AWARENESS OF VARIOUS POPULATION GROUPS OF THE VORONEZH REGION ABOUT IODINE DEFICIENCY AND WAYS OF ITS PREVENTION

Full Text

RELEVANCE

In accordance with the criteria for assessing the severity of iodine deficiency diseases by WHO (2000), the situation with iodine deficiency in Voronezh and the Voronezh Region is regarded as mild with a tendency to transform into moderate severity [1]. In children and adults, in 65-95% of cases, the cause of thyroid diseases is insufficient iodine intake [2]. 9 municipalities were classified as risk territories in 2019 in the Voronezh Region for the incidence of endemic goiter associated with iodine deficiency: Buturlinovsky, Verkhnekhavsky, Gribanovsky, Nizhnedevitsky, Olkhovatsky, Pavlovsky, Podgorensky, Ternovsky municipal districts and Borisoglebsky city district [3]. Therefore, at present, the issues of prevention of iodine deficiency diseases are still relevant in the Voronezh region.

AIM

to study the awareness of various groups of the population of the Voronezh region about iodine deficiency and to raise awareness of people on the issues of iodine prophylaxis.

MATERIALS AND METHODS

The study was conducted on the basis of the Voronezh State Medical University named after N.N.Burdenko of the Ministry of Health of the Russian Federation (VSMU) in the city of Voronezh and on the road in four districts of the Voronezh Region (Buturlinovsky, Verkhnemamonsky, Paninsky, Podgorensky). To assess the awareness of the population, a questionnaire was developed and conducted among schoolchildren of grades 8-10 (2018 - 2019) and teachers of secondary educational institutions (2018 - 2019), as well as among students of VSMU (2020-2021). Respondents were asked to answer 8 questions anonymously.

1) Your age.

2) Place of residence.

3) Place of study/work.

4) Do you live in an area with iodine deficiency?

5) Do you know why iodine is needed for the human body?

6) How often do you consume iodine-rich foods?

7) Do you use iodized salt in your food?

8) Do you want to learn more about the effects of iodine, its deficiency on the human body and iodine prophylaxis?

All 678 survey participants were divided into three groups. The first group included 312 students aged 14 to 16 years, of which 62 people (20%) live in Voronezh, 250 (80%) in rural areas. The second group included 204 teachers aged 25 to 73 years, of which 33 people (16%) live in Voronezh, 171 (84%) in rural areas. The third group included 162 students living at the place of study in the city of Voronezh. Statistical processing was performed using Microsoft Excel and Statistica 12 software. Based on the results of the study, a lecture presentation "Prevention of endemic goiter" was prepared for a conversation with schoolchildren, teachers, students, and information materials (information sheets and a booklet) were developed in pdf format.

RESULTS

To the questionnaire question "Do you live in a territory with iodine deficiency?" 28% of schoolchildren (87 people) answered positively, 25% (77 people) — negatively, 47% (148 people) found it difficult to answer. Among teachers, 41% (84 people) answered positively, 19% (39 people) negatively, 40% (81 people) found it difficult to answer. Among the students, 39% (63 people) answered positively, 48% (78 people) — negatively, 13% (21 people) found it difficult to answer. 72% of schoolchildren, 59% of teachers, 61% of students do not know that they live in an area with iodine deficiency. There was no statistically significant difference between urban and rural populations (p=0.23).

To the question of the questionnaire, "Do you know why iodine is needed for the human body?" In the first group (schoolchildren), 87% (272 people) responded positively and 13% (40 people) negatively. In the second group (teachers) 94% (192 people) answered positively and 6% (12 people) negatively. In the third group (students) - 87% (141 people) responded positively and 13% (21 people) negatively. Rural schoolchildren are more confident in their knowledge of iodine (p=0.044), since 91% (227 people) gave affirmative answers and only 9% —23 people) - negative answers, respectively, against 73% (45 people) and 27% (17 people) of urban schoolchildren. There is no such difference between rural and urban teachers (p=0.56): 97% (166 people) of rural teachers gave affirmative answers and only 3% (5 people) - negative answers, respectively, against 85% (28 people) and 15% (5 people) of urban teachers' answers.

In the questionnaire question "How often do you consume iodine-rich foods (sea fish, seaweed, etc.)?" respondents were asked to choose the answer options: rarely, often, I don't know. Schoolchildren answered: rarely - 69% (216 people), often - 29% (89 people), do not know - 2% (7 people). Teachers answered: rarely - 77% (157 people), often - 16% (33 people), do not know - 7% (14 people). Students answered: rarely - 64% (104 people), often - 26% (42 people), do not know - 10% (16 people). The vast majority of 69% of schoolchildren, 77% of teachers, 64% of students rarely consume foods rich in iodine. At the same time, urban schoolchildren more often consume foods rich in iodine (p= 0.049). This trend can be traced in the responses of urban and rural teachers (p=0.67).

To the question "Do you use iodized salt for food?" the following results were obtained: among schoolchildren, 18% (56 people) did not know about such salt, 24% (74 people) use iodized salt for food, 45% (141 people) do not use, 13% (41 people) found it difficult to answer the question; among teachers, 52% (106 people) use iodized salt for food, 48% (98 people) do not use; among students, 58% (94 people) use iodized salt for food, 39% (63 people) do not use, 3% (5 people) found it difficult to answer the question. Urban schoolchildren are much more likely to use iodized salt than rural ones: 39% (24 people) versus 20% (50 people). If in the city only 6% of schoolchildren (4 people) did not know about iodized salt, then in rural areas — 21% (52 people). Among teachers, other data: rural teachers are much more likely to use iodized salt than urban ones: 59% (100 people) versus 36% (12 people).

To the questionnaire question "Do you want to learn more about the effect of iodine, its deficiency on the human body and iodine prophylaxis?" schoolchildren answered: "yes" - 75% (233 people) of respondents, "no" - 18% (58 people), "I don't know" - 7% (21 people); teachers answered: "yes" - 67% (137 people) of respondents, "no" - 26% (53 people), "I don't know" — 7% (14 people); students answered: "yes" — 97% (157 people) of respondents, "no" — 3% (5 people). In the city, 55% (34 people) of schoolchildren want to learn more about the effect of iodine on the body, in the village – 80% (199 people).

DISCUSSION

When analyzing the results of the survey, less than half of both teachers and students, and less than 1/3 of schoolchildren, have knowledge that the Voronezh Region is a territory with iodine deficiency. The vast majority of schoolchildren, teachers and students are aware of the role of iodine in the human body, rural schoolchildren and students are more knowledgeable. Respondents rarely consume iodine-rich foods and use iodized salt, while 18% of schoolchildren do not even know about iodized salt. Medical students and rural schoolchildren were the most interested in obtaining new knowledge on iodine prophylaxis.

The survey data showed the need to organize events on the territory of Voronezh and the Voronezh Region aimed at raising awareness of the population about iodine deficiency and the need for its prevention. The results of this work, as well as earlier studies [4, 5] formed the basis for the creation of visual information illustrative material (information sheet, booklet, presentations), which was used during the campaign "Iodine - for every family". The action was organized by VSMU together with the Department of Medical Prevention of Voronezh Regional Clinical Hospital No. 1 (VOKB No. 1). The venues for the campaign were secondary educational institutions of the city of Voronezh and districts of the Voronezh region (2018 - 2019), VSMU (2020 - 2021), VOKB No. 1 (2021). VSMU students, medical volunteers, together with VSMU teachers, employees of the Department of Medical Prevention, doctors of VOKB No. 1, along with questionnaires, distribution of information material during the campaign, conducted conversations with schoolchildren about the benefits of iodine for the body, made presentations to teachers about the effects of iodine deficiency on the body and ways to prevent iodine deficiency, participated in the interactive "Where to find iodine for the thyroid gland?", solved cases "Thyroid gland – how to make the right choice?".

CONCLUSION

On the territory of the Voronezh Region, various groups of the population in 65% of cases do not suspect that they live in an iodine-deficient region, 76% note the rare use of iodized products and only 40% use iodized salt. At the same time, 89% have a clear idea of why iodine is needed for the human body, and 78% expressed a desire for new knowledge about the effects of iodine, its deficiency on the human body and iodine prophylaxis.

Preventive actions on iodine prophylaxis, organized with the cooperation of educational and medical institutions, allow not only to voice the problem of iodine deficiency, but also to inform the participants of the action on all issues of prevention of iodine deficiency diseases using various communicative competencies.

In the future, in order to increase the effectiveness of preventive iodine prophylaxis programs before the adoption of mandatory mass prevention of iodine deficiency at the legislative level, it is necessary to continue awareness-raising work not only among schoolchildren, students and teachers, but also among other groups of the population of the iodine-deficient region of the Voronezh region.

About the authors

Aleksandr A. Tcurkan

Voronezh State Medical University named after N.N. Burdenko
of the Ministry of Health of the Russian Federation
Department of Public Health and Health Care

Author for correspondence.
Email: alexandertsu@yandex.ru
ORCID iD: 0000-0003-1814-9260
SPIN-code: 4964-8860

student

Russian Federation, Voronezh, Studencheskaya street, 10

References