ABSTRACT
Objectives: Achievement the complete elimination of iodine deficiency and control of the situation is necessary to establish a well-functioning monitoring model using clearly-defined evaluation criteria and methodology. In this regard, the purpose is implementation of iodine status monitoring of indicator groups of the population in the framework of the State Program of Kazakhstan for 2011-2015 "Salamatty Kazakhstan". Methods: A population based cross sectional study was surveyed to analyze data of iodine intake among children and women in each region of Kazakhstan. Urinary iodine excretion was measured in casual urine samples and iodine intake was defined in resource iodine lab of Kazakh Academy of Nutrition which successfully participated in external quality control program EQUIP (CDC, Atlanta). The women were interviewed about salt iodization issue and salt samples were collected from their households for iodine determination. Results: Implementation of IDD monitoring began in 2011 covering all 16 regions of Kazakhstan and reflects the current situation. From 2012 a survey has conducted annually in three or four oblasts. It means in 2015 all oblasts of Kazakhstan will cover with situation analysis in each oblast to take corrective measures and improvements iodine issue in Kazakhstan. Conclusions: Thus, the strategy of establishing biological monitoring will provide an objective picture of IDD status in each oblast at intervals of 5 years, which will monitor the situation of supplementation iodine intake of Kazakhstan population. Effective and long-term strategy of monitoring supported by government will lead to reduce iodine consequences and brain damage.
ABSTRACT
Objectives: The need for and lack of iodine resource laboratories in Central and Eastern Europe led to an agreement between the Centers for Disease Control and Prevention (CDC) and UNICEF for developing a regional iodine reference laboratory at the Kazakh Academy of Nutrition (KAN). Objectives included conducting reliable iodine measurements, KAN capacity strengthening, operating an external quality assurance (EQA) program, and self-sustainability. An underlying aim was ensuring quality laboratory data for management and decision-making of iodine disorder elimination programs. Methods: Creation of the laboratory at KAN was undertaken through technical support, training, funding, and material resources from CDC and UNICEF. Initial activities included building a fully-functioning laboratory, developing partnerships, and creating and operating a website and EQA program. Later activities included a landscape analysis, harmonized guidelines, an inaugural workshop attended by 17 regional laboratories, and a business sustainability plan. Results: The KAN reference laboratory was established and an operational plan is being implemented that will ensure sustainability. The plan includes contracts with the Kazakh government for multiple micronutrient analyses in four surveys, and fee-based trainings and assessments for regional laboratories as provided for Serbia, Kyrgyzstan, and Moldova. Participation in at least one EQA round by 78% of regional laboratories and consistent participation from 11/18 labs indicates that KAN assistance was well received. Conclusions: An up-to-date, high-quality reference laboratory and resource center for iodine assessments, led by technical experts capable of managing reliable iodine measurements in salt and urine and coordinating an EQA service for national iodine laboratories, has been established in the region.