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Indian Pediatr 2009;46: 57-59 |
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Urinary Iodine Excretion Levels Amongst
Schoolchildren in Haryana |
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Umesh Kapil
From the Department of Human Nutrition, All India
Institute of Medical Sciences,
Ansari Nagar, New Delhi1 110 029, India.
Correspondence to: Dr. Umesh Kapil, Professor, Department
of Human Nutrition,
All India Institute of Medical Sciences, Ansari Nagar,
New Delhi 110 029, India.
E- mail: [email protected]
Manuscript received: August 6, 2007;
Initial review completed: October 11, 2007;
Revision accepted: March 25, 2008.
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Abstract
This study was conducted in 2006 to assess the
current iodine nutriure of the population in Haryana by assessing the
urinary iodine excretion levels amongst the school age children between
6-12 years. Altogether 3,019 urine samples were collected from all the
19 districts in Haryana. The urinary iodine was analyzed by using wet
digestion method. Less than 1 % of children had urinary iodine excretion
levels below 20 mcg/L. Percentage of children with urinary iodine
concentration 21-50 mcg/L, 51-99 mcg/L, and 100 mcg/L were 0.8%, 6.2%
and 92.6%, respectively. We conclude that the Universal Salt Iodization
program is being successfully implemented in the state as the population
has adequate iodine status at the time of the survey.
Keywords: India, Iodine deficiency.
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W hether or not a
universal salt iodisation program (USI) is providing an adequate amount of
iodine to the target population, can be reliably assessed by reference to
measurements of urinary iodine excretion(UIE)(1). However, a single
urinary iodine measurement is not representative of individual nutritional
iodine status; UIE levels are useful, when used in cross-sectional,
epidemiological surveys in population samples of appropriate size( 2).
The Government of Haryana has adopted a policy of
Universal Salt Iodization (USI) since 1986, under which all the edible
salt is iodized for the state’s population. The effectiveness of this
policy was assessed through an analysis of urine samples collected from
3019 children families from 19 districts in 2006.
Methods
The study was conducted in the year 2006 in all the 19
districts of Haryana state. The sample size for urine samples to be
collected per district (n=100) was calculated keeping in view the
prevalence of urinary iodine excretion deficiency as 30%, relative
precision of 15% and a confidence interval of 95%(2).
In each district, all the primary schools were enlisted
and one school, which was at least 40 km away from the district
headquarters, was selected by random sampling. All the children attending
the school on the day of the survey were assembled and a lecture on health
consequences of IDD was delivered. From each school 150 children in the
age group of 6-12 years of age were included. If the sample size could not
be covered from the identified school, then the nearest primary school was
included in the study. An informed consent for participation was taken
from parents of all children. All the selected children were requested to
provide "on the spot" casual urine samples. Plastic bottles with screw
caps were used for collection of the urine samples. The samples were
stored in a refrigerator until analysis. UIE levels were analyzed using
the wet digestion method(3). An internal quality control sample was run
with every batch of test samples. If the results of the internal quality
control sample was within the range, then the test was deemed in control
and if the results were outside the range, then the whole batch was
repeated. The urinary iodine concentration
was expressed in µmol iodine/L urine.
Results
The UIE levels in each district are depicted in
Table I.
TABLE I
Urinary Iodine Excretion Level in Districts of Haryana
|
District |
n |
Urinary Iodine Excretion Level (mg/L) |
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|
< 20.0 (%) |
20.0 – 49.9 (%) |
50.0 – 99.9 (%) |
100.0 (%) |
Median |
| Sonipat |
152 |
1 (0.7) |
3 (2.0) |
8 (5.3) |
140 (92.1) |
200 |
| Panipat |
190 |
1 (0.5) |
5 (2.6) |
28 (14.7) |
156 (82.1) |
150 |
| Karnal |
152 |
0 (0.0) |
0 (0.0) |
1 (0.7) |
151 (99.3) |
200 |
| Yamuna Nagar |
152 |
0 (0.0) |
0 (0.0) |
3 (2.0) |
149 (98.0) |
210 |
| Kurukshetra |
152 |
0 (0.0) |
2 (1.3) |
7 (4.6) |
143 (94.1) |
200 |
| Ambala |
152 |
0 (0.0) |
1 (0.7) |
5 (3.3) |
146 (96.1) |
182 |
| Panchkula |
151 |
0 (0.0) |
0 (0.0) |
1 (0.7) |
150 (99.3) |
210 |
| Kaithal |
168 |
0 (0.0) |
5 (3.0) |
12 (7.1) |
151 (89.9) |
200 |
| Jind |
152 |
0 (0.0) |
0 (0.0) |
7 (4.6) |
145 (95.4) |
210 |
| Sirsa |
202 |
0 (0.0) |
5 (2.5) |
46 (22.8) |
151 (74.8) |
150 |
| Fatehabad |
152 |
0 (0.0) |
0 (0.0) |
14 (9.2) |
138 (90.8) |
200 |
| Hissar |
152 |
1 (0.7) |
1 (0.7) |
17 (11.2) |
133 (87.5) |
191 |
| Bhiwani |
159 |
0 (0.0) |
1 (0.6) |
11 (6.9) |
147 (92.5) |
200 |
| Mahendragadh |
152 |
0 (0.0) |
0 (0.0) |
1 (0.7) |
151 (99.3) |
210 |
| Rewari |
152 |
0 (0.0) |
0 (0.0) |
4 (2.6) |
148 (97.4) |
210 |
| Jhajar |
152 |
0 (0.0) |
0 (0.0) |
1 (0.7) |
151 (99.3) |
210 |
| Rohtak |
149 |
0 (0.0) |
1 (0.7) |
0 (0.0) |
148 (99.3) |
210 |
| Gurgaon |
152 |
0 (0.0) |
0 (0.0) |
16 (10.5) |
136 (89.5) |
200 |
| Faridabad |
176 |
0 (0.0) |
0 (0.0) |
4 (2.3) |
172 (97.7) |
200 |
| Total |
3,019 |
3(0.09) |
24 (0.8) |
186 (6.2) |
2,806(92.6) |
200 |
Discussion
In the present study, all districts of Haryana were
found to have adequate iodine nutriture as shown by UIE levels. The
findings of the present study also highlights the success of universal
salt iodization program in all the 19 districts included in the present
study. The urinary iodine excretion rates recorded in our study agree with
those reported in adjoining state of Delhi, where the median urinary
iodine value was 120 mcg/L. Similar findings are reported from other
studies conducted in India(4-10).
Our study has some limitations. We presumed that all
the primary schools which were at least 40 km away from the district
headquarters, would be consuming salt with similar iodine content (in real
life situation, the salt is marketed in the entire district mainly by
three-four wholesale salt traders only). We also presumed that the
children from the selected schools were representative of the children of
the entire district. With the above two presumptions, the findings
obtained from the selected schools in the present study may be generalized
to the entire district.
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What This Study Adds?
• Iodine status of primary school children in
Haryana is adequate.
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Funding: None.
Competing interests: None stated.
References
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Health Organi-zation 1994.
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