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Current Iodine Deficiency Disorder Situation
Population
Population: 10.27 million
Population growth rate: 0.15%
Population < 15 years: 17.3%
Birth rate: 10.58 per 1000
Life expectancy at birth: 78.13 years
Infant mortality: 4.64 per 1000
Prevalence of Goiter/ UIE
Median urinary iodine: 80 mcg/L (1998)
A 1998 survey of 2,855 schoolchildren from 23 sites found a median urinary iodine of 80 mcg/L (range 73-90 mcg/L) and a goiter prevalence of 5.6% (range 3.9-7.7%).
A 1995 survey reported median urinary iodine of 55 mcg/L and goiter prevalence of 11%. Similar results were found from the ThyroMobil in 1997.
Frequency of blood TSH > 5 mU/L five days after delivery is 4.5% (normal < 3%). Urinary iodines on neonates showed 53% had values < 50 mcg/L.
Studies in past 30 years report a goiter prevalence ranging from 2% in the West to 10% in the Eastern part of the country. Mean thyroid volume for 8-10 year olds, 2.51-3.70 ml (Chanoine, 1991). Prevalence of goiter in school-age children determined by ultrasonography (ThyroMobil, Delange et al., 97): 7-10%.
TSH normal in adults and adolescents but increased during pregnancy (Glinoer et al. 1992).
Iodized salt Coverage
Household iodized salt use: 10%
Salt Situation Analysis Production
100% of salt imported from France and the Netherlands.
Consumption
- Estimated daily per capita salt consumption: 6-10 g/day
- Estimated % of all salt consumed by people which is adequately iodized (household level): 10%
Iodine Procurement and Utilization
KI, NaI, and KIO3 are authorized for home and food use at 45-60 ppm
Universal Salt Iodization Program Information, Education, Communication (IEC) Activities
Legislation
- Legislation: Legislation for salt iodization has existed since 1990, but has never been implemented
- Legislation for Animals: no data
- Year Enacted: n/a
Program Monitoring and Evaluation
No official program. Ministry of Health appointed a committee which recommended iodine for pregnant and lactating women and for infants and children up to three years old, and iodized salt for humans and animals. Academy of Sciences of Belgium supported these recommendations but the government did not act on them. Members of ICCIDD, consumers' associations, and salt, drug, and food industries widely publicized the continuing presence of iodine deficiency and the need for iodized salt.
Monitoring by UI and ultrasound by academics, not official by government.
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Other Interventions No programs with iodized oil or water. Iodide added to pregnancy vitamin supplements (150 mcg and, optimally, tablets for children (90 mcg/day).
Key Lessons Learned
Challenges and Constraints
Belgian physicians have repeatedly drawn attention to the mild to moderate iodine deficiency in the country, with little government response.
Future Plans for Sustained IDD Elimination
Sources:
IDD NL 18(4):52, 2002
IDD NL 17(3):48, 2001
IDD NL 9(1):4, 1993
IDD NL 8(1):12, 1992
Chanoine et al., Eur J Pediatr 150:395, 1991
Delange et al., Eur J Endocrinol 136:180, 1997
Glinoer et al. JCEM 75:800, 1992 |
