LESSONS LEARNED FROM CHINA IN SUSTAINED ELIMINATION OF IODINE DEFICIENCY

摘要

IDD were recorded in ancient Chinese medical literatures for thousands of years which now is also one of very significant public health problem and continue to threaten the quality of life, human potential and social economic development in China. It was estimated that 700 million people are at risk for iodine deficiency prior to prophylaxis. The epidemiological surveys revealed there were 35 million patients with endemic goiter ( visible ), 250,000 typical cretinism and proportion of mild mental retardation (IQ 50-69) covered 5-15% of the children in many IDD endemias, IQ distribution curves of children have a generalized tendency to shift to the left and IQ deficit of 10 points in the population living in IDD areas. Strong political commitment on elimination of IDD has been made by Chinese Government and USI has been accepted as the major intervention for correction of iodine deficiency nationwide since 1995. China has set up monitoring system on IDD and iodized salt, which includes : (1) Regular salt monitoring activity at county level ( household ) each year ; (2) Quality control at production level ; (3) irregular check at retail level and ; (4) National Monitoring activity: China has already implemented National Monitoring Activities every two or three years in 1995,1997,1999,2002 and 2005 respectively since 1995 after USI. All the activities are based on WHO/UNICEF/ICCIDD criteria. The monitoring results in 2005 indicated that China has maintained the sustained elimination of IDD : Coverage rate of qualified iodized salt (20-50 PPM) at household level): 90.2%; Iodine concentration in iodized salt at consumer level : 30.8 PPM; Urinary iodine in children : 246.3 μg/L; Total goiter rate in 5% by palpation and 4% by ultrasound respectively. The success of National IDD Control Program provided the following experience: strong political will and commitment to virtual elimination of IDD by top leaders; multisectoral coordination at both central and provincial levels; legislation on Universal Salt Iodization and monopoly of the salt trade; effective monitoring system and international cooperation.