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Brazil

Iodine

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Monitoring
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EPIDEMIOLOGICAL DATA
   
Goiter  
Most Recent Goiter Survey Thyroid Mobil Project
Date: April-June 2000
Groups Surveyed: School age population (6-12 years)
Sample Size: 1977 
Sampling Method: School children in 17 sentinel sites were selected in 6 states.  Thyroid volume was measured by ultrasonography and casual urine samples were collected for 65% of the sample population to be analyzed for urinary iodine.  Salt samples for human consumption available at retail markets were also analyzed for iodine content.
Estimated Goiter Prevalence: 1.4%

Group

Sample size

Prevalence in sample (%)

Population with Goiter
Maranhăo    

 
Tocantins    

 
Goiás    

 
Mato Grosso    

 
Mato Grosso do Sul    

 

Minas Gerais

    

 

National Total

1013

Ultrasonography

 
 
 Urinary Iodine
Most Recent Urinary Iodine Survey -       Thyroid Mobil Project 
Date: April-June 2000
Groups Surveyed: School age population (6-12 years)
Sample Size: 1977 
Sampling Method: School children in 17 sentinel sites were selected in 6 states.  Thyroid volume was measured by ultrasonography and casual urine samples were collected for 65% of the sample population to be analyzed for urinary iodine.  Salt samples for human consumption available at retail markets were also analyzed for iodine content.
Estimated Goiter Prevalence: 

Region/Group

Sample size

Indicator (s) Specify cutoff and/or median urinary iodine

Prevalence in Sample %
Maranhăo 205 <50 µg/l

  2.4
Tocantins 188 <50 µg/l

  2.7
Goiás 187 <50 µg/l

  3.7
Mato Grosso 95 <50 µg/l

  5.3
Mato Grosso do Sul 239 <50 µg/l

0

Minas Gerais

 99 <50 µg/l

1

National Total

    

                       2.5
 
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POLICY AND LEGISLATION
 

Legislation on IDD
    

There is IDD legislation in Brazil.  First created in 1953, this legislation has been significantly revised since then.  Iodization of salt is mandatory at the level of 40-100 ppm. 
    

The government has published documents regarding IDD stating that all the salt for human consumption produced in Brazil must be iodized with quantities of 40-100 ppm. 
 
Government Agency to Address IDD
    

The government agency that deals with IDD is the Unit Food and Nutrition Policy under the Ministry of Health.  This agency coordinates the activities of control of the disturbances caused by the deficiency of iodine as well as coordinated funding. 
    

Another government agency, the National Agency for Health Surveillance, monitors salt producers and iodine salt process.
    

Contact information:  Denise Costa Coitinho, Ministry of Health.
   
     

PROGRAM DATA
Supplementation
     Not Reported
Fortification
Fortification
Production and Importation of Salt
    

 There is iodized salt production and it is enforced by Federal law, but imported salt is not iodized.
    

 The total annual national production of iodized salt was 1,100 tons as refined table salt. 
    

 The intended level of salt iodization at the point of production is 40-100 ppm as iodine.
    

 Large-scale salt iodization started in 1974.
    

 There are currently 24 main salt producers and all of the producers iodize salt.
    

 Potassium iodate is used to iodize salt.
    

 Sealed low density, polyethylene bags are used for packaging. 

    

 Salt iodine content at production level is assessed by manufacturers quality control check and regulators sample survey.
    

*    As related by the National Agency for Sanitation Surveillance, more than 90% of the salt production in Brazil achieve the target iodine level 
    

*    There are no other measures of fortification with iodine in widespread use.
 
Retail
   

*   The average retail cost of salt is as follows:
    Iodized salt:  
      - US $0.10- $0.20 per kg.  
    Un-iodized salt  
      - Not Reported  
Household Consumption
      The estimated daily per capita consumption of salt is 16.76 g/hab. per day

Iodized Salt Survey (1996)

 

Survey level

 

Date

 

Geographic area/ other grouping

 

Sample size

 

Sampling method

% of samples with ppm=

Average or Range of Iodine Content

> 15

> 50

Household

 2000 17sentinel sites in 6 states 1325   87.8 47.4
Other Programs
Mass-Media Campaign
    

Radio messages are being prepared to be broadcasted throughout the country.
   
Community-base Programs
    

The National Project of Prevention of Disturbances of Deficiency of Micronutrients-Iodine Priority was initiated in 2002.  It provides information to families regarding the disturbances caused by the deficiency of micronutrients Vitamin A, Iron, and Iodine of the Brazilian population and preventive measures.
   
Surveys of Iodized Salt
    

National Agency for Sanitary Surveillance elaborated Technical Regulations, Resolution NASS RDC Nbr. 28/2000.  
    

Defines good manufacturing practices for salt for human consumption, highlighting which controls should be carried out by which establishment to ensure appropriate iodine levels in the end product. 
    

The National Program for Sanitary Inspection and Establishment Producing Salt for Human Consumption was established by NASS Along with technical publications with the purpose of inspecting 100% of the national companies.
 
MONITORING
 
Salt Iodine
Current monitoring activities for iodine levels in salt
     The National Agency for Health Surveillance which monitors salt producers and the iodine salt process 
     Deals with the qualification of technicians of the establishments of salt producers as well as responsible for the training of the technicians. Agency also deals with programs to stimulate the sector of salt producers. 
     Monitors iodine in the salt in the retailers throughout the country, and analyzes samples collected from retailers in laboratories.  
Current monitoring activities for iodine levels in salt
Community-based monitoring of salt iodine
     Project goal is to identify the quantity of iodine in the salt and analyses of the salt was carried out with quick-test kits MBI, provided by UNICEF. 
     Provides pertinent orientation to the families about the disturbances caused by the deficiency of iodine and preventive measures.
      

IDD Indicators
     There are competent laboratories in Brazil to conduct analyses of biochemical measurements.
     
     
PROGRAM RESOURCES
 
Donor and Implementing Agencies Involved in IDD Programs
     The Ministry of Health (Unit Food and Nutrition Policy, National Agency for Health Surveillance) is the National/State Government agency involved in IDD programs.
     UNICEF is the sole external agency that is involved in IDD programs.
 
IDD Program Funding History and Projections

 

Year

IDD Activity

 

Total $(000)

Supplementation. $(000)   (if applicable)

Fortification. $(000)

Other (specify)

Activity

$(000)

1998

 

        

1999

 

  

Meeting of the Inter-Institutional Commission of prevention of disturbances caused by deficiency of iodine.

    

2000

 

  

Meeting of the Inter-Institutional Commission of prevention of disturbances caused by deficiency of iodine.

    

2001

 

  

National Agency for Health Surveillance- Program Monitoring salt producers and iodine salt process

    

2002

 

  

National Project for the Prevention of Diseases caused by Micronutrient Deficiency

UNICEF- US$ 180,000.

Ministry of Health- US$ 115,000.