Iodine Deficiency Disorder

Vitamin A

Ghana

Iodine

Iron

	EPIDEMIOLOGICAL DATA


Goiter
Most Recent Goiter Survey		National IDD survey
	Date:	1991 - 1994
	Groups Surveyed:	School children 10 - 19 yrs. and women of reproductive age 15 - 45
	Sample Size:	27,000
	Sampling Method:	Systematic Sampling
	Estimated Goiter Prevalence:

*Region/Group(by District)**	Sample size (1000 per district)	Population in region/group (if available)	Prevalence in sample %
Tema			11.4
Upper Denkyira			19.7
Agona			20.8
Mfantseman			17.6
Hohoe			26.0
Akatsi			20.1
Nkwanta			20.5
Kwahu South			30.5
Akwapim South			8.7
Birim North			21.2
Asuogyaman			13.7
Shama Ahanta			7.6
Wassa Amenfi			29.8
Sefwi Wiawso			19.0
Nkoranza			28.6
Asutifi			23.7
Berekum			28.1
Ahafo Ano North			19.2
Adansi West			13.8
Ejura Sekyeredumase			26.8
Kwabre			15.5
Bole			17.6
Tolon Kumbungu			21.9
Zabzugu Tatali			30.8
East Mamprusi			38.3
Bongo			56.5
Jirapa Lambusie			56.4

Urinary Iodine

Most Recent Urinary Iodine Survey - Same as goiter survey

Estimated IDD Prevalence:

*Region/Group(by district)**	Sample size (100 per district)	Pop. in region/group (if available)	Mean urinary iodine(ug/dl)
Tema			6.0
Upper Denkyira			9.9
Agona			10.9
Mfantseman			10.4
Hohoe			4.7
Akatsi			-
Nkwanta			3.0
Kwahu South			4.8
Akwapim South			18.3
Birim North			8.7
Asuogyaman			9.1
Shama Ahanta			10.4
Wassa Amenfi			5.8
Sefwi Wiawso			7.9
Nkoranza			6.3
Asutifi			7.7
Berekum			6.6
Ahafo Ano North			7.2
Adansi West			2.8
Ejura Sekyeredumase			6.8
Kwabre			-
Bole			2.3
Tolon Kumbungu			8.5
Zabzugu Tatali			4.8
East Mamprusi			4.2
Bongo			1.3
Jirapa Lambusie			2.9

TSH - Has not been measured

	POLICY AND LEGISLATION

Legislation on IDD
	IDD legislation in Ghana was passed in 1996 for universal salt iodization. The mandated level was initially 100ppm and then revised to 25 - 45 ppm.
	Iodization of salt is mandatory.

Government Agency to Address IDD
	Nutrition Unit of the Ghana Health Service. Their function is both coordination and monitoring.
	Contact information: Not reported

Supplementation
	Oral supplementation with iodized oil capsules is not currently used, and was not used in the past.

Fortification
Production and Importation of Salt
	There is production of iodized salt.
	The total annual national production of iodized salt is 200,000MT for 2001.
	The intended level of iodization at the point of production is 50ppm.
	Large-scale salt iodization started in 1995.
	How many salt producers are there? 88, 20+ of which iodize the salt.
	The compound used for iodization is Potassium Iodate.
	The method of packaging is polypropylene sachets and sacks.
	Salt iodine content at production level is assessed by field test kits and titration.
	The estimate of salt production that achieves target iodine level is 55% for 1998.
	There is no official importation of salt.


Retail
	The average retail cost of salt is US$0.10 to $0.15 per kg.


Household Consumption
	The estimated consumption of salt is 10 gm. per capita per day.
	The estimated percent of adequately iodized salt consumed by all people is 49.1%.*

	* Source: 2002 Iodated Salt Survey

Iodized Salt Surveys

Survey Results -- 2002

Survey Level (producer/ retail/ household)	Date of Survey	Geographic area/ other grouping	Sample size	Sampling Method	% of samples with >= 25 ppm	Average and/or Range of Iodine Content
Retail	Feb-May 02	National	30 major markets	30 cluster sample	16.7	0-100ppm
Household	Same	Same	5991	Same	49.1	same

Other Programs Related to Control of IDD
Mass Media Campaigns
	TV and radio adds.

Community-Based Programs
	IDD month celebration.

	MONITORING

Salt Iodine
Current monitoring activities for iodine levels in salt
	Not reported.
	The surveys described above may be repeated.

IDD Indicators
	There is no monitoring of goiter rate.
	There are lab facilities for biochemical measurements.

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)
Nutrition Unit of the Ghana Health Service	Meetings, reviews, supplies, IDD month celebrations-(UNICEF funded)		$60,801
	Same as above (USAID funded through UNICEF)		$50,000
	Potassium Iodate (UNICEF Ghana Internally generated funds)		$26,160

Total IDD Program Funding History and Forecast for Country

Year	IDD Activity				Total $(000)
	Supplementation $(000) (if applicable)	Fortification $(000)	Other (specify)
	Supplementation $(000) (if applicable)	Fortification $(000)	Activity	$(000)
1998		53.663			53.663
1999		36.271			36.271
2000		36.524			36.524
2001		131.605			131.605
2002		136.961			136.961
2003		120			120
2004		110			110
2005		80			80

EPIDEMIOLOGICAL DATA