PREVENTION AND CONTROL OF IODINE DEFICIENCY DISORDERS & NIDDCP

PREVENTION AND CONTROL OF IODINE DEFICIENCY DISORDERS & NIDDCP

1. PREVENTION AND CONTROL OF IODINE
DEFICIENCY DISORDERS & NIDDCP
Moderators:
Dr.Nikhat
Dr.Shaigan
Dr.Abdullah
Dr.Naveen
Dr.Saleem
Dr. Sameena
Presented by
MOHD YEZDANI
2k14

2. Pregnant Women
●
-IUD
●
-Abortion
●
-still birth
Neonate
-Neonatal
hypothyroidism
Children
-Cretinism
-Dwarfism
-Mental Retardation
Adult
-Strabismus
-Goiter
-Neuromuscular
disease
India having world’s biggest goiter belt (Himalayan Goiter Belt)
No state is free from Goiter
K.Park 24th Ed. 1/13
WHY IDD IS A MAJOR HEALTH
PROBLEM IN INDIA?
It affect all age groups with wide spectrum of diseases

3. PRIMARY PREVENTION
 HEALTH PROMOTION
1. HEALTH EDUCATION:
Create awareness in high risk group
Educate people to eat iodine rich food,salt and avoid
goitrogens
2. ENVIRONMENT MODIFICATION:
Fertilizers increase the soil iodide state
Reducing iodine volatilization loss
by liming the soil
2/13
LEVEL OF PREVENTION
K.Park 24th Ed.

4. 3. NUTRITIONAL INTERVENTION
Food fortification: fortified salt, double
fortified salt.
 Spraying of potassium iodate solution on
salt heap.
4. LIFESTYLE AND BEHAVIORAL
CHANGES
Difficult, slow and gradual process
Avoid goitrogens
Prefer Iodine rich food

3/13K.Park 24th Ed.

5. SPECIFIC PROTECTION
1. SPECIFIC DIET:
 Iodized salt
2. SUPPLEMENTATION:
Iodized oil injection(IM)-1ml gives protection for 4
years
Iodized oil capsule
4/13K.Park 24th Ed.
At
Production
level
At Consumer
level
Concentration
of Iodine
30 ppm 15 ppm
Level of Iodisation

6. SECONDARY PREVENTION
EARLY DIAGNOSIS:
Serum level of T3,T4 and TSH
Urine iodine excretion
Heel prick test in Neonates for
congenital hypothyroidism
TREATMENT :
Medical
Surgical
5/13
K.Park 24th Ed.

7. TERTIARY PREVENTION
DISABILITY LIMITATION
Prevent the transition of disease from impairment to
handicap
Dyspnoea, dysphagia, dysphonia-surgery
REHABILITATION
Psychological support
6/13
K.Park 24th
Ed.

8. NATIONAL IODINE DEFICIENCY
DISORDERS CONTROL PROGRAMME
(NIDDCP)
Initiated by Government of India as GOITRE CONTROL PROGRAMME in
1962.
In 1992, National Goiter Control Programme was renamed as NIDDCP.
1.GOALS:
To reduce the prevalence of iodine deficiency disorder below 10% in entire
country by 2012.
Achieve universal access to iodized salt

7/13
Source:NATIONAL HEALTH PROGRAMS OF INDIA

9. 2.OBJECTIVES:
Survey to assess the magnitude of IDD
Supply of iodated salt in place of common salt
Resurvey after every five year to assess
the extent of IDD and impact of iodized salt
Laboratory monitoring of iodated salt
Health education and publicity
8/13
Source:NATIONAL HEALTH PROGRAMS OF INDIA

10. 3.ACTIVITIES :
Iodization
Adequate iodization of salt
Standard of Salt:
-Moisture=not more than 6%

-NaCl=not less than 96%

-Anti-cracking agent=not
more than 2%

Source:NATIONAL HEALTH PROGRAMS OF INDIA
9/13

11. Primary level
•Estimation of
Iodine content
of salt by
Titration
method.
Secondary level
•Estimation of
urinary iodine
excretion.
Tertiary level
•Neonatal
screening for
Thyroid
Stimulating
Hormone.
Three levels of Monitoring:
•IDD LABORATORIES setup in each state
during 8th five year plan to monitor
Quality of iodized salt AND
Content of iodine in urine sample.
MONITORING AND SURVILLENCE
Source:NATIONAL HEALTH PROGRAMS OF INDIA
10/13

12. Increase in number of iodization plant from 12 in 1983 to 832
in 2011.
Production - 112% of required amount.
Banning the sale of non iodized salt issued under “Food
Safety & Standards Act 2006”.
For effective implementation of NIDDCP 33 States/UTs have
set up IDD control cell.
Standard of iodization set under “Prevention of Food
Adulteration Act”.
4.ACHIEVEMENTS
Source:NATIONAL HEALTH PROGRAMS OF INDIA
11/13

13. •Avoid goitrogens
•Iodine rich food
PRIMARY
PREVENTION
•Surgery
(thyroidectomy)
•Drugs( thyroid supplementation )
SECONDARY
PREVENTION
•Psychosocial support
•Follow up
TERTIARY
PREVENTION
CASE MANAGEMENT OF OUR
PATIENT
12/13
INDIVIDUAL INTERVENTION
Advice Given
Source:NATIONAL HEALTH PROGRAMS OF INDIA

14. •Air tight container for salt storage.
•Prevent exposure to heat and sunlight.
FAMILY
INTERVENTION
•Health education to community.
•Lectures and demos on salt usage to
students.
•Health exhibition.
COMMUNITY
INTERVENTION
•National programme launched by
government.
•Information education communication.

NATIONAL
INTERVENTION
Source:NATIONAL HEALTH PROGRAMS OF INDIA
13/13

15. References :
1)J. Kishore’s NATIONAL HEALTH PROGRAMS OF INDIA
2)Park’s Textbook of PREVENTIVE AND SOCIAL MEDICINE-24rd edition.
21st OCTOBER
GLOBAL IDD PREVENTION DAY