Strategy of liquidation of iodine deficiency diseases in the Russian Federation

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There are actually по territories in Russia without risk of iodine deficiency diseases (IDD) for the population. Iodine deficit in nutrition is observed in all heretofore examined areas of the country, from central regions to Sakhalin. Actual mean daily consumption of iodine by a resident of Russia is 40-80 pg (1995-1999), which is 2-3-fold below the recommended norm. Iodine deficiency is particularly pronounced in the rural residents and population with low income. Iodine deficiency of extreme severity was detected in the Republic of Tuva. A threatening tendency to increase in the incidence and prevalence of IDD and unfavorable socioeconomic changes which tell on the nutrition of population make the problem of IDD one of priority problems of public health and necessitate urgent measures aimed at liquidation of conditions for development of these diseases. Today the problem of IDD liquidation in Russia acquired state significance. The Government of the Russian Federation adopted on October 5, 1999, a Decision signed by V. V. Putin "On Measures for Prevention of Iodine Deficiency Diseases". Minister of Health of the Russian Federation, Chief State Sanitary Physician, organs of legislative and administrative power in the Federation determined by their order and decisions the strategic trends in prevention of IDD. The most efficient strategy of liquidation of iodine deficit in Russia is overall iodination of table salt. WHO and UNISEF recommend total salt iodination as a universal highly economic method for global liquidation of IDD. Individual and group iodine prevention should be carried out with drugs containing physiological dose of iodine in accordance with age requirements. The efficiency of various methods of iodine deficiency compensation by different methods (making use of iodinated salt, iodinated bread, and treatment with iodine preparations, such as potassium iodide and lipiodol) was evaluated at Endocrinology Research Center of Russian Academy of Medical Sciences. A method of bread iodination is developed and introduced. Among the priority problems of IDD control are introduction of a system of biological monitoring of iodine supply, epidemiological studies at the population level, drug supply, improvement of higher and vocational medical training and upgrading of physicians with special emphasis on diagnosis, prevention, and treatment of IDD, and education of the population with instructions on measures of iodine deficiency prevention.