Iodine Deficiency Disorder - Madagascar

Vitamin A

madagascar

Iodine

Iron

Malawi


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Country Index		Epidemiological Data
Country Profile		Policy & Legislation
		Program Data
		Monitoring
		Program Resources

	EPIDEMIOLOGICAL DATA


Goiter
Most Recent Goiter Survey		National Survey
	Date:	2001
	Groups Surveyed:	School aged children
	Sample Size:	500
	Sampling Method:	In 7 IDD sentinel sites, children aged 6-11 years attending primary schools were examined.
	Estimated Goiter Prevalence:

Group	Sample size	Population with Goiter	Prevalence in sample %
Children 6-11 years	3500		3.5
National Total

Urinary Iodine
Most Recent Urinary Iodine Survey
	Date:	1998
	Groups Surveyed:	School aged children
	Sample Size:	350
	Sampling Method:	In 7 IDD sentinel sites, 50 children from each sentinel site were randomly selected and examined for the determination of TGR.

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 %
Children 6-11 years	350		<100 mcg/L	9.8
National Total

	POLICY AND LEGISLATION

Legislation on IDD
	IDD legislation in Madagascar was passed in 1995 stating "universal iodisation of salt used for human and animal consumption. Supplementation occurred with iodized oil capsule until the availability of iodized salt on the market.
	This legislation created a national campaign against IDD and made iodization of salt mandatory at 50ppm.

Government Agency to Address IDD
	Government agency to deal with IDD: National Committee against IDD whose function is coordination and monitoring.
	Contact information: Dr. Simon Rakotonirina


	PROGRAM DATA

Supplementation
	No oral supplementation is conducted in Madagascar.

Fortification
Fortification
Production and Importation of Salt
	There is production of iodized salt.
	The total annual national production of iodized salt is 95,000 tons.
	The intended level of salt iodization at the point of production is 50 ppm
	Large-scale of salt iodization started in 1996.
	There are approximately 17 salt producers in the country. The 4 main salt producers control 75%-80% of the overall production and they do iodize salt correctly
	Potassium Iodate is used to iodize salt.
	Polyethylene surrounded double bags are used as packaging methods.
	There is no importation of salt.
	The salt iodine content is assessed by quality control checks at the manufacturing level of the big producers.
	Analysis of samples sent by the manufacturers to the labs of the Ministry of Health also assess salt iodine content.

.
Retail
	The average retail cost of salt is US$0.20 per kilo for iodized salt.


Household Consumption
	The estimated percent of adequately iodized salt consumed by all people is 76%.*

(Source for above information on IDD: MICS)

Iodized Salt Survey (2000)-h Not Reported

Other Programs
Mass-Media Campaigns
	The national campaign against IDD in Madagascar is the National IDD Day.
Education Campaigns
Community-based Programs
	No programs exist.

	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 is conducted via test-kit reports sent every three months to the District Health Services regarding iodized salt on the market.

IDD Indicators
	There is no monitoring of the goiter rate in Madagascar.
	The Nutrition Lab at the Ministry of Health is able to perform urinary iodine and TSH dosage level tests.
	The Ministry of Health also has facilities in 6 regional labs to conduct analysis of iodized salt.
IDD Indicators
TSH
	Not currently conducted.



	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	Other (specify)
National/State Governments	Cooridnation, Monitoring, and Evaluation of interventions.
External Agencies	UNICEF ............., Technical and financial support for epidemiological monitoring, Control for the application of legislation, Consultancies, and supplies such as laboratory reagents.

IDD Program Funding History and Projections- uNot Reported