Iodine Deficiency Disorder

Vitamin A

Cambodia

Iodine

Iron

	EPIDEMIOLOGICAL DATA


Goiter
Most Recent Goiter Survey		National
	Date:	1997
	Groups Surveyed:	School age population (8-12 yrs. old)
	Sample Size:	35,418
	Sampling Method:	Not Reported
	Estimated Goiter Prevalence:	17% countrywide (sample size of 35,418)

Urinary Iodine - Not Available

TSH - Not Available

Legislation on IDD
	Currently, there is no IDD legislation in Cambodia, but it is being developed.
	There was a circular issued by the National Council for Nutrition that recommends all salt produced in the country and imported be iodized (50ppm).

Government Agency to Address IDD
	National Sub-Committee for Control of Iodine Deficiency Disorders (NSCIDD. It's functions are both coordination and monitoring.
	Contact information: Mr. Ping Siv Lay, Chairperson of the NSCIDD, Ministry of Industry, Mines and Energy; #45, Norodom Blvd., Khan Daun Penh, Phnom Penh, Cambodia. Tel. (855) 12-929 522. Fax: (855) 23-216 086 Dr. Ouk Poly, Vice Chair of the NSCIDD, National MCH Center/Ministry of Health, No. 151-153, Kampuchea Krom, Phnom Penh, Cambodia. Tel. (855) 12 919 565. Fax: (855) 23 426 034

Supplementation
	Oral supplementation with iodized oil capsules is currently used. Supplementation for all child-bearing age women was provided in early 2002 in four northeastern provinces and one selected district of northern province where the prevalence of goiter rate is very high.
	The target population was child-bearing age women (110,721).
	The total number supplemented was 84,531 child-bearing age women. It utilized the national Tetanus Toxoid vaccination campaign for implementation.


Fortification
Production and Importation of Salt
	There is iodized salt production.
	The total annual national production of iodized salt was 12,000 metric tons in 2001.
	The intended level of salt iodization at the point of production is 50 ppm.
	Large-scale salt iodization started in 1999.
	There are around 150 groups of solar salt producers and around 35 boiled salt producers. One major salt producer makes iodized salt, and about 27 out of 35 smaller boiled salt producers in the Kampot province produce iodized salt.
	Potassium iodate is used to iodize salt.
	It is packaged in 50 kg. polyethylene bags with inner plastic lining and one kg. plastic bags with sealing.
	About 2% of imported salt was iodized.
	Salt is imported from Thailand, Vietnam, and Laos, mainly into provinces bordering those countries. In 2001, Pheapimex company imported more than 20,000 tons of salt from China without iodization.
	Salt iodine content at production level is assessed by 1) rapid test kit 2) samples from salt producers were collected every month for titration assessment conducted by the Ministry of Industry.

Retail

The average retail cost of salt per kilo is as follows:

Iodized salt:

- US$ 0.15 for boiled salt and US$ 0.12 for crystal salt.

Un-iodized salt:

- US$ 0.10 for boiled salt and US$ 0.076 for crystal salt.

Regional Differences: (Iodized salt)


Household Consumption
	The estimated daily per capita consumption of salt is 10gm.
	The % of households consuming iodized salt 1992 - 1998 was 7%. (Source: State of the World's Children 2000)
	National coverage of households consuming iodized salt is 14%. (Source: CDHS 2000)

Other Programs Related to IDD:
	Mass media campaign through TV and radio broadcast nation-wide.
	There are community-based programs and inter-personal communication at village and family level in approximately 1,000 Seth Koma villages and in provinces where highest prevalence of goiter rate reported.

Salt Iodine
Current monitoring activities for iodine levels in salt
	Monitoring activities carried out at production areas and in markets at province and district levels using rapid test kit solution by the members of NSCIDD.
	Household level monitoring at Seth Koma villages by Village Development Committees members and volunteers.
	UNICEF community based programme (namely Seth Koma) and various International NGOs working at the community level have been conducting monitoring of iodized salt.

IDD Indicators
	There is no ongoing monitoring of goiter rate.

Donor and Implementing Agencies Involved in IDD Programs

Implementing Agency	Description of Activities	Expenditure in current year
Implementing Agency	Description of Activities	Supplementation (if applicable)	Salt Iodization	Other (specify)
National/State Governments	· National Sub-Committee for Control of IDD (NSCIDD) · Ministry of Health	Staff time	Staff time
External Agencies*	UNICEF/USAID/Kiwinis International Government of Japan	$42,661 (2001)	$143,000 (2001)

IDD Program Funding History and Projections

Year	IDD Activity				Total $(000)
	Supplementation $(000) (if applicable)	Fortification $(000)	Other (specify)
	Supplementation $(000) (if applicable)	Fortification $(000)	Activity	$(000)
2002
2003		250 · Upgrading laboratory facilities, training, preparatory works for field survey and pilot study. · Provision of KIo3 and monitoring both at production and consumption level includes training and related relevant USI promotion activities. · Technical Assistance			250
2004		250 · Impact assessments study, national seminar and strengthening iodized salt production and monitoring · Technical Assistance			250

EPIDEMIOLOGICAL DATA