Santé Voyages : Boutique, Préventions, Vaccins et traitements pour la santé du voyageur

Introduction

Alain Fisch, MD, Eric Pichard MD, Thierry Prazuck, MD,Robert Sebbag, MD, Ghislaine Torres, PhD, Gérard Gemez, PhD, and Marc Gentilini, MD, PhD

As many as 400 to 800 million people may be exposed to iodine deficiency throughout tbe worid. 1 This deficiency is responsible for various disorders grouped under the heading of iodine deficiency disorders : goiter, hypothyroidism, impaired mental function, spontaneous abortions, stillbirths, congenital anomalies, increased perinatal and infant mortality, and neurological and myxedematous cretinisms.2 The main methods used to combat iodine deficiency in developing countries have been the following :

  • lodization of salt, a costly method that requires special packaging and the existence of national commercial networks, which are currently insufficient.3
  • Intramuscular injections of iodinated oil, an individual method of protection that is demanding because it requires medical intervention ; the disposable injection equipment that is required increases the cost per annum and per subject considerably.1-3
  • Oral intake of iodinated oil, an individual method of prevention whose duration of protection is inadequate, given the cost ; it requires the setting up of a distribution infrastructure, and long-term compliance with treatment bas been poorly assessed.3-5

Because of these problems with existing methods of iodine deficiency prevention, we developed a method of collective prevention using a vehicle that is both ubiquitous and a dietary staple : water. The iodine supplementation of water from any source is accomplished by means of a silicone elastomer device that releases a physiological amount of iodine (>100 µg·8 per day) over a 1-year period.

No specialized skills are required to set up the method and no special contribution is required from the populations. The device was initially developed in the laboratory and the laboratory results were then tested in the field (Mali, West Africa).

American Journal of Public Health
April 1993, Vol. 83, No.4


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