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Lyu S.,Institute for Endemic Disease Control | Xu D.,Institute for Endemic Disease Control | Wang Y.,Institute for Endemic Disease Control | Du Y.,Institute for Endemic Disease Control | And 2 more authors.
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] | Year: 2015

OBJECTIVE: Using the thyroid volume criteria for body surface area (BSA) to assess more precisely the effectiveness of removing iodized salt on the goiter status of children living in areas with excessive iodine in drinking water.METHODS: Three towns with median water iodine (MWI) of 150-300 µg/L were selected by simple random method in Hengshui city of Hebei province of China in May of 2010. A total of 452 and 459 children in the 3 towns were randomly selected to measure thyroid volume by ultrasound. Iodized salt was removed in July of 2010. In October of 2013, 459 children in these 3 towns were selected by simple random method to measure their thyroid volume by ultrasound again. Their goiter status was judged using the criteria of thyroid volume for BSA recommended by the WHO.RESULTS: After removing iodized salt, the overall BSA specific goiter prevalence in the three towns significantly decreased from 33% (149/452) to 6% (30/459) (χ² = 100.64, P < 0.001). The BSA specific goiter prevalence in 8, 9 and 10 year-old children decreased respectively from 38% (35/92), 31% (59/193) and 33% (55/167) to 6% (10/164), 7% (11/163) and 7% (9/132) (χ² values were 41.35, 31.66, 29.79, P < 0.001). The BSA specific goiter prevalence in boys and girls decreased from 34% (83/244) and 32% (66/208) to 6% (14/225) and 7% (16/234) (χ² values were 55.01, 45.06, P < 0.001) respectively.CONCLUSION: The BSA specific children's goiter prevalence decreased significantly after removing iodized salt from their diet in the HIA in Hebei province.


Jia L.-H.,Institute for Endemic Disease Control | Ma J.,Institute for Endemic Disease Control | Du Y.-G.,Institute for Endemic Disease Control | Ma D.-R.,Institute for Endemic Disease Control | And 6 more authors.
Chinese Journal of Endemiology | Year: 2011

Objective: To understand the status of drinking-water-borne endemic fluorosis and the effect of preventive measure in Hebei province, so as to provide a basis to prevent and cure the disease. Methods: Thirty-eight affected counties (cities, districts) with drinking-water-borne endemic fluorosis were sampled by random sampling in Hebei in 2009. All affected villages in every county were divided into mild, moderate and severe endemic fluorosis areas and a village was randomly selected from each category of the area to carry out the monitoring of endemic fluorosis. Dental fluorosis of children aged 8-12 were examined and 6 copies of urine samples were randomly collected in each age group in the above-mentioned villages. Clinical skeletal fluorosis was diagnosed among adults aged 16 and over and 20 copies of urine samples were tested for fluorosis in every village. Results: A total of 112 affected villages were investigated, among which the drinking water quality of 66 villages were improved and 46 villages were not improved. A total of 236 copies of water samples from the 66 villages were measured and the fluoride content ranged from 0.1 to 4.3 mg/L, among which 20 copies of water samples exceeded the fluorine standard of 1.2 mg/L, accounting for 33.3%. A total of 230 copies of water samples were collected in the 46 villages and the fluoride content ranged from 0.2 to 4.6 mg/L, among which 76.1% (35/46) of the water samples exceeded the fluorine standard of 1.2 mg/L. A total of 5169 children aged 8-12 were examined of dental fluorosis, the dental fluorosis rate was 36.43% (1883/5169) and the dental fluorosis index was 0.81. A sum of 71 497 adults aged over 16 years were examined, and the rate of skeletal fluorosis was 4.81% (3438/71 497), moderate or severe clinical detection rate of skeletal fluorosis was 1.56% ( 1114/71 497). A total of 2876 copies of children urine samples and 2021 copies of adult urine samples were tested and the geometric mean of fluoride content was 2.30,3.32 mg/L, respectively. Conclusions: The prevalence of dental fluorosis of children in the areas with improved water is less than 30% and the rate of dental fluorosis and skeletal fluorosis decline gradually with time. The rate of dental fluorosis and skeletal fluorosis increases with the increase of water fluoride in the water quality not improved areas. The endemic fluorosis is still comparatively serious in Hebei. The progress of improving water quality in the areas with endemic fluorosis should be accelerated and the acceptability of improved water should be enhanced.


Chong Z.-S.,Institute for Endemic Disease Control | Ma J.,Institute for Endemic Disease Control | Jia L.-H.,Institute for Endemic Disease Control | Lu S.-M.,Institute for Endemic Disease Control | And 7 more authors.
Chinese Journal of Endemiology | Year: 2011

Objective: To evaluate the effectiveness of health education on iodine deficiency disorders (IDD) in Hebei, and to provide basic information for development of control strategies. Methods: A total of 34 project counties were selected in Hebei province, and 3 townships were chosen in each project county. Heath educational activities were carried out in the classes of grade 5 in the central primary school of each selected township. In the meantime, 3 villages were chosen in each selected township where the health education for women of childbearing age in the community was carried out. Surveys on knowledge of IDD control were conducted in the 34 project counties before and after the health educational activities. Results The knowing rates of IDD control among pupils in all 34 project counties increased from 71.10% (7835/11 019) to 94.84% (10 840/11 430) after health education, with a average increase of 23.74%. The knowing rates of IDD control among housewives increased from 77.02% (4531/5883) to 95.32% (5902/6192), with a average increase of 18.30%. Of which, the knowing rates of IDD control among pupils in Hengshui city increased from 55.56% (750/1350) to 94.89% (1281/1350), with a average increase of 39.33%. The knowing rates of IDD control among housewives in Handan city increased from 65.68% (532/810) to 96.50% (909/942), with a average increase of 30.82%. Conclusions: The knowing rates of IDD control among pupils and housewives are remarkably increased after implementing the health education projects. They have better life and health habits, and the project achieves desired effect.


He F.-Z.,Institute for Endemic Disease Control | Guo M.,Institute for Endemic Disease Control | Danzengsangbu,Institute for Endemic Disease Control | Nimacangjue,Institute for Endemic Disease Control | Baimayangjin,Institute for Endemic Disease Control
Chinese Journal of Endemiology | Year: 2011

Objective: To find out the dynamics of drinking water borne endemic fluorosis in Tibet's, to evaluate the effect of control measures, and to provide a scientific basis for the timely adjustment of control strategies. Methods: During September to October 2009, according to the "2008 Central Government Special Funds to Subsidize Local Public Health in Drinking Water Borne Fluorosis in Tibet", Xigaze Xietongmen and Nyingchi Zayu were selected as project counties, three project villages were selected with simple random sampling method in each county, the functioning of water improvement projects, drinking water fluoride content, children's dental fluorosis and adult skeletal fluorosis were investigated. Water fluoride was detected by the "standard examination methods for drinking water the non-metallic targets" (GB/T 5750.6-2006) determination of fluoride; urinary fluoride was tested by ion selective electrode (WS/T 89-1996); dental fluorosis was diagnosed using Deans method; adult skeletal fluorosis was diagnosed by "endemic skeletal fluorosis clinical diagnostic criteria" (WS 192-2008). Results Mean water fluoride was 0.18-0.34 mg/L in drinking water changed areas, and 0.70-2.13 mg/L in not changed areas; prevalence of dental fluorosis of children 8-10 was 50.78% (65/128), dental fluorosis index was 1.04, mean urinary fluoride was 1.64 mg/L in drinking water changed areas ; prevalence of dental fluorosis of children 8-10 years old was 80.65% (25/31) in not changed areas, dental fluorosis index was 1.50, mean urinary fluoride of children was 2.08; adult clinical skeletal fluorosis was 38.7%(104/269) in drinking water changed areas, the mean urinary fluoride was 1.61 mg/L, prevalence of skeletal fluorosis was 15.4% (18/117) in not changed areas, mean urinary fluoride was 3.54 mg/L. Conclusions: The method of change the water to reduce fluoride decreases dental fluorosis to control levels, and severity is also reduced, urinary fluoride is decreased. However, the prevalence of skeletal fluorosis is higher than that of drinking water not changed areas.


Jia L.-H.,Institute for Endemic Disease Control | Ma J.,Institute for Endemic Disease Control | Du Y.-G.,Institute for Endemic Disease Control | Ma D.-R.,Institute for Endemic Disease Control | And 2 more authors.
Chinese Journal of Endemiology | Year: 2013

Objective: To find out the status of drinking-water-borne endemic fluorosis and the effect of preventive measures in Hebei Province, so as to provide a basis to prevent and cure fluorosis. Methods: One affected county (city, district) with drinking-water-borne endemic fluorosis was sampled in every city and 10 water improvement projects were investigated in that county. Three villages were taken out in every county. The operating state of the projects, the water fluoride content, and the dental fluorosis of children aged 8-12 and skeletal fluorosis of adults were investigated in these villages. Results: A total of 93 projects were investigated, among which 94.6%(88/93) were operating properly and the qualified rate(fluoride content ≤ 1.2 mg/L) of the projects was 54.84%(51/93). Among the 9 large projects, the water fluoride content of 7 projects exceeded 1.2 mg/L. A total of 23 villages with water improvement projects were investigated and only 43.4% (10/23) of them water fluoride content were lower than 1.2 mg/L. The dental fluorosis rate, the dental fluorosis index and the rate of skeletal fluorosis were 33.2% (532/1601), 0.74 and 5.7% (66/1155), respectively. In the 7 villages without water improvement projects, 2 of them exceeded 2.0 mg/L, but lower than and equal to 4.0 mg/L of water fluorosis and 5 of them were normal(<1.2 mg/L). The dental fluorosis rate, the dental fluorosis index and the rate of skeletal fluorosis were 33.4%(111/332), 0.72 and 2.9% (10/350), respectively. Conclutions: The qualified rate of water improvement projects of fluoride content ≤1.2 mg/L is low and the endemic fluorosis is still comparatively serious in Hebei Province. The progress of water improvement projects in the areas with endemic fluorosis should be accelerated and the quality of water improvement projects should be increased.


Gong H.-Q.,Institute for Endemic Disease Control | Guo M.,Institute for Endemic Disease Control | Dan Zeng S.-B.,Institute for Endemic Disease Control | He F.-Z.,Institute for Endemic Disease Control | And 2 more authors.
Chinese Journal of Endemiology | Year: 2010

Objective: To know the quality of iodized salt and the current situation of the salt coverage in Tibet, and to provide scientific basis for proposing proper prevention and control measures to Iodine dificiency disorders(IDD). Methods: In 2008, according to the "Sampling Methods of the Main Products in the Salt Industry", one batch fifteen salt samples were collected in iodized salt processing factory in Tibet. Five townships were chosen in each county based on 5 different directions of east, south, west, north and center. If the monitoring county has less than five townships, then all of the townships were sampled. In each township, four villages were selected with random sampling and importance sampling. In each township, 15 households were selected for salt collection. Results: A batch of 15 salt samples in a salt processing plant were tested, and all of them were qualified with salt iodine(34.6 ± 1.58) mg/kg. A total of 21 107 edible salt samples were tested, and 11 203 of them were qualified iodized salt. These results meant that the provincial iodized salt coverage rate was 53.08%. Shannan iodized salt coverage rate was 94.31% (3395/3600) which was the highest in Tibet. Those of Nagqu, Changdu, Ngari were lower, they were 29.84% (897/3006), 24.94% (823/3300) and 17.08% (205/1200), respectively. Conclusions: The quality of iodized salt in Tibet is up to the national standard, but the coverage rate of iodized salt is very low. We suggest that the strategy should be carried out according to the national overall program strategy and supplement iodized oil capsule for special groups.


Wang J.-H.,Institute for Endemic Disease Control | Feng X.-W.,Institute for Endemic Disease Control | Zheng Z.-X.,Institute for Endemic Disease Control | Liu W.,Institute for Endemic Disease Control | And 7 more authors.
Chinese Journal of Endemiology | Year: 2010

Objective: To establish information management systems of drinking water defluoridation project in water-related endemic fluorosis areas and investigate the status of drinking water defluoridation project in Liaoning, provide the basis for the development of control measures. Methods: Global positioning systems (GPS) and geographic information systems(GIS) were used in the study in August 2006 - July 2008. Water defluoridation projects of 1234 in 48 counties (cities, districts) in drinking water type of fluorosis areas were positioned. Latitude and longitude, water samples, water fluoride content were collected or tested. GIS was used to establish information management system of water defluoridation projects. Results: We have established information management system for the facilities of decreasing water fluorine in drinking water type of endemic fluorosis regions in Liaoning. One thousand two hundred and thirty four defluoridation facilities distributed in east longitude between 39.39° - 43.37°, north latitude between 119.25° - 125.50°, and altitude between - 6.60 and 801.14 meter in 48 endemic fluorosis counties in 13 cities. Nine hundred and twenty seven facilities for decreasing fluorine were able to supply water regularly.accounting for 75.1% of investigated projects; 29 facilities was not yet completely rebuilt, accounting for 2.4%; 278 facilities (supply water for 344 villages) were out of order or discarded for 22.5% of investigated projects. Water fluorine contents of 63 facilities were greater than 1.2 mg/L, accounting for 6.8% of investigation project Facilities working regularly and water fluorine was in accord with hygienic standard for drinking water facilities were 70.0%. Conclusions: The establishment of Liaoning province defluoridation project information management system in the whole province of drinking water type of fluorosis areas provides scientific basis for accurate decision-making on prevention and control of the disease.


He P.,Institute for Endemic Disease Control | An D.,Institute for Endemic Disease Control | Li D.-S.,Institute for Endemic Disease Control | Zhang B.-Y.,Institute for Endemic Disease Control | Liang Y.,Institute for Endemic Disease Control
Chinese Journal of Endemiology | Year: 2011

Objective: To investigate the usage of fluorine-proof iron stove in regions with coal-burning borne endemic fluorosis of Guizhou province and to provide scientific basis for the project management. Methods: According to "the local prevention programs against coal-burning borne endemic fluorosis-Guizhou iron stove usage survey scheme", in the 18 counties implemented the project of improving the iron stove from 2005 to 2008, 2 townships were selected randomly in each county of each project annually, 2 villages were selected in each township randomly, and 10 households were checked in each village. The project households were investigated using questionnaire of the related health knowledge and awareness as well as the satisfaction of the households. Results: Circled digit oneThe improvement rate of iron stove was 100.00% (1286/1286). Circled digit twoThe overall utilization rate of the improved stove was 94.09% (1210/1286), in which winter was 62.21% (800/1286) and annual was 31.88% (410/1286). Circled digit threeAmong the households that did not use the project stove, 46.05%(35/76) households was due to switch to other clean energy, in addition, 19.74%(15/76) was due to sell or send to other households, and 14.47% (11/76) was still used to use the open kitchen without the ventilating pipe, and still 13.16%(10/76) was due to high coal prices, and 6.58%(5/76) was due to that the improved stove can not meet the needs of life and no longer used. Circled digit fourAmong 1261 households investigated, households with damaged furnace was 24.58%(310/1261), and the parts damaged were mainly chimney (ventilating pipe) and the furnace core, accounting for 51.94%(161/310) and 29.03%(90/310), respectively. Repair rate of the damaged parts was 32.58%( 101/310). Circled digit fiveThe health knowledge rate was about 82.74% (1064/1286), and the satisfaction of the iron furnace was 88.65% (1140/1286). Conclusions: The improved stoves for the prevention of endemic fluorosis in the diseased area meet the people's living habits, and meet their basic livelihood needs. Most project households are still using the improved furnace. But we still need to further strengthen the project management and the health education intervention, establish and improve stove maintenance network, and reach the goal of sustainable control of coal-burning borne endemic fluorosis.


PubMed | Institute for Endemic Disease Control
Type: Journal Article | Journal: Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] | Year: 2015

Using the thyroid volume criteria for body surface area (BSA) to assess more precisely the effectiveness of removing iodized salt on the goiter status of children living in areas with excessive iodine in drinking water.Three towns with median water iodine (MWI) of 150-300 g/L were selected by simple random method in Hengshui city of Hebei province of China in May of 2010. A total of 452 and 459 children in the 3 towns were randomly selected to measure thyroid volume by ultrasound. Iodized salt was removed in July of 2010. In October of 2013, 459 children in these 3 towns were selected by simple random method to measure their thyroid volume by ultrasound again. Their goiter status was judged using the criteria of thyroid volume for BSA recommended by the WHO.After removing iodized salt, the overall BSA specific goiter prevalence in the three towns significantly decreased from 33% (149/452) to 6% (30/459) ( = 100.64, P < 0.001). The BSA specific goiter prevalence in 8, 9 and 10 year-old children decreased respectively from 38% (35/92), 31% (59/193) and 33% (55/167) to 6% (10/164), 7% (11/163) and 7% (9/132) ( values were 41.35, 31.66, 29.79, P < 0.001). The BSA specific goiter prevalence in boys and girls decreased from 34% (83/244) and 32% (66/208) to 6% (14/225) and 7% (16/234) ( values were 55.01, 45.06, P < 0.001) respectively.The BSA specific childrens goiter prevalence decreased significantly after removing iodized salt from their diet in the HIA in Hebei province.


Guo M.,Institute for Endemic Disease Control | Gong H.,Institute for Endemic Disease Control | Zhao S.,Institute for Endemic Disease Control | Danzeng S.,Institute for Endemic Disease Control | And 2 more authors.
Chinese Journal of Endemiology | Year: 2015

Objective To monitor the situation of iodine deficiency disorders ODD) in Tibet, and to provide a background information of iodine nutritional status of residents before adjustment of iodine concentration. Methods According to the method of population proportionate sampling (TPS), 27 counties were selected to carry out IDD surveillance. One primary school was selected in each county. Forty children aged 8-10 from each primary school were sampled to examine thyroid volume, arid edible salt samples were collected from their home to determine salt iodine. In addition, 12 of the sampled children, 15 pregnant women and 15 lactating women from three townships near the selected schools were chosen to detect urinary iodine. The methods of B-ultrasonography, oxidation-reduction titration (GB/T 13025.7-1999) and arsenic cerium catalytic spectrophotometry (WS/T 107-2006) were used to determine thyroid volume, salt iodine and urinary iodine, respectively. Results One thousand and eighty-one children aged from 8 to 10 were examined, and their goiter rate was 1.9% (20/1 081). Seven hundred and fifty-eight salt samples were determined, and the median salt iodine level was 38.3 mg/kg and the consuming rate of qualified iodized salt was 88.1%(758/668). Meanwhile, urine samples of 522 children aged 8 - 10, 267 pregnant women and 336 lactating women were also tested, and their median urinary iodine level was 166.1, 132.7, 138.1 μg/L, respectively. Conclasions The results show that the goiter rate and urinary iodine level of children aged from 8 to 10 have reached the national standard of 11)1) elimination ( < 5%, 100 - 300 μg/L), while the residents consumption rate of qualified iodized salt is still lower than the national standard (90%). In particular, the iodine nutrition of pregnant women is inadequate, which is lower than the national standard (urinary iodine 150 (μg/L). It is still necessary to strengthen the monitoring of salt iodine as well as iodine nutrition in special groups in the future, and strengthen health promotion at the same lime.

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