Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2008) 16 P786

ECE2008 Poster Presentations Thyroid (146 abstracts)

From elimination to sustainable control over iodine deficiency in Bulgaria 1997–2006

Iva Stoeva

University Pediatric Hospital Sofia, Sofia, Bulgaria.

Iodine deficiency (ID) and ID disorders (IDD) are a global problem. ID elimination would significantly contribute to achieving at least 6 of the 8 millennium developmental goals.

Aim: To adapt the Neonatal thyroid screening (N?S) based on TSH with a view to its applicability as a permanent indicator in monitoring the effect from the iodine prophylaxis of IDD in Bulgaria.

Tasks: To study: 1) dependence of TSH on age after birth; 2) influence of perinatal application of iodine-containing desinfectants on TSH concentration in newborn children (NB); 3) TSH – distribution prospectively; 4) commercially available iodized salt according to the new state standard (KIO3 28–55 ppm) and its relation to the percentage of TSH >5 mU/l.

Material and methods: TSH analysis (Delfia) from NTS of 619 898 NB from all over Bulgaria (1997–2006) by specially designed software for registering each screened NB. The TSH concentration of 5 mU/l in <3% of NB was used as a sign of iodine repletion (WHO proposal).

Statistics: SPSS 10.

Results: Obvious, significant dependency of TSH on age/inversely proportional/and the application of iodine-containing desinfectants/directly proportional. The percentage of NB in Bulgaria with TSH > the suspicious for congenital hypothyroidism (cutoff 15 mU/l) rapidly decreased (1.8–0.09%; P<0.0001). The relative share of NB on L-thyroxine treatment increased from 25 to 70%. The significant reduction of NB with TSH>5 mU/l and levels <3% (first time in 2006) was accompanied by previous stable, sustainable increase of iodized food grade salt above 90%.

Conclusion: Universal salt iodization is an effective strategy for ID elimination. Bulgaria has reached the first stage of sustainable control over ID. NTS, after thorough ?daptation, might be a useful instrument in monitoring the effect of programmes for securing optimal iodine supplementation at population level among the most sensitive to ID individuals represented by the NB.

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