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Current Iodine Deficiency Disorder Situation
Population
Population: 1.32 million
Population growth rate: 2.54%
Population < 15 years: 42.3%
Birth rate: 36.5 per 1000
Life expectancy at birth: 57.1years
Infant mortality: 55 per 1000
Prevalence of Goiter/ UIE
Median urinary iodine: 190 mcg/L. First national study in 2001, 3,280 schoolchildren, 6-12 years old, from 50 schools, in ecological ranges of the country; urine samples from every fifth child, and goiter survey by palpation. The national goiter prevalence was 17.1%: 31.7% in the savanna, 21.4% in the forest, 20.0% in the mountains, 4.1% in the littoral. By province, Hauta Ogoouea (49.3%), Ogoouea-Lolo (28.3%), Ngounie (20.1%), were most severe. Estuaire and Nyanga were 4.5% and 5%, respectively. Several hyper-endemic divisions were Ogoouea-Litili (71.7%), Lebayi-Brikolo (45%), Lebombi-Leyou (41.1%), Mouloundou (40%), and Ogoolou (38.8%).
Of 576 urine samples, median value 190 mcg/L, mean ± standard deviation 273 ± 306.1 mcg/L, range 0-2478 mcg/L. 30% were > 300 mcg/L.
The same study measured urinary thiocyanate. The median for the country was 10.9 mg/L, reflecting high level of consumption of goitrogenic foods, especially cassava; for regions: littoral 7.1, savanna 10.9, mountain 4.9, and forest 30.3 mg/L.
A previous survey in 1989 in Ogoouea-Lolo in the southeast found 38% of children and 34.4% were goitrous.
Iodized salt Coverage
Household iodized salt use: 36% (2000)
Salt Situation Analysis Production
No Production, all salt imported from Cameroon , France , Namibia .
Consumption
- Estimated daily per capita salt consumption: no data
- Estimated % of all salt consumed by people which is adequately iodized (household level): 36% (MOH, 2001). While awaiting legislation, salt dealers have been given a moratorium to exhaust all non-iodized salt (ending in 2003) and then supply only iodized salt.
Iodine Procurement and Utilization
Authors of the national survey suggested potassium iodate at 20-40 ppm as iodine.
Imported at KIO3 100 ppm from Cameroon , 50 ppm from Senegal
Universal Salt Iodization Program
Information, Education, Communication (IEC) Activities
Broad based sensitization workshops have been held in two of the 4 most afffected provinces
Legislation
- Legislation: No legislation yet. Draft law has reached Secretary General of Executive Council of Government. A national workshop May 2002 recommended legislation.
- Legislation for Animals: no
- Year Enacted: n/a
Program Monitoring and Evaluation
Ministry of Health is responsible. A national program and a plan of action have been recommended. Two national seminars have been held to form a National Coalition, to include the Presidency, Commerce, Agriculture, Customs, Education, Culture, University, WHO, UNICEF, salt producers, others.
2001 survey carefully done by cluster survey, random sampling, included goiter by palpation, testing of urinary iodine and thiocyanate, and salt by test kit. Laboratory personnel were trained in urinary iodine technique and urinary iodine methodology in Cameroon , and iodine laboratory is being set up in Libreville . IEC manual produced with indicators for monitoring and eventual evaluation before 2005.
Other Interventions
Money has been made available to provide iodized oil capsules in high risk populations in provinces with most severe deficiency.
Key Lessons Learned
Challenges and Constraints
Future Plans for Sustained IDD Elimination Considerable momentum on iodine nutrition since year 2000, including 2001 survey and May 2002 review of results. Recommendations from study report included a plan of action, national legislation, training, monitoring of iodized salt, survey of food habits for goitrogens (cassava), and follow-up survey.
Sources:
D. L. Lantum, direct communications to ICCIDD, 2004, and 2003
IDD NL 18(1):4, 2002
Biodiagnostics and Therapy 15:27-32, 2001
IDD NL 10(3):32, 1994
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