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Current Iodine Deficiency Disorder Situation
Population
Population: 43.6 million
Population growth rate: 0.26%
Population < 15 years: 32 %
Birth rate: 21.1 per 1000
Life expectancy at birth: 48.1 years
Infant mortality: 60.3 per 1000
Prevalence of Goiter/ UIE
Median urinary iodine: 177 mcg/L (1998). A 1998 report for the Department of Health found national and provincial median UI concentrations in the iodine sufficient range, but 16% of the 200 schools visited showed evidence of iodine deficiency, and goiter rates were high in all of the 49 schools assessed for thyroid size.
Endemic goiter first reported in 1920. Partial survey in 1955 identified belt in the east, from east C ape to eastern Transvaal , including Lesotho and Swaziland .
Iodized salt Coverage
Household iodized salt use: 62% (1998)
Salt Situation Analysis Production
The country has 24 registered salt companies, of whom 12 producers iodize salt for human consumption. Of these, 26% of samples were within the legal requirements of 40-60 ppm, 47% contained more than 30 ppm but 44% had less than 20 ppm at production site. A questionnaire to producers showed limited information on the health benefits of iodized salt, and the legal requirement in South Africa .
Small amount of salt imported.
Consumption
- Estimated daily per capita salt consumption: no data
- Estimated % of all salt consumed by people which is adequately iodized (household level): 63%. Large amounts of noniodized salt for livestock is used by humans.
Iodine Procurement and Utilization
KIO3 at 50 ppm.
Universal Salt Iodization Program
Information, Education, Communication (IEC) Activities
The MOH and UNI C EF have been active in IE C , but agree that the education program, especially to key local people who influence local priorities, such as health inspectors, should be strengthened. The MOH is currently planning urinary iodine monitoring in 2004-2005. In 2002 a national coalition has been formed, a partnership between the government and the private sector.
Legislation
- Legislation: yes
- Legislation for Animals: no
- Year Enacted: 1929, revised in 1972 to 10-20 ppm, in 1995 to 50 ppm
Program Monitoring and Evaluation
The Department of Health, Medical Research C ouncil, universities. A national coalition is being formed in 2002 as a partnership between the government and private sector.
Salt monitored at production, also by MOH. UI used for surveys.
Other Interventions
None
Key Lessons Learned
Challenges and Constraints
Some issues include access to noniodized animal salt, availability of freely accessible salt deposits in various parts of the country, delegation of responsibility for sampling and enforcement of iodization laws to the local authorities (as part of decentralization), and wide variation in the iodine content of the salt.
Future Plans for Sustained IDD Elimination
Sources:
Jooste PL 2001 IDD: South Africa salt producers' practices and perceptions. Technical report by MR C for DOH and UNI C EF.
IDD NL 17(2)27, 2001
IDD NL 16(2):25, 2000
IDD NL 13(2):22 (1997)
USI Update (UNI C EF) 4, 1996
IDD NL 10(3):30 (1994)
Jooste PL , Benade AJ, Kavishe F, Sanders D 1995 Does iodine deficiency exist in South Africa ? (editorial) South African Medical Journal 85(11):1143-4.
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