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Prevalence of Iodine Deficiency Disorders

by Tasneem Mossddeq
***Iodine deficiency haa alarming health consequences, some of which are eaaily noticeable, while the rest take time to set in, but eventually affect larger section of the population.
HEALTH for all Is Iha 1—1 motto that Bangladesh JL 1 b endeavouring lo accomplish for its people by the year 2000 Accordingly, the government. In collaboration with different International bodies. has undertaken extensive programme* to provide 1t* people with minimum health and sanitation facilities Bui the general mass. apparently healthy, exhibit very Hille vigour, alertness and sustained mental preparedness for the task ahead The rural popu lation migrating tn droves to the elites a* well a* In their native habitats seem to be perpetually suffering from apathy bordering on suicidal tendency Strange phenomena indeed as the diseases with severe debilitating and dlaa era^teated^or are in the process o( extermination!
With the Aveiopmcnt of communication, the growth.of Industrialisation and mass lit eracy drives, there has been tremendous exposure to modernisation tn every walk of life Projects arc being Implemented to reduce infant mortality and increase-general average life span. Yet. looking around one gets the distinct impression as though the people are almost reluctant lo change the status qua. Their indifference- lo efforts taking place to alkvlate their suffer ing is rather discouraging. The ultimate question arises why? The answer lies in Iodine Deficiency Disorders (IDD)
Bangladesh being a della ts subjected lo recurrent Hoods and heavy monsoon, that washes away the essential minerals from Its sod, specially iodine. In some parts, the continuous washing has depleted the soil almost completely. of this micro-nutrient. As a result, crops grown in these areas naturally contain less iodine. As it is, crops grown tn Bangladesh contain only 10 micrograms of iodine per kg against 1000 micro-grams/kg found in crops from iodine-rich soil. Therefore, a deficiency in the soil results-not only In less Intake but the altogether absence of Iodine from the normal food and water. The effects of which are devastating. .
Health Consequences
Iodine deficiency has alarming health consequences, some of which are eaaily notiecabfe. while the rest lake lime to set in, but eventually affect larger section of the population. The most prominent manifestation of this deficiency is goitre: cnlarged thyroid gland. This condition ensue* when the body fail* lo produce Ihyroxim (thyroid hormone) because of iodine deficient diet. Lack of thyroxine or hypothyroidism lead* to farther health conipll cation* — sometime* fatal and irreversible. Occurring in women of productive age, il may severely effect the ofl spring, resulting tn crc-Unism or mental retardation. Other visible clkxls arc deaf mutism, dwarfism and impediment to the development of the nius cuio skek-lal system Thyroid hormones are absolutely esse ntial at the formative stage when the brain and nervous system is developing simultaneously with physteal growth. While cretinism tn extreme form causes Irrevocable damage lo mental faculties, tn its mild form It is evident in certain prevalent characteristics such as sluggishness, drowsiness, abortions and still births. These Individual symptoms collectively has a negative Im p>K-l on the community. Iodine deficient people arc difficult lo motivate and educate and the productive level of their work is very low. From a broader perspective, the collection of communities consisting such individuals retards the socioeconomic development in general.
Between July 1981 and December ’82. the Institute ol l*ublic Health Nutrition in col laboralion with WHO carried the first National Goitre Prevalence Study. As many as 214.608 people in 417 upazi-las were surveyed. And II was (bund that approximately 11.3 million people suffer from visi Lie goitre. And another estimated 37 million arc at risk. Arcus where upto 10% of the population suffer from IDD arc identified as endemic by WHO. It is not merely the numbers but 11k- widespread prevalence of IDD and its regressive functional implications that is of grave concern.
IDD, if neglected, can result is serious health cxxnplUal ions of unimaginable magnitude. YcL iodine deficiency by Itacl! is so ea*y to prevent and gon iroi. Ignoram'c has led lo social ostracism and iMtonipanv ing painful experiences for people with goitre.
Out of public guxe. In sonic places a community of goitre suffe-rers grew out of the nc cessity to survive. Totally unaware of the consequences of iodine deficiency In producliv ity, women with goitre were married lo men with the same affliction. And in the process children wen bom with con genital abnormalities, nco-na tai hypothyroidism and other mental and physical crippling conditions. Taking Into account the seriousness of IDD and its endemic prevalence in some areas, immediate and tn-ten’s Ive national Intervention was recommended.- Rising upto Ibt almost insurmountable task of treatment, control and future prevention of IDD. llw government lias taken up two prujoels with ihc assis laiKV of the UNICEF.
Preventive Measures
Universal Salt iodization project is primarily intended for long-term control and pre-vu-nlkMi of IDD. An adult needs 0 »Smgs of iodine ncr day Fortifying nomad edible salt with liny amounts of Iodine is a popular and widely used method of supplying the required daily dietary afiowancc of iodine to large population groups. The use of iodised salt does not need any change in dietary pattern and also the luobillsallon' of cosily and time-consuming distribution system. In Bangladesh formal legislation or the production and supply of Iodised salt was passed by the parliament on February 28, 1989. This programme alms to achieve na tlonwlde capacity of Universal Salt Iodization and its distribution throughout the country. In this context, salt Iodization plant* will be fabricated foragy urn! act up In phase* over h pe rx>d of three years Meanwhile, five lodUalkin plant* were In stalled by the government with the asatstanre ot the UNICEF
The other project I* Iodine In Oil Injection (Llpiodoi) Campaign. It Is basically an in tcrirfi and Immediate method of controlling IDD. specially goitre In hyper-endemic areas. Ihc campaign Is conducted by Injecting Llpiodoi to the "at risk" population of all female* (O 45 years age group) and all males (O 15 year*) One dose of Llpiodoi Injection would protect the 'at risk" population against IDD upto five year*.
This comprehensive Llpiodoi campaign so far has been highly simicss ful 1.4 million people have till now been administered with Llpiodoi. A tot
of ground still remains lu be covered by monitoring and impact evaluation on the popu latlon In this regard, the technologies and facilities at the IPHN for estimating uri nary iodine excretion, Hje simple paper strip method to ascertain the Iodine level In iodised salt developed by the Institute of Food Science Technology and the Immuno assay method at the Institute of Nuclear Medicine should be Integrated and al*o be easily accessible. Campaign on the popular mass media such a* TV radio and even newspaper. If launched, will generate the necessary public support and participation for removing IDD completely and effectively.