2007-2008年内蒙古自治区碘缺乏病高危地区病情及碘营养现状调查

目的 了解内蒙古碘缺乏病高危地区是否存在新发地方性克汀病病例,掌握地方性甲状腺肿(简称甲肿)流行现况及综合防治措施落实情况,为制订碘缺乏病的防治策略提供依据.方法 2007-2008年,在内蒙古历史地克病流行严重的松山区、克什克腾旗、喀喇沁旗,扎赉特旗、卓资县,凉城县、清水河县、和林县、东胜区、准格尔旗、伊金霍洛旗等11个旗(县、区),对10岁以下儿童进行新发地克病病例搜索;每个旗(县、区)选择3～5个乡,每个乡选择3～5个村小学,每所小学选择120～200名8～10岁儿童,进行甲状腺检查、智商和尿碘检测;每个乡选择2个村,每个村选择30个居民户,检测家庭主妇尿碘及家中食用盐含碘量情况.结果 11个项目旗(县、区)共搜索出56例疑似新发地克病病例,无确诊病例.触诊法和B超法检查8～10岁甲状腺,甲肿率分别为5.2%(309/5922)、4.3%(252/5922);8～10岁儿童尿碘中位数为241.5μg/L,尿碘为100.0～300.0 μg/L占65.9%(3901/5920).其中9个项目旗(县、区)的尿碘中位数在200.0～300.0μg/L,尿碘<50.0μg/L所占的比例>5%的旗(县、区)为0,<100.0μg/L所占的比例>10%的有1个.家庭主妇的尿碘中位数为225.6μg/L,<50.0μg/L占2.2%(35/1597).<100.0 μg/L所占比例>10%的旗(县、区)有4个.调查的2109户居民中有97.45%(2055/2109)的存食用碘盐,有2.55%(54/2109)的居民食用无碘盐.结论 调查的11个项目旗(县、区)儿童甲肿率降至10%以下,未发现新发克汀病病例,防治成绩显著;儿童和育龄妇女碘营养水平基本适宜;碘盐覆盖率高、销售网络比较健全、价格合理、购买方便,食盐加碘为主消除碘缺乏病防治措施得到有效的落实,儿童的智力得到有效保护.碘缺乏病健康教育仍然是防治工作中的一个薄弱环节,亟待加强.

Abstract：

Objective To investigate new cases of endemic cretinism in high-risk areas of Inner Mongolia, the prevalence of endemic goiter, the implementation of comprehensive measures, and to provide scientific basis for developing control strategies against iodine deficiency disorders (IDD). Methods In 2007 and 2008, a search for new cretin cases was conducted among children under the age of 10 in 11 historical serious epidemic cretinism prevalent areas of Songshan district, Keshiketeng qi, Kalaqin qi, Zhalaite qi, Zhuozi county,Liangcheng county, Qingshuihe county, Helin county, Dongsheng district, Zhungeer qi and Yinjinhuoluo qi. Three to 5 towns were selected in each qi(county, district) and 3 to 5 village primary schools were selected in each town.One hundred and twenty to 200 children aged 8 to 10 were selected in each school to inspect thyroid by B ultrasound and palpation and to test intelligence and urinary iodine. Two villages were selected in each town and 30 households were selected to determine urinary iodine of housewives and salt iodine. Results A total of 56 cases of suspected cases of endemic cretinism were found from the 11 counties but no case was confirmed. The goiter rate of children aged 8 to 10 was 5.2% (309/5922) by palpation and 4.3% (252/5922) by B-ultrasound. The median urinary iodine of children aged 8 to 10 was 241.5 μg/L, and urinary iodine was 100 to 300 μg/L, accounted 65.9%(3901/5920). Median urinary iodine of the 9 Qis(counties, districts) was in the range of 200 and 300μg/L.Higher than 5% of the 11 Qis(counties, districts) with urinary iodine lower than 50 μg/L was zero. Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 1. The median urinary iodine of housewives was 225.6 μg/L, and lower than 50 μg/L accounted for 2.2%(35/1597). Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 4. A total of 2109 households were investigated and 97.45%(2055/2109) of them ate iodized salt and 2.55%(54/2109) of them ate non-iodized salt. Conclusions In the 11 investigated counties, goiter rate of children has decreased to less than 10%, and no new cretin was found. It could be concluded that the fulfillment of prevention and control of IDD is effective. The iodine nutrition of children and women of childbearing age is in an adequate level. The coverage rate of iodized salt has maintained at a higher level, the sales network is sound, the salt price is reasonable and salt is easy to get and the children's intelligence is protected effectively. But, the health education about IDD is still weak, need to be reinforced.

Survey of prevalence of iodine deficiency disorders and iodine nutrition in high-risk areas of Inner Mongolia in 2007 and 2008

Objective To investigate new cases of endemic cretinism in high-risk areas of Inner Mongolia, the prevalence of endemic goiter, the implementation of comprehensive measures, and to provide scientific basis for developing control strategies against iodine deficiency disorders (IDD). Methods In 2007 and 2008, a search for new cretin cases was conducted among children under the age of 10 in 11 historical serious epidemic cretinism prevalent areas of Songshan district, Keshiketeng qi, Kalaqin qi, Zhalaite qi, Zhuozi county,Liangcheng county, Qingshuihe county, Helin county, Dongsheng district, Zhungeer qi and Yinjinhuoluo qi. Three to 5 towns were selected in each qi(county, district) and 3 to 5 village primary schools were selected in each town.One hundred and twenty to 200 children aged 8 to 10 were selected in each school to inspect thyroid by B ultrasound and palpation and to test intelligence and urinary iodine. Two villages were selected in each town and 30 households were selected to determine urinary iodine of housewives and salt iodine. Results A total of 56 cases of suspected cases of endemic cretinism were found from the 11 counties but no case was confirmed. The goiter rate of children aged 8 to 10 was 5.2% (309/5922) by palpation and 4.3% (252/5922) by B-ultrasound. The median urinary iodine of children aged 8 to 10 was 241.5 μg/L, and urinary iodine was 100 to 300 μg/L, accounted 65.9%(3901/5920). Median urinary iodine of the 9 Qis(counties, districts) was in the range of 200 and 300μg/L.Higher than 5% of the 11 Qis(counties, districts) with urinary iodine lower than 50 μg/L was zero. Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 1. The median urinary iodine of housewives was 225.6 μg/L, and lower than 50 μg/L accounted for 2.2%(35/1597). Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 4. A total of 2109 households were investigated and 97.45%(2055/2109) of them ate iodized salt and 2.55%(54/2109) of them ate non-iodized salt. Conclusions In the 11 investigated counties, goiter rate of children has decreased to less than 10%, and no new cretin was found. It could be concluded that the fulfillment of prevention and control of IDD is effective. The iodine nutrition of children and women of childbearing age is in an adequate level. The coverage rate of iodized salt has maintained at a higher level, the sales network is sound, the salt price is reasonable and salt is easy to get and the children's intelligence is protected effectively. But, the health education about IDD is still weak, need to be reinforced.