Programme on Monitoring of

Iodine Deficiency Disorders

Dushanbe August 1-4, 2005

Kasymova

Salomat Jamolovna

Director of Republican Clinical Center of Endocrinology

IDD problems in the world

IDDs – present most typical example of micronutrient disorders.

IDDs are the most prevalent noninfectious diseases in mankind.

More then 1,5 billion of world population has a risk of lacking iodine assumption;

WHO estimates that more then 655 million people by 2000 have IDDs, 43 million have brain disorders and mental retardation caused by iodine deficiency.

IDDs problems in Tajikistan

Tajikistan is of the regions where IDDs are serious medical and social problems.

Economic decline in transition period caused deterioration of nutrition structure in country population.

Deterioration of nutrition structure in country population appeared due to protein-vitamin and micronutrient deficiency of food contain.

Change in nutrition structure led to increase in aliment-dependant diseases, particular IDDs in children and women of reproductive age.

Food assumption per capita was decreased in 1992-98

per year:

Meat and meat foods for 5,4 times;

Milk and dairy products for 3,6 times;

Eggs for 16,5 times; Grains for 1,2 times; Vegetables for 1,6 times

Prevalence of endemic goiter for 100 000in the Republic of

Tajikistan for 1998-2004.

5941 5839

4841

2619

0

1000

2000

3000

4000

5000

6000

7000

1 2 3 4

1998г. 2000г. 2002г. 2004г.

Prevalence of endemic goiter in children up to 14 years old in the

Republic of Tajikistan

1998г. 2000г. 2002г. 2004г.

7510 7300

5069

3000

010002000300040005000600070008000

1 2 3 4

Frequency of endemic goiter in children up to 14 years in the

Republic of Tajikistan in 2000- 2004

2000г. 2001г. 2002г. 2003г.

33%

24,2%21%

24,4% 23,3%

0,00

5,00

10,00

15,00

20,00

25,00

30,00

35,00

1 2 3 4 5

2004г.

Annually preventive check ups are conducted in 200.000-400.000 children. In different regions of republic goiter frequency varies from 24 to 83% Goiter frequency in pregnant women was observed in 42- 56% cases;

Iodine concentration in children’s urine based on

sentinel study in 2003-2004.

30,0

5,1

43,8

5,1

15,0

43,6

11,2

46,2

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2

Normal

2003г. 2004г.

Легкая степень

Средняя степень

Тяжелая степень

Iodine concentration in children’s urine in GBAO in

dynamic

Норма

2003г. 2004г.

Легкая степень

Средняя степень

Тяжелая степень

18,55,5

21,2

7,2

32,2

16,7

28,1

70,6

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2

Iodine concentration in pregnant women urine

Dushanbe (2003)

64,9

25,1

7,3

2,7

Норма Легкая степень

Средняя степень Тяжелая степень

Experience and achievements

Prevalence of IDDs has a tendency to decrease;

Population knowledge on IDDs problems has improved in comparison with previous years;

Legislative basis on iodized salt provision to population is strengthened;

Monitoring system of iodized salt production is improving;

National survey on IDDs is conducted in Tajikistan;

Problems and constraints

Up to now IDDs prevalence is high among target groups particular in Khatlon Region and RRS (Rayons of Republican subordination);

Educational Programs among the population is not systemic;

Representatives of local Khukumats (local authorities) of some places don’t realize the importance of IDDs problems and quality control of iodized salt;

There is effective mechanism of обратной связи In many regions health professionals are not

trained on IDDs preventive measures;