Effectiveness of the iodine prophylaxis model adopted in Poland.

OBJECTIVE: Most of the Polish territory has been classified as an iodine-deficient and endemic goiter area according to the International Council for Control of Iodine Deficiency (ICCIDD) criteria. In 1997 the obligatory model of iodine prophylaxis was implemented. Our investigations were aimed at the effectiveness of iodine prophylaxis in Poland. METHODS: We assessed urinary iodine excretion and goiter prevalence in 5663 children aged 6-12 yr. The population of children from the same 27 schools was investigated from 1992 to 1994 (1406 girls and 1244 boys) and from 1999 to 2005 (1563 girls and 1450 boys) using identical laboratory and ultrasound methods. RESULTS: We found significant increase in iodine urinary concentration (median 52 microg/l vs 93 microg/l, p<0.001) with accompanying drop in goiter prevalence (29.6% vs 5.2%, p<0.001) after implementation of iodine prophylaxis. Iodine excretion distribution changed significantly after 1997 with an increase in the percentage of children with iodine urinary concentration above 100 microg/l from 10.8% to 45.4%, respectively. A significantly higher iodine urinary concentration was observed in lowlands compared to uplands both before and after implementation of iodine prophylaxis (median, 50 microg/l vs 57 microg/l and 86 microg/l vs 114 microg/l, respectively, p<0.001). The goiter prevalence did not differ between girls and boys from 1992 to 1994 (28.8% vs 30.5%, p=0.35) and 1999 to 2005 (5.5% vs 4.9%, p=0.45). CONCLUSIONS: Implementation of the new model of iodine prophylaxis in Poland in 1997 has led to significant increase in iodine urinary concentration and decrease in goiter prevalence among Polish schoolchildren. In the youngest group of children (6-8 yr olds), prevalence of goiter decreased to 3.2%--i.e. below endemic levels.

Prevalence of goiter in schoolchildren--a study on the influence of adequate iodine prophylaxis in Poland.

Poland has been known as an area with iodine deficiency. Surveys carried out in 1992/1993 and 1994 revealed that the voluntary model of iodine prophylaxis introduced in 1986 was ineffective. In 1997 a new model of iodine prophylaxis based on obligatory household salt iodization has been implemented. In order to assess its effectiveness new studies were undertaken in 1999-2001. The study involved 1471 school-children aged 6-15 years from 12 sites. In every subject thyroid volume by means of ultrasound and urinary iodine concentration were assessed. The results were compared with data obtained from the same schools in the 1992/1993 survey. Between 1992/93 and 1999/2001 goiter prevalence decreased from 14.5% to 5.2% (p<0.05) and median urinary iodine concentration increased from 56 microg/l to 103 microg/l (p<0.05). A decrease in goiter prevalence was observed in 6 sites with moderate goiter endemia, whereas the changes in goiter prevalence were statistically insignificant in other 6 sites. Three sites were characterized by goiter prevalence close to 5% before and after implementing the obligatory model of iodine prophylaxis. Goiter prevalence in the remaining three sites remained within the same limit of 7-10%, in spite of observed ioduria increase. The Authors conclude that the Polish model of obligatory iodine prophylaxis ensures efficient iodine supplementation and this is confirmed by a significant increment in ioduria. The effect of this model on thyroid volume is evident in moderate goiter endemia areas. Slight changes in goiter prevalence in mild goiter endemia regions need further monitoring and considering other factors affecting thyroid volume.

[Frequency of appearance of antibodies to bovine serum albumin in children with diabetes type I]. / Czestosc wystepowania przeciwcial przeciwko albuminine wolowej (BSA-Ab) u dzieci ze swiezo wykryta cukrzyca typu 1.

It has been suggested that antibodies to bovine serum albumin may participate in the autoimmune process leading to the destruction of pancreatic islets. In the present study the frequency of antibodies to bovine serum albumin (BSA-Ab) in 45 children with newly diagnosed diabetes type 1, 32 children with diabetes lasting from 1-10 years and 65 healthy children was evaluated. BSA-Ab were determined by fluoroimmunometric method. The average value of fluorescence intensity 19 children with newly diagnosed diabetes type 1, who feeding mother's milk was 2037 x 10(3) +/- 898 x 10(3) impulse of fluorescence per minute (IMF) and was significant lower than the average value of fluorescence intensity of children with newly diagnosed diabetes type 1, who feeding artificiality. Antibodies to bovine serum albumin were found in 10% of children with newly diagnosed diabetes type 1, who feeding at the first six months of their life mother's milk, in 42% of children with newly diagnosed diabetes type 1, who feeding artificially and 3% of healthy children.

Epidemiologic estimation of goiter in children from Gdansk, Elblag, Olsztyn and Torun districts (Gdansk coordinating center).

The study comprised 1604 children (49.9% of boys and 50.1% of girls) of age between 6 and 13 years living in the districts of Gdansk, Elblag, Olsztyn and Torun. 55.5% of children were from urban area, 44.5% from rural area. This districts have been divided into 3 geographic regions. 1) Olsztyn region: 174 children and the villages near Olsztyn--178 children, 2) Seaside region: Gdansk and Elblag--358 children and 3 villages situated in the distance less than 60 km from the sea--533 children, 3) Torun region: Torun--181 children and villages near Torun--180 children. A significant relationship between the incidence of goiter and the place of living was found. The presence of goiter was observed in 9.2% of children in Gdansk and Elblag and in 23% of children in the seaside region (with the peak in Glincz village--35%). In Olsztyn region the incidence was 18.2%, in Torun region--12.5%. Among 1604 studied subjects in 263 (16.4%) with goiter, the nodular goiter was in 2.3% of cases. The lowest occurrence of goiter was noted in Gdansk and Elblag. Urinary iodine concentration in children with goiter from Gdansk and Elblag (123.1 micrograms/l) was higher than in those living in villages in the seaside region (90.8 micrograms/l). The thyroid size as measured by ultrasonography was different in children with and without goiter in each age group. In the age group of 6-8 years it was 4.8 ml in children without goiter and 6.3 ml in children with goiter, in the age group 9-10 years, 5.7 ml and 8.6 ml, in the age group 11-12 years, 6.6 ml and 10.0 ml, in children 13 years old--8.0 ml and 12.1 ml. All the children with goiter have greater body weight and height than those in the same age groups without goiter. 13.2% of studied persons consumed iodized salt. There was no difference in the incidence of goiter in children receiving and not receiving iodized salt (13.4% and 13.1% in all regions). There was also lack of relation between urinary iodine concentration and rate of consumption of iodized salt.