engleski

IDD Status in Croatia

In the 1950&#8217; endemic goiter was present in most parts of Croatia, with a prevalence of 50-80% in schoolchildren, and presence of cretinism. Wide range of other iodine deficiency disorders (IDD) was also observed in endemic areas: short stature, low intelligence and deaf-mutism. The socio-economic consequences of IDD were tremendous. In 1953 the first regulation on obligatory salt iodination for both human and animal consumption, requiring 10 mg of potassium iodide (KI) per kg of salt was established. A three-fold reduction of goiter prevalence, together with disappearance of cretinism was recorded ten years later. Epidemiological investigations performed in 1991-1995 demonstrated the presence of mild to moderate ID in Croatia with the prevalence of goiter in 8-35% and urinary iodine excretion (UIE) < 10 &#956; g/dL in 66-83% of schoolchildren. The new obligatory regulation, requiring 25 mg of KI/kg of salt, was established in 1996. After the new regulation, medians of urinary iodine excretion in schoolchildren from all parts of Croatia demonstrated rising values. In 2002, Croatia has finally reached iodine sufficiency. Thyroid volumes (Tvol) and medians of UIE in schoolchildren from all four major geographic regions of Croatia were for the first time within the normal range according to the WHO/ICCIDD criteria. Overall median of UIE for schoolchildren in Croatia was 14 &#956; g/dL. Significant improvement in UIE was detected in adults from Zagreb, the Capital of Croatia: from 6.7 &#956; g/dL in 1995 and after the new regulation 10.1 &#956; g/dL in 1999 and 15.3 &#956; g/dL in 2004. Monitoring of IDD status in schoolchildren from the village of Rude in 2004 and 2005, where the highest prevalence of goiter and cretinism was detected in the country prior to compulsory salt iodination in Croatia, demonstrated after new regulation sufficient iodine intake (median of UIE 19.0 &#956; g/dL and BSA-adjusted Tvol within the normal range according to the new international reference values for Tvol in iodine-sufficient schoolchildren). An intensive cooperation with ICCIDD significantly contributed in resolving the problem of IDD in Croatia. Croatia crossed a path from severe ID detected in the 1950&#8217; , to the period of mild to moderate ID during the 1990&#8217; , and finally, nowadays, iodine sufficiency has been achieved.

goiter; Croatia; iodine sufficiency

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