Iodine Deficiency in Tanna, Vanuatu Fact Finding Study

1. Iodine Deficiency in Tanna, Vanuatu (Fact Finding Study) Ms. Myriam Abel Director General Ministry of Health Vanuatu

2. Fact Finding Study The aims of the present study were to determine iodine nutritional status and the prevalence of goitre in school children on the island of Tanna, the availability and usage of iodized salt and the potential contribution of dietary sources of goitrogen. National Health Information System was indicating an increase number goitre in school children. The University of Sydney in collaboration with Ministry of Health (Vanuatu)

3. Survey Methods and Sampling 153 Children aged 8-10 years (5% of this age in the total population of Tanna) 14 schools were located in 4 area in Tanna Each child was measured and weighed, in the presence of a teacher or parent, and provided a spot urine sample for urinary iodine and thiocyanate estimations. Thyroid volume was measured by ultrasound. A dietary questionnaire designed to obtain information on the frequency of consumption of good dietary sources of iodine, as well as foods thought to contain thiocyanate in the Ni-Vanuatu diet was used in the survey.

4. Findings of the study According to the WHO/UNICEF/International Council for the Control of Iodine Deficiency Disorders criteria the children from Tanna Island are moderately iodine deficient with median UIE of 49�g/l. This is further corroborated by the enlarged thyroid glands of these children. The lower UIE levels were associated with greater thyroid volumes, which by definition make Tanna an endemic goitre area. From the 46 individual salt samples collected, 20 were iodized. Children and their mothers had no knowledge of what type of salt they consumed.

5. WHO Epidemiological criteriafor assessing iodine nutrition based on median urinaryiodine concentrations in school-aged children Median Iodine intake Iodine urinary iodine (mg/l) < 20 Insufficient Severe iodine 20-49 Insufficient Moderate iodine 50-99 Insufficient Mild iodine 100-199 Adequate Optimal www.who.int/nutrition/publication/en

6. Steps to address Iodine Deficiency Disorder in Vanuatu Policies & Legislation Universal salt iodisation (USI) is the main global intervention strategy for the prevention and control of iodine deficiency disorders. This requires our governments to develop public policy for mandatory fortification of all edible salt with iodine. Efforts should also be made to raise public awareness and create demand for iodized salt informing the general public of the benefits of consuming iodized salt without necessarily encouraging an increase in salt intake that may have adverse cardiovascular effects on the population in the longer term. As Tanna imports all of its salt and as 90% of the residents use salt on a daily basis it should be relatively easy to mandate only iodized salt be imported The results of this study have major public health implications pointing to the need for an assessment of iodine nutrition in the residents of the other islands in the Republic of Vanuatu.