engleski

Fifty years of struggle against iodine deficiency in Croatia: the battle is won

In the 1950', endemic goiter was present in most parts of Croatia, with the prevalence of 50-80% in schoolchildren, and presence of cretinism. In 1952, in the village Rude near Zagreb, the capital of Croatia, goiter was detected in 85% of schoolchildren with 2, 3% of cretinism in the village. Wide range of other iodine deficiency disorders (IDD) was also observed in endemic areas: short stature, low intelligence and deaf-mutsim. The socioeconomic consequences of IDD were tremendeous. In 1953 the first regulation on obligatory salt iodination for bioth human and animal consumption, requiring 10 mg of potassium iodide (KI) per kr of salt was established. A three-fold reduction of goiter prevalence, together with dissapearance of cretinsim was recorede 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. In 2002, Croatia has finally reached iodine sufficiency. Medians of IUE for all four major regions of Croatia were within the normal range according to ICCIDD criteria (overall median was 14 &#956; g/dL). No goiter was detected by ultrasound in schoolchildren from Croatia according to the WHO/ICCIDD reference values. Medians of UIE in schoolchildren from the village of Rude demonstrated rising values in &#956; g/dL: from 7.4 in 1991, and after the new regulation 11.4 in 1997, 14.3 in 2002, 15.4 in 2003 and 19 in 2004. In 2003 no goiter was detected by ultrasound in schoolchildren from Rude. CONCLUSION: Croatia crossed a path from severe ID detected in the 1950', to the period of mild to moderate ID during the 19909, and finally, nowadays, iodine sufficiency has been achieved. This struggle against IDD in Croatia will contribute to the benefit of future generations.

iodine deficiency; endemic goitre

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