Iodine Deficiency Disorder

Vitamin A

guinea

Iodine

Iron

Guinea Bissau




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	EPIDEMIOLOGICAL DATA

Goiter

Most Recent Goiter Survey

Date:

1999

Groups Surveyed:

Children 8 - 19 yrs.; in one prefecture of each natural region (Siguiri, Kindia, Lola, Labé)

Sample Size:

1234

Sampling Method:

WHO 30 cluster methodology.

Estimated Goiter Prevalence:

Region/Group	Sample size	Population in region/group (if available)	Prevalence in sample %
Upper Guinea I	173		45.8
Upper Guinea II	19		6.1
Upper Guinea III	2		0.6
Forest Guinea I	198		55.6
Forest Guinea II	18		8.4
Forest Guinea III	0		0
Middle Guinea I	164		42.5
Middle Guinea II	33		10.6
Middle Guinea III	0		0
Lower Guinea I	112		26
Lower Guinea II	8		2.6
Lower Guinea III	0		0

National Total:

Urinary Iodine
Most Recent Urinary Iodine Survey -- same as above
	Date:	1999
	Groups Surveyed:	Children 8 - 19 yrs.
	Sample Size:	1234
	Sampling Method:	WHO 30 cluster sampling.

Estimated Prevalence of IDD: Indicator < 100 microgram/L

Region/Group	Sample size	Population in region/group (if available)	Median urinary iodine	Prevalence in sample %
Upper Guinea			80mg/l
Middle Guinea			44mg/l
Forest Guinea			44mg/l
Lower Guinea			41mg/l
National Total

TSH

Upper Guinea 0.51% hyperthyroidie Basedow; Forest Guinea 1.87%; Middle Guinea 1 case. Hypothyroid decompensation: 4.2% in Lower Guinea.

	POLICY AND LEGISLATION

Legislation on IDD
	There is IDD legislation in Guinea. It was passed in 1995.
	Iodization of salt is mandatory. The mandated level of iodization is 100ppm.
	The government has published documents regarding IDD. (Application decrees in 2000)

Government Agency to Address IDD
	Programme TDCI
	Ministry of Public Health Guinea Conakry. This agencies functions are funding, coordination and monitoring.


	PROGRAM DATA

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Supplementation
	Oral supplementation with iodized oil capsules is not currently used, however it was used in 1997-1998.
	The target population was children 0-15 yrs old and women of childbearing age.
	The total number of subjects estimated to be supplemented was 2.5 million.
	Distribution was done by school health programs and financed by the World Bank.

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Fortification
Production and Importation of Salt
	Iodized salt is produced.
	The total annual national production of iodized salt: 20000 tons in 2001
	The intended level of salt iodization at the point of production: 100 ppm
	Large scale iodization started in 1997.
	Approximate number of salt producers: 2500 to 3000 small local producers, not all of which iodize salt.
	--Salt is bought by a number of cooperatives that do the iodization, 800 tons were iodized (year not provided).
	The compound used to iodize salt: Potassium iodate
	The packaging method used is: Second hand bags (used for wheat flour) and polyprophilene bags
	Not all Imported salt is iodized. It is imported from Senegal and Ivory Coast.
	The intended level of iodization for imported salt is 100 ppm.
	Salt iodine content at production level is assessed by UNICEF salt testing kits.


Retail
	The average retail cost of iodized salt is US$0.08 per kilo. Salt is more expensive in the rural areas because of transport costs.


Household Consumption
	The estimated daily per capita consumption of salt is 4-6 g/person/day.
	The estimated percent of adequately iodized salt consumed, as a national average is 12% in 1999. (Source: NDHS, 1999)

Other Programs Related to Control of IDD

Mass Media Campaigns

National radio and television campaigns financed by UNICEF; local NGO's campaign in the field

Community-Based Dietary Promotion

Not reported.

Surveys of Iodized Salt

NDHS, 1999

Survey Results

Survey Level (producer/ retail/ household)	Date of Survey	Geographic area/ other grouping	Sample size	Sampling Method	% of samples with > 30 ppm	Average and/or Range of Iodine Content

Household	1999	National	5090 HH's	293 clusters, weighted proportional to size, 5 strata	11.8% ( no specification, just yes/no question)	not done

	MONITORING

Salt Iodine
Current monitoring activities for iodine levels in salt
	Monitoring is done at each level (prefectoral, regional, at production sites and country borders)
	The surveys mentioned above are not being repeated.
	There is community-based monitoring of salt iodine. Test kits are given to community workers in "SLAC" villages (Système d’Information à Assise Communautaire)


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



	PROGRAM RESOURCES


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	Detoxication of goitrogenic cassava:
National/State Governments	Ministry of Public Health pays salary of IDD Coordinator
UNICEF & WHO			X
World Bank		X

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	*400*	*100*	Promotion	40	*540*
1999		50	*Promotion/Monitoring*	50	*100*
2000		50	*Promotion/Monitoring*	50	*100*
2001		50	*Promotion/Monitoring*	40	90
2002		60	*Promotion/Monitoring*	50	*110*
2003
2004
2005

EPIDEMIOLOGICAL DATA

POLICY AND LEGISLATION

PROGRAM DATA

Sampling Method

MONITORING

PROGRAM RESOURCES

IDD Activity