Iodine Deficiency Disorder

Congo, Democratic Republic.

Vitamin A

Cote d'ivoire

Iodine

Iron

Djibouti

	EPIDEMIOLOGICAL DATA


Goiter
Most Recent Goiter Survey		Evaluation of Iodine Deficiency in Cote d'Ivoire
	Date:
	Groups Surveyed:	School aged children in endemic areas.
	Sample Size:	1200
	Sampling Method:	In forty schools/villages in the endemic areas, urine samples were taken from thirty children in each school in the north and west of the country.
	Estimated Goiter Prevalence:

Urinary Iodine
Most Recent Urinary Iodine Survey
	Date:	June-July 1996
	Groups Surveyed:	School aged children
	Sample Size:	1267
	Sampling Method:	Urine samples collected directly in closed plastic boxes from 1267 children from all over the country for a duration of 1 month.

Estimated Prevalence of IDD: Indicator <100 µg/L

Region/Group	Sample size	Population in group/region	Indicator(s) specify cutoff and/or median urinary iodine.	Prevalence in sample %
Man	407			70.8
Danané	322			43.2
Odienné	216			57.9
Touba	152			86.1
Guiglo	170			60.6
National Total	1267			62.0

	POLICY AND LEGISLATION

Legislation on IDD
	IDD legislation in Cote d'Ivoire was passed in 1994, and this policy was significantly revised.
	Government passed a decree regarding IDD in June 1994, but this legislation was halted by the administration in April 1996.

Government Agency to Address IDD
	There is a government agency to address IDD named National Nutrition Program (NNP) whose function is coordination and monitoring.
	Contact information: Dr. Pierre Adou, Director NNP.

Supplementation
	No oral supplementation is conducted in Cote d'Ivoire.

Fortification
Fortification
Production and Importation of Salt
	There is production of iodized salt.
	The total annual national production of iodized salt is 300 million tons in 2000.
	The intended level of salt iodization at the point of production is 50-80 ppm
	Large-scale of salt iodization started in 1996.
	There are approximately 20 salt producers in the country, with only 6 producers iodizing their salt product.
	Potassium Iodate is used to iodize salt.
	Salt is imported from Senegal and Ghana.
	The intended level of salt iodization for imported salt is 50-80 ppm.
	A recent assessment of the percent of salt production that achieves the target level of iodine is 32%. This assessment is done by quality control at the manufacturing level as well as External Laboratory controls.
	The assessment of salt production is controlled by titration.

.
Retail
	The average retail cost of salt is half a dollar ($0.50) per kilo for iodized and uniodized salt.


Household Consumption
	The estimated consumption of salt is 6.8g per capita per day.
	The estimated percent of adequately iodized salt consumed by all people is 30%.*

(Source for above information on IDD: UNICEF, MICS, and European Journal of Clinical Nutrition 1999,53,680-686.)

Iodized Salt Survey (2000)

Survey level	Date	Geographic area/ other grouping	Sample Size	Sampling Method	% of samples with ppm=		Average or Range of Iodine Content
Survey level	Date	Geographic area/ other grouping	Sample Size	Sampling Method	>15 ppm	>30 ppm	Average or Range of Iodine Content
Area		Center	440	Center	25.8		440
		North Center	571	North Center	32.0		571
		North-East	360	North-East	48.8		360
		East Center	191	East Center	42.9		191
		South (Sans Abidjan)	1227	South (Sans Abidjan)	30.9		1227
		South-West	645	South-West	18.3		645
		West Center	882	West Center	20.8		882
		West	673	West	27.5		673
		North-West	288	North-West	8.1		288
		North	414	North	14.1		414
		Abidjan	1619	Abidjan	51.9		1619
		Urban	3613	Urbain	43.4		3613
		Rural	3698	Rural	20.1		3698
		Total	31.0		31.0		31.0

Other Programs
Other Programs
Mass-Media Campaigns
	There are national Tv/radio campaigns to promote iodized salt consumption. Local radio information is also conducted concerning iodized salt to combat goiters and iron deficiency.
Education Campaigns
Community-based Programs
	The community-based programs involve training the chiefs of villages and providing them with the control test. The control test allows the chiefs to be in charge of salt quality in their personal communities.

	MONITORING

Salt Iodine
Current monitoring activities for iodine levels in salt
	Surveys for monitoring activities for iodine levels in salt are conducted every year.
	Quality control of the monitoring the salt iodine include the National Lab, the Nutrition lab in the National Institute of Public Health, and the Lab of the Ministry of Industry for quality control.

IDD Indicators
	Not Reported
IDD Indicators
TSH
	Elevated thyrotropin levels are found in 1% of children in Cote d'Ivoire.


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	-Human Resources -Policy Maker	Yes	Yes
External Agencies	UNICEF- ............., advocacy, technical support, and funding African Development Bank- Funding	Yes Yes

IDD Program Funding History and Projections

EPIDEMIOLOGICAL DATA