lodine deficiency control in Iran
9. Azizi F. Monitoring of IDD prevention. Proceedings of the
Fifth International Congress of Endocrine Disorders. 6-9
Sept. 1999, Tehran, I.R. Iran, p. 9.
monitoring; 7) regular data on salt iodine at factory
(daily), retail (monthly) and household levels (yearly)
are collected in each province and analyzed by the
IDD executive officer; 8) regular laboratory data on
urine iodine in school aged children with appropriate
sampling for higher risk areas is being collected and
processed in each province on a yearly basis and na-
tionally every 5 yr; 9) cooperation from the salt in-
dustry for the maintenance of quality control is ex-
cellent and it is supervised by the IDD executive of-
ficer; 10) a database with the records of results or
regular monitoring procedures, particularly for salt
iodine and urine iodine is available in the Ministry of
Health. Neonatal TSH was measured in 1989 and
1997-1999. This shows a significant decrease in tran-
sient hyperthyrotropinemia and recall rate.
Therefore, the IR of Iran fulfills all 10 programmatic
indicators set by WHO/UNICEF/ICCIDD (20). Ac-
cording to these criteria, the IR of Iran appears to
have reached a sustainable IDD control program
since 1996. The monitoring of the IDD control pro-
gram is planned every 5 yr to evaluate the sustain-
ability of the program. We conclude that the imple-
mentation of an adequate and sustainable program
of IDD control needs many effective programmatic
steps, in particular its integration into the health net-
work. Furthermore it may require mandatory iodized
salt consumption in certain situations.
10. WHO/UNICEF/ICCIDD. Indicators for assessing iodine de-
ficiency disorders and their control through salt iodiza-
tion.Geneva, WHO/NUT/94.6, 1994,
11. Dunn J.T., Crutchfield M.E., Gutekunst R., Dunn A.N.
Methods for measuring iodine in urine. Geneva, ICCIDD/
UNICEF/WHO publication, 1993.
12. Azizi F. Iodine Deficiency Disorders in the Republic of
Yemen. Assignment Report No. WHO/EMORO/EM/NUT/
106/E/R/12.91/30. Alexandria, World Health Organization,
EMRO.
13. WHO/UNICEF/ICCIDD. IDD in the Middle East. IDD News-
letter. 1993, 9: 13-17.
14. WHO/EMRO. Assessment of monitoring of iodine defi-
ciency disorders in countries of the eastem Mediterranean
region. Report of a symposium-workshop, 9-11 Sept. 1999,
Tehran, I.R. Iran, 2000.
15. Azizi F., Sarshar A., Nafarabadi M., et al. Impairment of
neuromotor and cognitive development in iodine deficient
schoolchildren with normal physical growth. Acta Endo-
crinol. 1993, 129: 501-504.
16. Azizi F., Kalani H., Kimiagar M., et al. Physical, neuromotor
and intellectual impairment in non-cretinous schoolchil-
dren with iodine deficiency. Int. J. Vitam. Nutr. Res. 1995,
65: 199-205.
17. Aghini-Lombardi F., Antonangeli L., Pinchera A., et al.
Effect of iodized salt on thyroid volume of children living in
an area previously characterized by moderate iodine defi-
ciency. J. Clin. Endocrinol. Metab. 1997, 82: 1136-1139.
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