| ObjectiveTo find out the status of iodine deficiency disorders (IDD), and assess the effects of prevention and control measures in Linxia Hui Autonomous Prefecture, Gansu province, and further summarize the knowledge of experience for sustainable eliminating IDD in rural national autonomous areas.Methods1. Iodine levels in local water body, salt, and urine samples random collected from local pregnant women, lactation samples, unpregnancy women of child-bearing age, and 0-3 years old infants were tested respectively. Thyroid volume and intelligence quotient (IQ) among 8-10 years old children, the development quotient (DQ), body height and weight among 0-3 years old infants were then investigated. Furthermore, IDD health knowledge level among pupils and women was surveyed by questionnaire.2. Intervention measures for IDD such as health promotion and iodine oil strengthening supply for target population were first performed, and then iodine levels in salt and urine samples were examined 1 year later for evaluation of the effect of the intervention.Results1. (1) Iodine background level was much lower in local total environment where iodine level in 90% local water body was lower than 10μg/L. (2) The pass percentage of iodized salt sold locally was above 95%. In term of household level, the local consumption rate and coverage rate of iodized salt were 83.2% and 85%, respectively, which were below than the recommended level (90%) of eliminating IDD issued by Chinese government. Non-iodized salt still had a coverage rate as high as 15%, especially 20% non-iodized salt coverage rate was observed in local 3 national autonomous counties. (3) The median of urine iodine among pregnant women, lactation samples, unpregnancy women of child-bearing age was below than the reference value of 150μg/L recommended by Chinese government, but the median of urine iodine among 0-3 years old infants was higher than 100μg/L. The percentage of urine iodine level below than 100μg/L and 50μg/L among the target population was 52.8% and 22.8%, respectively, showing severe iodine deficiency was prevalent for the vulnerable population. (4) Goiter among the children aged 8-10 years was 10.3% by B ultrasound examination and 9.94% by palpation. The average IQ was only 85 and a bias frequency distribution was found. (5) The average DQ among 0-3 years old infants was 92.4. Additionally, a bias frequency distribution in DQ, body height and weight was also observed, where both the low level and high level had a more rate than the normal level, indicating that the local children development was severely retarded. (6) The local illiteracy rate of women was 52.6%, however, the women who knew the role of IDD playing in intelligence damage, the role of IDD playing in goiter, and iodated salt as the key measure to prevent IDD accounted for 28.3%, 48.6% and 39.6% among women, and 79.2%, 76.5%, 82.3% among pupils. 65% of women obtained information from pupils, and 60% of the pupils obtained information through media such as the TV, broadcast and newspapers.2. (1) After 1 year intervention, the local consumption rate and coverage rate of iodized salt were 88.4% and 89.7%, respectively, which were near 90%. Non-iodized salt rate decreased to 10.3%. The IDD information rates were significant different compared with pre-intervention among pupils and women. (2) Iodine oil was a safe way to supply iodine for unpregnancy women of child-bearing age, pregnant women, lactation samples and 0-3 years old according to the dosage of 400mg, 200mg, 200mg and 40 mg per year respectively. (3) After iodine supply, the median of urine iodine among 4 groups objects was all about 135μg/L. The percentage of urine iodine level below 100μg/L and 50μg/L among the target population was 32.3% and 11.8%, respectively, indicating the iodine nutrient was abundant in target population.Conclusions1. (1) Severe IDD is prevalent in Linxia Hui Autonomous Prefecture. Iodine background level was lower in local total environment. The measure of using iodized salt (USI) has not been performed completely. The population iodine intake was not well-fed. (2) The iodine nutrient is not abundant in target population, especially in pregnant and lactation women, children growth and development is thus impacted seriously. The iodine supplement is urgent need to ensure abundant iodine nutrient among pregnant women, lactation samples, unpregnancy women of child-bearing age. (3) The iodine nutrient is not enough in pregnant and lactation women in the regions where the local consumption rate and coverage rate of iodized salt are about 80% and 95%, respectively. The inconsistency indicates that iodized salt supply can not meet the need of iodine nutrition for vulnerable population in rural national autonomous areas. (4) The target population is lacking of IDD information, hence the health education should be strengthened to change unsatisfied health behaviors.2. (1) The measure combined the government, all department, and all people should be built to eliminate IDD as a systematic social project. (2) Iodine oil supply is a safe and effective way for human iodine nutrient. After iodine supplement, the urine iodine concentration of the target population achieves or approaches the criteria of IDD elimination, indicating that iodine oil supply is effective to improve the population quality in special regions and special population. (3) All people should be motived, the education promotion should be performed, and USI measure should be insisted to prevent and control IDD in rural national autonomous areas. (4) The further study is necessary for exploring the median of urine iodine still under 100μg/L among target population even the same dose iodine oil were used after 1-year-intervention in rural national autonomous areas.
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