90 likes | 110 Views
This report outlines the legislative framework, monitoring indicators, iodized salt production, and overall status of Iodine Deficiency Disorders (IDD) in Bulgaria. It includes current iodine intake levels, goiter rates, and incidence of hypothyroidism. The country has made significant strides towards eradicating IDD through universal salt iodination since 1994.
E N D
IDD Status in Bulgaria Ivanova, L*. B. Lozanov**, Zv.Timcheva*** *National Center of Hygiene, Medical Ecology and Nutrition, Sofia ** Clinical Center of Endocrinology, *** Ministry of Health
National Program for Control of IDD - Multisectoral Efforts • Legislation: Since 1958; Updated 1994 • Decree 96/94 of Council of Ministers; Ordinance RD-09-244/94 of the Chief Sanitary Inspector; Amendment of the Bulgarian State Salt Standard • Institutional support / Intersectoral Co-ordination • National Coordinating Committee for IDD Control (MOH,- Industry, -Trade, Salt Producers, Thyroidologists, Nutritionists, NGO,s) • Expert Council on IDD at Ministry of Health
Salt production/iodination • Local production - 40% ; import - 60% • Local production - 6000 t/last year iodized salt - 20 % of iodized salt required for humans • Iodine compound: KIO3 • Level of iodination: 19-32 ppm I2 (28-55 ppm KIO3) • Availability of iodized salt : general
Assessment/Monitoring/Evaluation • Monitoring plan of IDD status Indicators Proportion of adequately iodized salt at the market Urinary Iodine Excretion Total Goiter Rate: palpation; ultrasound Neonatal TSH
IDD STATUS • Total Goiter Rate:18 % (5-26%) (National survey, 1996) 14.8% -palpation; 2.7% ultrasound (Sofia-city, 2001) • Urinary Iodine Excretion: 111.4 mcg/L (1996); 145.0 mcg/L(2001) • Incidence of Congenital Hypothyroidism: 1: 4000 live births • Incidence of Transient Hypothyroidism in newborn:8.8% • Neonatal TSH > 5 U/mL: 9.2%
Percentile Distribution of ioduria from representative surveys of schoolchildren 1994-2001
Conclusions • The legislation and capacity building of the IDD Program was completed. • The iodine intake of Bulgarian population was substantially improved after the implementation of universal salt iodination in 1994. • Our country is already achieving the final goal - eradication of IDD at population level