Assessment of iodine deficiency disorders in Meerut district, Uttar Pradesh

Iodine deficiency disorders (IDD) are an important public health problem in India. Meerut district, Utter Pradesh, is a known IDD endemic area. A study conducted in 1986 reported a total goitre rate of 24.9% in the entire population of Meerut district. During 1990-97 intensive efforts were taken by the Uttar Pradesh Government to ensure universal availability of iodized salt to the population. No survey has been conducted since 1997 on the status of iodine deficiency in the Meerut district. Hence, the present study was conducted in order to assess the prevalence of IDD and to estimate the iodine content of salt consumed in the households of Meerut district, Uttar Pradesh. The 30 cluster sampling methodology and indicators for assessment of IDD as recommended by the joint WHO/UNICEF/ICCIDD (World Health Organization/United Nations Children's Fund/International Council for the Control of Iodine Deficiency Disorders) Consultation in full was utilized for the survey. A confidence level of 95%, relative precision of 10% and design effect of three were considered in the calculation of the sample size. The prevalence of goitre at the time of survey was estimated to be 15%. A total of 6485 school children in the 6-10 years age group were selected using probability proportionate to size cluster sampling methodology. A total goitre prevalence rate of 11.6% was found in the district. It was observed that 5.4, 2.9 and 19.9% of the children had urinary excretion levels of < 2.0, 2.0-4.9, and 5.0-9.9 mu g/dL, respectively. The median urinary iodine excretion of the children studied was found to be 15.0 mu g/dL. Fifty-three percent of the children studied consumed salt with an iodine content of less than 15 p.p.m., which was below the stipulated level (15 p.p.m.). The study showed that the population is in a transition phase from iodine deficient (as revealed by total goitre rate) to iodine sufficient (as revealed by median urinary iodine excretion of 15.0 mu g/dL). There is a need to further strengthen the existing monitoring system for the quality of iodized salt in the district in order to achieve the elimination of IDD.