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Iodene Disorders
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For more information in iodine deficiency disorders click here.

Iodine deficiency disorders (IDD) - efforts to eliminate it in South Africa
South Africa, like the rest of the world is committed to the virtual elimination of iodine deficiency disorders (IDD). Remarkable progress has been made improving the iodine and goitre status of the South African population since the introduction of mandatory iodisation in 1995.

South Africa, like virtually all other African states and, in fact, most of the countries of the world, has a lack of iodine in the environment in many geographical areas. In the past this lack of iodine resulted in insufficient iodine in the food chain and consequently, due to inadequate dietary intake, in iodine deficiency disorders (IDD).

The most devastating of the range of IDD is the damaging effect on the developing brain of children during the foetal stage and during childhood. Indeed, iodine deficiency is regarded as the most preventable cause of brain damage and mental retardation worldwide.

The results from the household and retail salt samples that have been conducted, show that nearly two thirds of the households in the country have access to adequately iodated salt. However, the goal is that at least 90% of households in the country, especially in the rural areas should have access to adequately iodated salt.

South African IDD Network
In order to achieve this goal, a nationally coordinated strategy was required for the overall coordination and strengthening of the various activities related to the sustainable elimination of IDD in the country, by a IDD network that consist of various role players in IDD in South Africa. The South African IDD Network is made up of the following: Department of Health (Directorate: Food Control and Directorate: Nutrition), UNICEF, the MRC and any other role players that may contribute to the elimination of IDD.

The South African IDD Network will mobilize role players; coordinate IDD activities; facilitate and conduct capacity development of various role players to expand and sustain the IDD effort; support the salt producers toward optimal iodation; introduce an Information; Education and Communication programme; monitor and evaluate progress; stimulate and conduct IDD research; and become a repository of South African IDD documentation.

Future Challenges
Despite of all this important information to guide programme development there are still challenges in terms of creating awareness and providing information on the prevention and control of IDD, especially to the deep rural areas of South Africa.

Recently, an opportunity to visit a community where IDD is still endemic was created. The visit was to Sambandou village in the Limpopo Province where IDD is still endemic and to assess constraints faced by this community. The South African IDD Network delegation composed of Maanda Mandavha (Food Control), Maude de Hoop (Nutrition), Joan Matji (UNICEF), Pieter Jooste (MRC), a Journalist, and a Photographer.

The group first visited Bergpan Salt Producer near Vivo where salt is produced by means of an evaporation process. Salt produced at Bergpan is not iodised and is meant for agriculture purposes (animal feed). It is packed in 20kg bags when ready for sale.

The other visit was to Sambandou Village in Venda where goitre is still prevalent. Two elderly women and a 14-year-old girl with goitre were interviewed. They had been unaware of the cause of the goitre, but as a result of a recent health campaign they have started using iodised salt. They however referred to the price difference between iodated and non-iodated salt, which is strange, because non-iodated salt may not be sold for human consumption according to legislation. Non-iodated salt is also supplied as a reward to labour. Different brands from the local supermarket were bought for further iodine analysis to see whether they are correctly labelled as "iodated salt."

It is unfortunate that the vulnerable groups in the population are still exposed to under or non-iodinated salt. These groups are low socio-economic rural people with households using predominately non-iodated coarse salt intended for agricultural purposes. It thus appears that significant progress achieving the coverage of adequately iodated salt is accompanied by factors and practice, weakening the national iodation programme. Factors noted to be responsible for the consumption of under or non-iodated salt were the following:

bulletNon-iodated agricultural salt obtained from producers and repackaged was cheaper compared to iodised fine salt from the retailers. The fact that some of the salt was also obtained as a reward for labour.
bulletThe possible iodine loss during transport and storage in the hot and humid climate of the Limpopo province may be contributing to the low iodine concentration found in household salt.
bulletSpaza shops repackaging industrial salt which is exempted by the regulation.

The challenge now is for the producers, health officials, consumers and other role players to eliminate or minimize factors in this way and increasing the percentage of households' countrywide using adequately iodated salt by at least 90%.
Maanda Mandavha

Published by the Directorate: Food Control

 

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