Iodine deficiency disorders (IDD) are a significant public health problem in India. It is estimated that 150 million people in the country are afflicted with IDD. In addition to goitre and cretinism, IDD is linked to neurological defects, stunted growth, still births, and reproductive failure. This project will determine the prevalence of IDD in two "at risk" populations: women of reproductive age and adolescents in both the slums of Bombay and in the districts of Amravati and Dhule. Iodine intake will also be assessed, and the knowledge and perceptions of community members regarding IDD and the iodization of salt will be investigated. It is expected that the findings will be used by the government to improve their policies and programs aimed at the prevention and control of IDD.

Purpose:

The goal of the study was to determine the prevalence of iodine deficiency disorders (IDD) in high risk groups (women of reproductive age and adolescents) in the city of Bombay.

Objectives: 

The project objectives were as follows: to assess the iodine status and the prevalence of IDD among women and adolescents in urban slums in Bombay; to determine iodine intake form different food items, water and salt; to determine patterns of salt consumption; and to investigate the awareness of slum dwellers of iodized salt and their knowledge and perceptions on IDD.

Project findings:

Three hundred adolescents, from a slum at Kandivli, were clinically examined and given biochemical test to determine their iodine status. The results indicate a high prevalence of mild and moderate IDD among adolescents in the sample, with girls having higher rates of total goitre and visible goitre rates than boys. Among pre-school children, goitre was more prevalent in boys than in girls. Just over two hundred pre-schoolers were tested. The prevalence of IDD among 479 pregnant women from urban slums in Bombay was 27.3 percent. Urine tests and goitre rates clearly indicated that the women were at risk of hypothyroidism. An investigation of salt consumption showed that 95 percent of the women consumed non-iodized salt, and the majority showed different grades of thyroid enlargement and deficient urinary iodine excretion. A comparative determination of iodine status in the fishing community of Bombay was carried out. Seventy-five families involved in fishing and who consumed fresh or dry fish on a daily basis were surveyed. In spite of an iodine rich diet, there were still high rates of IDD prevalence, particularly of goitre. This suggest that another factor (probably an unknown goitrogen) was inhibiting iodine updake.

The sources of dietary iodine in 10 different regions of India were investigated. Cereals contribute 32 to 49 percent of dietary iodine. Milk and other dairy products were another important source. Depending on the amount consumed, fresh fruit and vegetables provided between 4 and 27 percent of daily requirements. Salt provided 15 to 42 percent of daily requirements. Iodine losses during cooking ranged from 37 to 70 percent. In seven out of ten regions, the iodine content of cooked mixed diets was below the recommended daily allowance. Consumption of iodized salt was lowest among women of low-income groups as they bought mostly coarse, non-branded salt.

(Research team was trained in the assessment of iodine status and in urinary iodine estimations. Graduate students from the Department of Postgraduate Studies and Research in Home Science were involved in all stages of research.)

 

Contact:

Dr. Marianne Varghese, Director   Dept. of Post-Graduate Studies and Research in Home Science   SNDT Women's University   Sir Vithalas Vidyavihar   Juhu Road, Santa Cruz (West)   Bombay 400-049, India   Tel: 91-22-612-8855   Fax: 91-22-610-4159

 

Post-program summary:

Research results indicated that goitre is a public health problem in the urban slums of Bombay. High goitre prevalence was noted in almost all the groups studied (preschoolers; pre-adolescents; adolescents; and women). Mild to moderate iodine deficiency was present in all pregnant women. The project showed that even fishing villages in the area had endemic goiter rates. The major sources of dietary iodine were observed to be cereals for the lower income groups, and milk and milk products in the higher income groups. The daily mean intake of iodine for the lower income groups was 110 mcg/day, below the recommended daily intake of 150 mg/day. The iodine content of the water supply in the Bombay area was low. The project showed that the iodisation of the water supply could be used to increase the iodine intake of the groups studied. Estimations of dietary iodine questioned the validity of using the iodine content of raw foods for computing the iodine intake, as significant losses were recorded in processing and cooking. Project results were disseminated at various regional and international conferences. A workshop was held in Bombay in February 1993 with participants from the government, academia, and medical professions where the salient findings of the project were presented. Areas for future research were identified; and participants agreed on an integrated strategy for controlling IDD.

Project literature: 

N.S. Dodd. 1992. Report on iodine deficiency in urban slums in Bombay. SNDT Women's University. 1992. 162 p. : ill. 
Final report Location: ARCHIV 616.39 D 6 BIBLIO ISN: IDRC-Lib-101573