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Current Iodine Deficiency Disorder Situation
Population
Population: 57.72 million
Population growth rate: 0.05%
Population < 15 years: 14.1%
Birth rate: 8.93 per 1000
Life expectancy at birth: 79.25 years
Infant mortality: 5.76 per 1000
Prevalence of Goiter/ UIE
Median urinary iodine: 55-142 mcg/L.
Urine iodine = 10-122 mcg/g creat where goitre was 14-69%; 88-175 mcg/g creat where goitre was 2.2-8%.
Edpidemiological surveys conducted from 1978 to 1991 including over 70,000 schoolchildren (primarily in endemic areas) indicated a goitre prevalence varying from 14 to 69% in endemic areas. The average TGR was 39%, although 84% of these were 1A. IDD persists in mountain (Apli & Appennini), although some coastal areas are affected as well. IDD doesn't exist in big cities and heavily populated areas.
Cretinism was present in past, not known recently.
TSH not elevated in older children or adults. Newborn screening nationwide, incidence 1:3500, reaches 1:2000 in some areas, with corresponding increase in proportion that are transient, consistent with iodine deficiency.
Iodized salt Coverage
Household iodized salt use: 3%
Salt Situation Analysis Production
No information on iodized salt.
Consumption
- Estimated daily per capita salt consumption: no data.
- Estimated % of all salt consumed by people which is adequately iodized (household level): 3%
Iodine Procurement and Utilization
30 ppm as either KI or KIO3
Universal Salt Iodization Program
Information, Education, Communication (IEC) Activities
Endocrinologists in Italy have been particularly active in assessment, intervention, and advocacy.
Legislation
- Legislation: Awaiting final approval of Parliament, limits sales to iodized salt alone, with non-iodized available on special request.
- Legislation for Animals: none.
- Year Enacted: n/a
Program Monitoring and Evaluation
Ministry of Health is responsible. An institutional committee has existed since 1985, comprised mostly of thyrodologists. Its members have actively advocated iodized salt use and relevant legislation.
Monitoring of urinary iodine and thyroid size by ultrasound has taken place as part of academic studies but systematic monitoring of salt and nutrition is now being planned. A large school-based study of thyroid size by ultrasound, as an advocacy tool, took place in much of southern Italy , results awaited.
Other Interventions
Water iodination was carried out in Troina , Sicily , resulting in a nearly complete goiter eradication in 1982.
Key Lessons Learned
Challenges and Constraints
Future Plans for Sustained IDD Elimination
Sources:
IDD NL 18(4):54, 2002
IDD NL 13(3):37, 1997 ( Sicily )
IDD NL 12(1):14, 1996
IDD NL 10(1):9, 1994 ( Sardinia )
IDD NL 9(1):7, 1993
Costante et al.. J Endocrinol Invest 20(5):251, 1997
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