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Current Iodine Deficiency Disorder Situation
Population
Population: 3.6 million
Population growth rate: 1.85%
Population < 15 years: 43.2%
Birth rate: 37.05 per 1000
Life expectancy at birth: 43.8 years
Infant mortality: 105.2 per 1000
Prevalence of Goiter/ UIE
Median urinary iodine: 21 mcg/L (1991). National survey of 17 sites conducted in 1991 by the government and UNICEF. Median UI 21 mcg/L. All areas surveyed indicate IDD to be highly endemic with some regions reporting > 80% of all school-age children with goiter. Overall TGR was 62% (range 23-90%). Some cretins found in every province. Of 309 TSH samples, 62% were > 5 uU/ml; 30% 10 uU/ml. TGR 70% in area of water iodization trial (1994).
Iodized salt Coverage
Household iodized salt use: 87% (2000)
Salt Situation Analysis Production
All salt is imported. An average of approximately 4100 tons of salt is imported from South Africa (Salt Company Ltd, Swakopmund) and Cameroon (SELCAM) of which 20% is iodized.
All is imported except traditional salt extracted from the boiling of saline leaves and twigs. Salt from S. Africa is believed to originate from the large salt field in Namibia (Salt Company Ltd, Swakopmund). The salt is imported by sea up to Pointe Noire and then up the Rivers Congo and Uobangui to Bangui . Salt from Cameroon emanates from the only producer located in Douala (SELCAM) and is distributed to the western part of the country. Salt produced by three major importers of salt in Bangui is in crude, crystalline form. Salt from Namibia is fairly white in color. It is imported in 18 kg bags and sold in loose form. Also iodated salt from France .
Consumption
- Estimated daily per capita salt consumption: 5-8
- Estimated % of all salt consumed by people which is adequately iodized (household level): 86.5% (2000)
Iodine Procurement and Utilization
KIO3 at 50-100 ppm
Universal Salt Iodization Program
Information, Education, Communication (IEC) Activities
Universal salt iodization was enacted in 1996, and an aggressive control program implemented. The program has been backed by a strong IEC component, utilizing television, radio, posters, and pamphlets.
Legislation
- Legislation: yes
- Legislation for Animals: yes
- Year Enacted: 1996
Program Monitoring and Evaluation
MOH is responsible. Iodized salt is controlled at all borders by mixed teams from the Ministry of Commerce and Finance (customs) and the Ministry of Health. Lab technicians have been trained in Cameroon to titrate iodine in salt. Monitoring has also been carried out by medical students for the M.D. thesis. The Nutrition Service of the Ministry of Health checks iodized salt coverage yearly.
Interministerial collaboration in salt quality control exists at all borders. The latest control point was in the northeast, to stop infiltration of noniodized salt from Sudan .
Other Interventions
Massive supplementation with iodized oil capsules 1993-96. Water iodization (Rhodifuse) in Nana-Grebizi, population 80,000, from 1992-1993, with limited results; could not be maintained.
Key Lessons Learned
Challenges and Constraints
Future Plans for Sustained IDD Elimination
Sources:
Direct communication, D. L. Lantum (2/2003)
IDD NL 17(2):25, 2001
IDD NL 16(2):25, 2000
ICCIDD Water iodization Report (1997)
IDD NL 12(4):63, 1996
IDD NL 12(2):21, 1996
IDD NL 12(1):15, 1996
IDD NL 10(3):32, 1994
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