PREVENTION AND CONTROL OF IODINE DEFICIENCY DISORDERS & NIDDCP

1. PREVENTION AND CONTROL OF IODINE
DEFICIENCY DISORDERS & NIDDCP
 Moderators:
Dr.Nikhat
Dr.Shaigan
Dr.Abdullah
Dr.Naveen
Dr.Saleem
Dr. Sameena
 Presented by
MOHD YEZDANI
2k14

2. Pregnant Women
●
-IUD
●
-Abortion
●
-still birth
Neonate
-Neonatal
hypothyroidism
Children
-Cretinism
-Dwarfism
-Mental Retardation
Adult
-Strabismus
-Goiter
-Neuromuscular
disease
India having world’s biggest goiter belt (Himalayan Goiter Belt)
No state is free from Goiter
K.Park 24th Ed. 1/13
WHY IDD IS A MAJOR HEALTH
PROBLEM IN INDIA?
It affect all age groups with wide spectrum of diseases

3. PRIMARY PREVENTION
 HEALTH PROMOTION
1. HEALTH EDUCATION:
Create awareness in high risk group
Educate people to eat iodine rich food,salt and avoid
goitrogens
2. ENVIRONMENT MODIFICATION:
Fertilizers increase the soil iodide state
Reducing iodine volatilization loss
by liming the soil 2/13
LEVEL OF PREVENTION
K.Park 24th Ed.

4. 3. NUTRITIONAL INTERVENTION
Food fortification: fortified salt, double
fortified salt.
 Spraying of potassium iodate solution on
salt heap.
4. LIFESTYLE AND BEHAVIORAL
CHANGES
Difficult, slow and gradual process
Avoid goitrogens
Prefer Iodine rich food
3/13K.Park 24th Ed.

5. SPECIFIC PROTECTION
1. SPECIFIC DIET:
 Iodized salt
2. SUPPLEMENTATION:
Iodized oil injection(IM)-1ml gives protection for 4
years
Iodized oil capsule
4/13K.Park 24th Ed.
At
Production
level
At Consumer
level
Concentration
of Iodine
30 ppm 15 ppm
Level of Iodisation

6. SECONDARY PREVENTION
EARLY DIAGNOSIS:
Serum level of T3,T4 and TSH
Urine iodine excretion
Heel prick test in Neonates for
congenital hypothyroidism
TREATMENT:
Medical
Surgical
5/13
K.Park 24th Ed.

7. TERTIARY PREVENTION
DISABILITY LIMITATION
Prevent the transition of disease from impairment to
handicap
Dyspnoea, dysphagia, dysphonia-surgery
REHABILITATION
Psychological support
6/13
K.Park 24th
Ed.

8. NATIONAL IODINE DEFICIENCY
DISORDERS CONTROL PROGRAMME
(NIDDCP)
 Initiated by Government of India as GOITRE CONTROL PROGRAMME in
1962.
 In 1992, National Goiter Control Programme was renamed as NIDDCP.
1.GOALS:
To reduce the prevalence of iodine deficiency disorder below 10% in entire
country by 2012.
Achieve universal access to iodized salt
7/13Source:NATIONAL HEALTH PROGRAMS OF INDIA

9. 2.OBJECTIVES:
Survey to assess the magnitude of IDD
Supply of iodated salt in place of common salt
Resurvey after every five year to assess
the extent of IDD and impact of iodized salt
Laboratory monitoring of iodated salt
Health education and publicity
8/13Source:NATIONAL HEALTH PROGRAMS OF INDIA

10. 3.ACTIVITIES :
Iodization
Adequate iodization of salt
Standard of Salt:
-Moisture=not more than 6%
-NaCl=not less than 96%
-Anti-cracking agent=not
more than 2%
Source:NATIONAL HEALTH PROGRAMS OF INDIA 9/13

11. Primary level
• Estimation of
Iodine content
of salt by
Titration
method.
Secondary level
• Estimation of
urinary iodine
excretion.
Tertiary level
• Neonatal
screening for
Thyroid
Stimulating
Hormone.
Three levels of Monitoring:
• IDD LABORATORIES setup in each state
during 8th five year plan to monitor
 Quality of iodized salt AND
 Content of iodine in urine sample.
MONITORING AND SURVILLENCE
Source:NATIONAL HEALTH PROGRAMS OF INDIA
10/13

12.  Increase in number of iodization plant from 12 in 1983 to 832
in 2011.
 Production - 112% of required amount.
 Banning the sale of non iodized salt issued under “Food
Safety & Standards Act 2006”.
 For effective implementation of NIDDCP 33 States/UTs have
set up IDD control cell.
 Standard of iodization set under “Prevention of Food
Adulteration Act”.
4.ACHIEVEMENTS
Source:NATIONAL HEALTH PROGRAMS OF INDIA
11/13

13. •Avoidgoitrogens
•Iodinerichfood
PRIMARY
PREVENTION
•Surgery
(thyroidectomy)
•Drugs(thyroidsupplementation)
SECONDARY
PREVENTION
•Psychosocialsupport
•Followup
TERTIARY
PREVENTION
CASE MANAGEMENT OF OUR
PATIENT
12/13
INDIVIDUAL INTERVENTION
Advice Given
Source:NATIONAL HEALTH PROGRAMS OF INDIA

14. •Airtightcontainerforsaltstorage.
•Preventexposuretoheatandsunlight.
FAMILY
INTERVENTION
•Healtheducationtocommunity.
•Lecturesanddemosonsaltusageto
students.
•Healthexhibition.
COMMUNITY
INTERVENTION
•Nationalprogrammelaunchedby
government.
•Informationeducationcommunication.
NATIONAL
INTERVENTION
Source:NATIONAL HEALTH PROGRAMS OF INDIA
13/13

15. References :
1) J. Kishore’s NATIONAL HEALTH PROGRAMS OF INDIA
2) Park’s Textbook of PREVENTIVE AND SOCIAL MEDICINE-24rd edition.
21st OCTOBER
GLOBAL IDD PREVENTION DAY