Network E-Bulletin
Volume 1 Issue 7, November 2005
Welcome to the seven first issue of the Electronic Bulletin from the Network for Sustained Elimination of Iodine Deficiency.
The current Bulletin includes:
1. Conference on Quality of Salt Iodization in Central Asia and Mongolia: Tashkent, November 22-24, 2005.
2. World Development Report 2006
3. Update from ICCIDD
4. Research Publications
a. Prevalence of goiter among schoolchildren from Gorgan, Iran, a decade after national iodine supplementation: association with age, gender, and thyroperoxidase antibodies. J Endocrinol Invest. Sep 2005 28(8): p. 727.
b. Determination of iodine concentration in urine by isotope dilution analysis and thyroid volume of school children in the west coast of Turkey after mandatory salt iodization. Clin Endocrinol. Nov 2005 63(5): p. 543.
1. Conference on Quality of Salt Iodization in Central Asia and Mongolia (November 22-24, 2005)
Salt producers in Central Asia and Mongolia met in Tashkent, Uzbekistan last month to explore opportunities for mitigating iodine deficiency disorders and iron deficiency anemia among mothers and children, as well as food fortification issues. The three-day Second Regional Meeting of Salt Producers from Central Asia and Mongolia, jointly organized by Asian Development Bank, the Ministry of Health of Uzbekistan and UNICEF, discussed the results of the Improving Nutrition for Poor Mothers and Children in Asian Countries in Transition project and the Sustainable Food Fortification in Central Asia and Mongolia project. Both projects were supported by the Japan Fund for Poverty Reduction (JFPR).
The projects aimed to improve the nutrition status of mothers and children by mitigating iodine deficiency disorders and iron deficiency anemia through wider iodized salt1 production and consumption, and help the countries further progress in food fortification.
When the first project was launched in 2001, only Azerbaijan and Kyrgyz Republic had a Universal Salt Iodization Law. Now Kazakhstan, Mongolia, Tajikistan, and Turkmenistan have adopted similar legislation. All participating countries have increased their production of iodized salt and most have developed standardized methods of fortification, regulations, tax and tariff exemptions for potassium iodate and fortification equipment, and quality control systems. They have also strengthened awareness of and demand for iodized salt. However, challenges remain. Universal salt iodization legislation is yet to be adopted in Uzbekistan. As a result, household coverage for iodized salt is lower than its neighboring countries. Major challenges for salt producers include how to secure regular supplies of reasonably priced potassium iodate, and how to improve the quality of iodized salt.
The participants of the Conference were representatives of salt industries from Kazakhstan, Kyrgyz Republic, Mongolia, Tajikistan, and Uzbekistan. Topics discussed in the meetings included issues of quality assurance and control, production monitoring, trade and customs procedures affecting the quality of iodized salt production, procurement of fortificants and equipment, as well as the needs of salt industries.
Source: Asian Development Bank, Nov 2005 www.adb.org
2. World Development Report 2006: Equity Enhances the Power of Growth to Reduce Poverty.
Inequality of opportunity, both within and among nations, sustains extreme deprivation, results in wasted human potential and often weakens prospects for overall prosperity and economic growth, concludes the 2006 World Development Report, the World Bank’s major annual publication.
To correct this situation and reduce poverty more effectively, Equity and Development recommends ensuring more equitable access by the poor to health care, education, jobs, capital, and secure land rights, among others. It also calls for greater equality of access to political freedoms and political power, breaking down stereotyping and discrimination, and improving access by the poor to justice systems and infrastructure.
To level the playing field among countries, and thereby reduce global inequities that hurt the poor in developing countries, the report calls for removal of trade barriers in rich countries, flexibility to allow greater in-migration of lower-skilled people from developing countries, and increased—and more effective—development assistance. For more information about the WDR 2006 please visit www.worldbank.org2
3. Update from ICCIDD
By: D Haxton
- The International Thyroid Congress, comprised of the major associations of thyroid specialists in the world, endorsed the policies and strategies long promoted by ICCIDD and called upon Members, both organizations and individuals, to join National Coalitions to assure sustained success in national endeavors, and called upon all Members to assist in implementing the WHA Resolution calling for regular annual reporting by States Members.
- Progress in Egypt toward USI achievement continues. A national ICCIDD organization has been formed. It is comprised of key leaders on iodine nutrition and key producers of salt in the country. A survey will be undertaken early in 2006 led by ICCIDD. Materials on IDD and on programming issues in USI are being translated into Arabic.
- Turkmenistan is celebrating ten years of sustained and successful USI implementation in the country. ICCIDD issued a letter to the President commending this action and encouraging additional steps to assure continued success.
- ICCIDD and UNICEF have signed an agreement to review practices in the laboratories in 8 countries of Eastern Europe and to prepare a guideline for standards mutually acceptable as well as appropriate manuals for training and work performance. The work will be complete and shared by March-April 2006.
4. Research Publications
Prevalence of goiter among schoolchildren from Gorgan, Iran, a decade after national iodine supplementation: association with age, gender, and thyroperoxidase antibodies. HR Bazrafshan, S Mohammadian, A Ordookhani, F Farhidmehr, M Hedayati, N Abdolahi, F Azizi, LE Braverman, and EN Pearce. J Endocrinol Invest 1 Sep 2005 28(8): p. 727.
Background: One decade after universal salt iodization in Iran, goiter prevalence, urinary iodine concentration (UIC) and thyroperoxidase antibody (TPOAb) values were assessed among schoolchildren in Gorgan, Iran.
Methods: From 2003-2004, 500 girls and 900 boys aged 7-11 yr were evaluated for goiter by palpation. UIC was measured in 183 randomly-selected goitrous children. Serum TSH, T4, and TPOAb were measured in 53 goitrous and 30 non-goitrous children with adequate UIC.
Results: Goiter was detected in 370 (26.4%) children. Goiter was present in 31% of girls and 17% of boys age 9 (p<0.012); 37% of girls and 20% of boys age 10 (p<0.003); and 52% of girls and 19% of boys age 11 (p<0.0001). Median (range) UIC for all goitrous children sampled was 190 (20-600) microg/l; 220 (30590) in boys and 170 (20-600) in girls (p=0.001). Eight point seven percent of goitrous children and 22% of goitrous girls aged 10-11 had UIC<100 microg/l, while 47% of the goitrous children had UIC> or =200 microg/ l. TPOAb was present in 52.8% of goitrous children and 10% of non-goitrous children (p=0.0001). TPOAb was present in 53.9% of 10-11 and 22.7% of 7-9 yr old goitrous and non-goitrous children (p=0.003) with adequate UIC. Median (range) TSH was 2.9 (0.3-10.9) mlU/I in TPO-positive and 1.8 (0.5-4.1) in TPO-negative children (p=0.001). 3
Conclusions: Gorgan, Iran, is an iodine-sufficient area and almost half of schoolchildren have more than adequate UIC. TPOAb is associated with endemic goiter. Despite sufficient UIC overall, some school-aged girls remain at risk of iodine deficiency.
Source: http://highwire.stanford.edu/cgi/medline/pmid;16277169
Determination of iodine concentration in urine by isotope dilution analysis and thyroid volume of school children in the west coast of Turkey after mandatory salt iodization
S Darcan, P Unak, O Yalman, FY Lambrecht, FZ Biber, D Goksen, and M Coker
Clin Endocrinol (Oxf) 1 Nov 2005 63(5): p. 543.
Objective: This study was designed to evaluate iodine deficiency status in children 6–12 years in the west coast (Aegean Region) of Turkey after 5 years of mandatory iodine prophylaxis. A total of 2300 children from 72 populations (rural and urban area) were evaluated with urinary iodine excretion and thyroid volume.
Design: Cross-sectional, observational study designed and performed according to surveillance methods for iodine deficiency disease (IDD) prevalence recommended by WHO/UNICEF/ICCIDD.
Subjects: The study population consisted of 2300 school children age ranging from 6 to 12 years. The children were selected by multiple stage randomization from 91 primary schools of 76 zones (91 clusters). Information about the use of iodized salt was obtained from the families.
Measurements: Data on the following were collected: birth date, sex, weight, height, thyroid size by palpation and ultrasonography; and urinary iodine by isotope dilution analysis method. Thyroid volumes above 97th percentile according to the WHO/ICCIDD by age and body surface area (BSA) were accepted as goitre.
Results: Iodized salt consumption was 51·7%. The prevalence of goitre determined by palpation was 12·1% and by ultrasound based on BSA and age were 9·8% and 5·5%, respectively. Median urinary iodine was 53 (2–142) μg/L.
Conclusion: Mild to severe degree of iodine deficiency was detected in the west coast of Turkey.
Source: http://highwire.stanford.edu/cgi/medline/pmid;16268807
The Iodine Network Bulletin is prepared by the Network for Sustained Elimination of Iodine Deficiency and posted on its website, www.IodineNetwork.net. If you have any information to share or queries please contact Dr. Juliawati Untoro, IDD Network Secretary at Info@IodineNetwork.net
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