论文部分内容阅读
目的评价山西省实施全民食盐加碘以来的防治效果及存在的问题,进一步完善可持续防治策略。方法1995-2003年的9年时间里,山西省地方病防治研究所对省辖的119个县(市、区)全部进行了碘缺乏病(IDD)监测。有4年是按照国家统一指导方案监测,其余间隙年山西省自行按PPS法抽样,产生30个监测点进行监测。监测指标包括8～10岁儿童甲状腺肿大率、儿童尿碘、盐碘及健康教育得分。结果(1)9年间,儿童甲状腺肿大率由1995年的10.9%下降到2003年的3.9%;(2)执行新的食盐加碘标准后,盐碘中位数从1999年的峰值49.7mg/kg逐年下降到2003年的31.7mg/kg,儿童尿碘中位数也由峰值407.5μg/L逐年下降到2003年的263.6μg/L,尿碘值在100~300μg/L的比率由低谷值24.6%逐年上升到2003年的51.1%;(3)9年间,合格碘盐食用率为48.3%~93.1%,碘盐覆盖率为90.5%~99.6%;(4)5年级学生和家庭主妇的IDD健康教育问卷知晓率均有逐年下降趋势。结论(1)自2000年山西省阶段性IDD消除目标实现以后,各项指标得到明显的提高,一直处于可持续消除IDD状态;(2)建议将食盐加碘执行标准改为(30±10)mg/kg,即能保证且适合各类人群的碘营养需求;(3)非碘盐冲击市场的现象始终存在,IDD健康教育工作需要继续加强。
Objective To evaluate the control effect and existing problems since the implementation of universal salt iodization in Shanxi Province and to further improve the strategy of sustainable prevention and control. Methods Nine years from 1995 to 2003, Institute of Endemic Diseases Control of Shanxi Province conducted iodine deficiency disorders (IDD) surveillance in 119 counties (cities and districts) under provincial jurisdiction. There are 4 years in accordance with the national unified guidance program monitoring, Shanxi Province, the remaining years in accordance with the PPS sampling method to produce 30 monitoring points for monitoring. Surveillance indicators included goiter rates, urinary iodine, salt iodine and health education scores for children aged 8-10 years. Results (1) In the 9 years, the rate of goiter in children dropped from 10.9% in 1995 to 3.9% in 2003; (2) After implementing the new standard of salt iodization, the median salt iodine increased from 49.7 mg / kg year by year to 31.7mg / kg in 2003, the median urinary iodine in children also decreased from 407.5μg / L to 263.6μg / L in 2003, and the urinary iodine value ranged from 100μg / L to 300μg / L. The value of 24.6% increased year by year to 51.1% in 2003; (3) The consumption rate of qualified iodized salt was 48.3% -93.1% in nine years and the coverage rate of iodized salt was 90.5% -99.6%; (4) Grade 5 students and housewives IDD health education questionnaire awareness rates have declined year by year. Conclusions (1) Since the phased IDD elimination goal was achieved in Shanxi Province in 2000, all indicators have been significantly improved and have been in a state of sustainable elimination of IDD. (2) It is suggested that the implementation standard of iodized salt should be changed to (30 ± 10) mg / kg, that is, the iodine nutrition requirement that can be guaranteed and suitable for all kinds of people; (3) Phenomena of non-iodized salt impact on the market always exist, and IDD health education needs to be further strengthened.