Iodine Deficiency Disorder

Malawi

Vitamin A

Mali

Iodine

Iron

Mauritania

	EPIDEMIOLOGICAL DATA


Goiter
Most Recent Goiter Survey
	Date:	Segou region: December 2000 to January 2001 in the region
		Kayes region: 1997 and 1999
		Sikasso region: 1999
	Groups Surveyed:	Segou region: public school students
		Kayes region: adult men and women
		Sikasso region: school children
	Sample Method/Size:	Segou region: simple random sample of 1416 children
		Kayes region: simple random sample of 687 adults in 1997, 884 men and 1029 women in 1999
		Sikasso region: Simple random sample of 394 school children
	Estimated Goiter Prevalence:

Region/Group*	Sample size	Population in region/group (if available)	Prevalence in sample %
Ségou	1416		20.5%
Kayes/1997/adults	687		41.0%
Kayes/1999/men	884		55.8%
Kayes/1999/women	1029		76.0%
Sikasso	394		9.60%

Urinary Iodine
Most Recent Urinary Iodine Survey
	The Thyromobil study took place in 4 western African countries, including Mali.
	This study looked at 901 students in 9 sites.
	The overall goiter prevalence was 13.3% (ranging from 4.1% to 24%).
	Sites were selected in areas previously known to harbor iodine deficiency that were accessible by vehicle.
	The urinary iodine level indicator cutoff was < 100mcg.l.
	The median urinary concentration was 203 mcg/l.
	The prevalence among children in the sample was 34%.

	POLICY AND LEGISLATION

Legislation on IDD
	There is currently IDD legislation in Mali. It was passed in 1999 which prohibits the importation or distribution of non- iodized salt.

Government Agency to Address IDD
	The government agency that deals with IDD is the Nutrition Division of the Ministry of health. They are responsible for coordination and monitoring.

Supplementation
	Supplementation with iodized oil capsules was used until 1999.

Fortification
Production and Importation of Salt
	There is no national production of iodized salt.
	Iodized salt is imported from Senegal.
	The imported salt has a 25 ppm level of iodization.
	Iodized salt is monitored upon entering the country, but without taking samples for iodine level testing.
	There are no other widespread methods of fortification in use.


Retail
	The average price for iodized salt is 200/kg.
	The price is slightly elevated in rural areas mainly during rainy periods.


Household Consumption
	There are no studies on household consumption.

Other Programs

There are radio advertisements promoting good iodine status in the Koulikoro region.

There are national television advertisements for good iodine status.

There is a community based program by HKI in the Koulikoro region.

Surveys of Iodized Salt

Date of Survey

Geographic area/ other grouping

Sample size

% of samples with > 15 ppm

2000

Région de Koulikoro

2175

Random sample

. Iodate/: ppm>25= 53.8%

. Iodure: ppm>25= 3%

Salt Iodine
Current monitoring activities for iodine levels in salt
	Test kits are made available to health workers, community authorities, and salt wholesalers who must periodically test their salt.

IDD Indicators
	Goiters and other IDD's are detected and followed only in hospital settings.

	There are lab facilities capable of testing T3, T4, TSH, and urinary iodine.


Donor and Implementing Agencies Involved in IDD Programs
	The National and State Governments are involved in training, public awareness campaigns, and grants.
	UNICEF, OMS, USAID and HKI provide the testing kits, training, and public awareness campaigns.


IDD Program Funding History and Projections
	For 2001-2003, $139,000 is available for behavior change advertising programs.
	For 2001-2006, $122,300 is available for epidemiological surveillance programs.
	For 2002-2006, $127,000 is available for importation, distribution, and quality control programs.

EPIDEMIOLOGICAL DATA