IDD Status in Bulgaria

Ivanova, L*. B. Lozanov**, Zv.Timcheva***

*National Center of Hygiene, Medical Ecology and Nutrition, Sofia** Clinical Center of Endocrinology, *** Ministry of Health

National Program for Control of IDD - Multisectoral Efforts

Legislation: Since 1958; Updated 1994 Decree 96/94 of Council of Ministers; Ordinance

RD-09-244/94 of the Chief Sanitary Inspector; Amendment of the Bulgarian State Salt Standard

Institutional support / Intersectoral Co-ordination National Coordinating Committee for IDD Control

(MOH,- Industry, -Trade, Salt Producers, Thyroidologists, Nutritionists, NGO,s)

Expert Council on IDD at Ministry of Health

Salt production/iodination

Local production - 40% ; import - 60% Local production - 6000 t/last year iodized

salt - 20 % of iodized salt required for humans Iodine compound: KIO3Level of iodination: 19-32 ppm I2 (28-55 ppm

KIO3)Availability of iodized salt : general

Assessment/Monitoring/Evaluation

Monitoring plan of IDD status Indicators

Proportion of adequately iodized salt at the market

Urinary Iodine Excretion Total Goiter Rate: palpation; ultrasound Neonatal TSH

IDD STATUS

Total Goiter Rate:18 % (5-26%) (National survey, 1996)

14.8% -palpation; 2.7% ultrasound (Sofia-city, 2001) Urinary Iodine Excretion: 111.4 mcg/L (1996);

145.0 mcg/L(2001) Incidence of Congenital Hypothyroidism:

1: 4000 live births Incidence of Transient Hypothyroidism in

newborn: 8.8% Neonatal TSH > 5 U/mL: 9.2%

Percentile Distribution of ioduria from

representative surveys of schoolchildren 1994-2001

0

20

40

60

80

100

120

140

160

180

200

220

1994 1996 1999 2001 year

iod

uri

a m

cg/L

P25

P50

P75

Conclusions

The legislation and capacity building of the IDD Program was completed.

The iodine intake of Bulgarian population was substantially improved after the implementation of universal salt iodination in 1994.

Our country is already achieving the final goal - eradication of IDD at population level

Thank you