IODINE deficiency is the world’s greatest preventable cause of brain damage and mental retardation.<br><br>
By Vision Reporter
IODINE deficiency is the world’s greatest preventable cause of brain damage and mental retardation.
Even a minor lack of this nutrient can reduce a child’s intelligence quotient (IQ) by 10—15 points, limiting the economic development of communities, experts say.
As a result, they agree that a few global health problems could be cheaply solved, yet nearly one third of the world’s population remains at risk.
Although Uganda lacks viable data, the World Health Organisation estimates that iodine deficiency affects more than 700 million people, mostly in developing countries.
The solution has been around for decades, but is yet to appear in Ugandan kitchens. Iodised salt is required for the proper functioning of the thyroid gland.
Adding iodine to salt could cost less than 10 cents per person per year. The US Network for Sustained Elimination of Iodine Deficiency says a dollar spent preventing iodine deficiency can yield $28 (sh55,000) in productivity gains.
Access to sufficient iodine for over half the 1.6 billion would cost only $12 million a year, pocket change in terms of international health spending. In Uganda, dramatic progress has been made to date.
The number of people using iodised salt has tripled in the last few years, thanks to public information campaigns, laws mandating the use of iodised salt and a major push by governments and civil society to involve private salt producers in iodisation efforts.
Iodine can be difficult to come by, particularly for the small-scale producers who provide salt to millions of the world’s poorest. Only a few countries, such as Japan and Chile produce it in significant amounts.
The principal nutritionist of the health ministry, Ursula Wangwe, says food fortification is one of the key interventions in addressing micro-deficiency. But iodine deficiency is hardly limited to the developing world.
A 2006 study found nearly half of Australia’s school children lacking iodine and it was also blamed for diminished IQ and increased incidence of attention deficit and hyperactivity disorder among Irish children.
The prevalence of iodised salt in Australia and Ireland was just 10% and 3.3% respectively. But it is poor countries that suffer most. Fourteen nations have been identified as bearing the major burden of iodine deficiency, including China and Uganda.
“If we’d made progress in those countries, the worldwide coverage would go above 80-85%,†says Gerard Burrow, the head of the International Council for Control of Iodine Deficiency Disorders.
Providing iodine to 90% of the world’s population would still leave hundreds of millions at risk of decreased mental capacity and a host of other problems that include deafness, dwarfism and goitre (enlargement of the thyroid gland).
Salt has long been considered an ideal vehicle for iodine. Everyone may use salt, but not everyone buys it. Some coastal communities collect theirs directly from the sea, while others live near natural salt beds.
As iodine occurs naturally in only a few foods, these populations must get theirs some other way, says Wangwe.
Capsules can be taken annually, providing the thyroid with a year’s worth of iodine. However, this requires a well-functioning public health system to get everyone the capsules on a regular basis.
There is no shortcut, Dr. Jesca Nsungwa, a paediatrician in-charge of childhood illness at the health ministry, says.
“Iodine is needed at every age, but it is most important during the first trimester of foetal growth, when a baby relies on its mother’s thyroid hormone for critical brain development.â€
Iodine deficiency in the mother can lead to severe and irreversible mental retardation. All women of childbearing age should have a steady and sufficient supply of iodine, says Nsungwa.
Iodine in a daily diet requires collaboration and communication. Experts say small-scale producers, whose operations are often clustered around natural salt sources, must be identified and linked with a means of iodisation.
Populations must also be educated and superstitions overcome. Some communities believe iodised salt is bad for the skin.
Perhaps most importantly, salt iodisation needs to become second nature to the salt manufacturers. Already table salt producers in Uganda are required to add to iodine to eliminate micronutrient deficiencies.