The recent editorial(1) highlighted the achievements made in India in the field of Prevention and Control of Iodine Deficiency Disorders. It was interesting to note that the author has referred to published research work undertaken only by himself, while published research work of many distinguished scientists working in the field of IDD has not been mentioned.

It is not surprising to find persistence of prevalence of goiter more then 5 per cent amongst school children who have now a normal urinary iodine excretion. Disappearance of goiter in. the affected children and the absence of occurrence of any new case usually take couple of years after urinary iodine is corrected. This may be the possible reason of continued high prevalence of goiter seen in some areas. A recent study conducted by the Indian Council of Medical Research (ICMR) in whiCh one district was selected in the states of Jammu and Kashmir, Uttar Pradesh, Himachal Pradesh and Maharashtra, the prevalence of goiter in children (6-12 years) was found to be 5.1%, 4.2%,2.2% and 0.2% respectively(2). These finding are similar to the findings observed by the author in his re- search studies(1).

The author has not discussed about the possible side effects due to consumption of iodised salt like Iodine Induced Hyperthyroidism (IIH). This has been documented to be an important side effect, although rare, but still it requires careful consideration in a country like India, 'which had history of severe chronic iodine deficiency and now iodine supplementation is being done rapidly. It has been documented that the incidence of IIH is normally dependent upon three factors: (i) level of pre-existing severity of iodine deficiency in the population; (ii) quantity of iodine supplemented to the population for correction of iodine deficiency; and (iii) rapidity with which the iodine supplementation is undertaken(3). Although there are no published studies on the higher incidence of IIH in India after initiation of iodine supplementation program, this aspect needs to be further investigated.

The administration of iodized oil in prevention of iodine deficiency disorders is a political issue on which decision needs to be taken. by the national authorities depending upon the existence of severity of iodine deficiency, incidence of cretinism and other iodine deficiency disorders. However, the data quoted by the author( 1) clearly reveals that in India the expensive and sophisticated technology of iodized oil may not be required in prevention of IDD.

The success of national IDD control program is almost similar to National Universal Immunization Programme and the factors responsible for the success should be further highlighted and shared with national and state health planners, administrators and academicians so that they can also adopt similar strategies for efficient implementation of other national health programmes in the country.

Ritu Pradhan,
Nutritionist,
1/1866, Mansarovar Park,
Delhi 110 032, India.