Salt iodisation and public health campaigns to eradicate iodine deficiency disorders in Armenia

Background: Iodine deficiency disorders (IDD) are endemic in the mountain regions of Armenia. Universal salt iodisation has been chosen as the control measure. Objectives: (1) To measure the prevalence of iodine deficiency in the Armenian population; (2) to evaluate household use of iodised salt; and (3) to monitor iodised salt promotion strategies. Design: Cross-sectional study on a nationally representative sample of 2627 households, including 3390 children under five and 2649 women of fertile age. Cluster sampling design on four population strata: residents, refugees, rural and urban. Results: Thyroid was palpable in one-third of the women, 6% of them having a visible goitre. Median of urinary iodine excretion in children was 139.5 mug l(-1). One-third of the children showed low urinary iodine concentration. Iodised salt was consumed in 66% of the households. The national IDD control programme included modernisation of the Yerevan Salt Factory, legislative regulation of the iodine content of the salt, and public information by the media. Conclusions: Armenia was still an endemic zone for goitre in 1997. The iodine status of children under five in 1997 was not considered alarming even though 33% of them had low values of urinary iodine. After four years of intervention strategies, the use of iodised salt has increased by 17%. Further efforts should be made to control salt imports and to monitor IDD indicators in vulnerable groups.