Iodised salt programme in Himachal Pradesh launched under the National Goiter Control Programme in 1962 needs to be urgently reviewed, says a study published in the recent edition of Indian Journal of Endocrinology and Metabolism. It has also called for starting a neonatal screening programme for early detection of children suffering with iodine deficiency (ID) to ensure them timely treatment.
The observation from the researchers from the Delhi-based All India Institute of Medical Sciences and Institute of liver and Biliary Sciences came after they found that despite the programme, a high percentage of children, mothers and neonatal in the hilly State were suffering from acute ID.
Incidentally, Himachal Pradesh is the hometown of Union Minister of Health JP Nadda who heads the Union Health Ministry.
While ID can be prevented by ensuring an adequate intake of iodine, its shortage in fetus results in miscarriages, stillbirths, brain disorders, retarded psychomotor development, speech, and hearing impairments. In pregnant mother, ID leads to decreased synthesis of thyroxin by the fetal thyroid, which causes compromised mental and physical development of the fetus. In children, its deficiency results retarded physical and mental growth.
“The findings of the present study indicate that there is an urgent need to strengthen the ID control programme for its prevention in Himachal Pradesh. There is a high prevalence of ID among school-going children, pregnant mothers, and neonates of Himachal Pradesh. Thus, there is a need to review the implementation of the iodised salt programme in the State. Furthermore, there is an urgent need for a neonatal screening programme for early detection if children with ID,” say the researchers.
The team comprises researchers Ajeet Singh Bhadoria from Institute of liver and Biliary Sciences in Delhi, Umesh Kapil, Neha Sareen, Preetika Khenduja and Ravindra Mohan Pandey from Delhi-based All India Institute of Medical Sciences.
A total 5,748 school going children, 1,711 pregnant mothers and 1,934 neonates were studied from Kangra, Mandi, and Shimla in Himachal Pradesh in the year 2012-2014. Clinical examination of thyroid and urine of each child and pregnant mothers was conducted while cord blood samples were collected for estimation of thyroid stimulating hormone (TSH) among neonates.
One district was selected randomly from Kangra (Kangra region), Kullu (Mandi region), and Solan (Shimla region). Among school going children, total goiter rate (TGR) was 15.8 per cent (Kangra), 23.4 per cent (Kullu), and 15.4 per cent (Solan). In Pregnant mothers, TGR was 42.2 per cent (Kangra), 42.0 per cent (Kullu), and 19.9 per cent (Solan). In Neonates, TSH levels were also quite high.