin Nutr. 2006;15(4):528-32. PubMed PMID: 17077070.[PubMed].

Assessment of the Iodine Deficiency Disorders and Monitoring Their Elimination - A Guide for Programme Managers. Geneva, World Health Organization; 2001. 2nd edition; p77-100. http://whqlibdoc.who.int/hq/2001/WHO_NHD_01.1.pdf .

RSP Rao. Prevalence of Goitre among School Children in Coastal Karnataka. IJP. 200;69:477.

Nutrition Available from [Last accessed on 1 June 2018]

District Census 2011. Registrar general of India. Available from http://www.census2011.co.in/district.php [Last accessed on 1 June 2018]

Assessment of the Iodine Deficiency Disorders and Monitoring Their Elimination - A Guide for Programme Managers. Geneva, World Health Organization. Available from http://whqlibdoc.who.int/hq/2001/WHO_NHD_01.1.pdf. [Last accessed on 11 May 2018]

World Health Organization. Urinary iodine concentrations for determining iodine status in populations. Vitamin and Mineral Nutrition Information System. WHO/ NMH/NHD/EPG/131 2013:3–4. Available from http://apps.who.int/iris/ bitstream/10665/85972/1/WHO_NMH_NHD_EPG_13.1_ eng.pdf. [Last accessed on 20 May 2018]

WHO, UNICEF, ICCIDD. Recommended Iodine Levels in Salt and Guidelines for Monitoring Their Adequacy and Effectiveness. Geneva: World Health Organization; 199671 Report of a Joint WHO/UNICEF/ICCIDD Consultation on Indicators for Assessing Iodine Deficiency Disorders and Their Control Programmes WHO. 1992; pp. 22-29.

Chander S, Kapil U, Jain V, Sareen N. Iodine deficiency disorders in school age children in Kullu District, Himachal Pradesh. Indian Pediatr. 2013 Sep;50(9):883-4. doi: 10.1007/s13312-013-0233-7. PubMed PMID: 24096846.[PubMed].

Misra S, Kantharia SL, Damor JR. Prevalence of goitre in 6 -12 years school-going children of Panchmahal district in Gujarat, India. Indian J Med Res. 2007 Nov;126(5):475-9. PubMed PMID: 18160754.[PubMed].

Kapil U, Pandey RM, Prakash S, Sareen N, Bhadoria AS. Iodine deficiency status amongst school children in Pauri, Uttarakhand. Indian Pediatr. 2014 Jul;51(7):569-70. doi: 10.1007/s13312-014-0449-1. PubMed PMID: 25031137.[PubMed].

Kapil U, Pandey RM, Prakash S, Kabra M, Sareen N, Bhadoria AS. Assessment of iodine deficiency in school age children in Nainital District, Uttarakhand State. Asia Pac J Clin Nutr. 2014;23(2):278-81.

Biswas AB, Chakraborty I, Das DK, Biswas S, Nandy S, Mitra J. Iodine deficiency disorders among school children of Malda, West Bengal, India. J Health Popul Nutr. 2002 Jun;20(2):180-3. PubMed PMID: 12186199.[PubMed].

Das DK, Chakraborty I, Biswas AB, Sarkar GN, Shrivastava P, Sen S. Iodine deficiency disorders among school children of Dakshin Dinajpur District, West Bengal. Indian J Public Health. 2005 Apr-Jun;49(2):68-72. PubMed PMID: 16457098.[PubMed].

Agarwal J, Pandav CS, Karmarkar MG, Nair S. Community monitoring of the National Iodine Deficiency Disorders Control Programme in the National Capital Region of Delhi. Public Health Nutr. 2011 May;14(5):754-7.

P.V. S, C.S. K. Iodine Status and Prevalence of Goitre in School Going Children in Rural Area. Journal of Clinical and Diagnostic Research?: JCDR. 2014;8(8):PC15-PC17.

Vila L, Donnay S, Arena J, Arrizabalaga JJ, Pineda J, Garcia-Fuentes E, García-Rey C, Marín JL, Serra-Prat M, Velasco I, López-Guzmán A, Luengo LM, Villar A, Muñoz Z, Bandrés O, Guerrero E, Muñoz JA, Moll G, Vich F, Menéndez E, Riestra M, Torres Y, Beato-Víbora P, Aguirre M, Santiago P, Aranda J, Gutiérrez-Repiso C. Iodine status and thyroid function among Spanish schoolchildren aged 6-7 years: the Tirokid study. Br J Nutr. 2016 May;115(9):1623-31. doi: 10.1017/S0007114516000660. Epub 2016 Mar 10. PubMed PMID: 26961225.[PubMed].

Campos Rde O, Reboucas SC, Beck R, de Jesus LR, Ramos YR, Barreto Idos S, Marques TX, Cerqueira TL, Santos WA, Oliveira CA, Teixeira LS, Souza VC, Barbosa F Jr, Ramos HE. Iodine Nutritional Status in Schoolchildren from Public Schools in Brazil: A Cross-Sectional Study Exposes Association with Socioeconomic Factors and Food Insecurity. Thyroid. 2016 Jul;26(7):972-9. doi: 10.1089/thy.2015.0448. Epub 2016 Jun 10. PubMed PMID: 27184190[PubMed].

Fuse Y, Igari T, Yamada C, Sakano S, Ito H, Umenai T, et al. Epidemiological survey of thyroid volume and iodine intake in schoolchildren, postpartum women and neonates living in Ulaan Baatar. Clin Endocrinol (Oxf). 2003 Sep;59(3):298-306.

Girma K, Nibret E, Gedefaw M. The Status of Iodine Nutrition and Iodine Deficiency Disorders among School Children in Metekel Zone, Northwest Ethiopia. Ethiopian Journal of Health Sciences. 2014;24(2):109-116.

Roy R, Chaturvedi M, Agrawal D, Ali H. Household use of iodized salt in rural area. J Family Med Prim Care. 2016 Jan-Mar;5(1):77-81. doi: 10.4103/2249-4863.184628. PubMed PMID: 27453848; PubMed Central PMCID: PMC4943155.[PubMed].




How to Cite

Bali S, Gupta A. Universal Salt Iodinization is not that Universal - A study among school age children in Mandla District, Madhya Pradesh. Indian J Community Health [Internet]. 2019 Dec. 31 [cited 2024 Mar. 4];31(4):450-6. Available from: https://www.iapsmupuk.org/journal/index.php/IJCH/article/view/1202



Original Article