At January 1998, Department of Endocrinology of the University of Patras in corporation with the non- governmental organization «Doctors of the World- Department of Greece», with Medical School in Baku and with Institute of Endocrinology in Baku started conducting a scientific survey aiming at the precise estimation of the extent of iodine deficiency. Until then, estimations were mainly based either on clinical observations or on data originated from previous studies of WHO (1989). The study was designed and conducted by a six member group of doctors of the University of Patras. The required equipment was the following: 1) two updated portable ultrasound sonography apparatus with special heads, 2) equipment for inplace urine iodine detection, which had already been introduced in clinical research from the German Company Merck KgaA, 3) reagents for serum hormonal determinations provided by Greek which were acquired with the corporation of Greek Institute of Child Health (Athens), 4) reagents for serum thyroid hormonal and urine iodine determinations in Laboratory of Endocrinology of University of Patras.
The survey was conducted in the subcontinent of Azerbaijan and in the province of Nakhichavan. The results of this survey have been announced at International Conferences (Satellite Symposium of the 27th Annual Meeting of the European Thyroid Association, Krakow, Poland August 29-30,2001), Greek Conferences (26º and 27º Hellenic Conference of Endocrinology) and published at valid international magazines (Thyroid, Journal of Endocrinological Investigation).
This study proved that iodine deficiency in the population and especially in certain regions of Northwestern Azerbaijan (Caucasus) and of Nakhichavan is by far more severe than it was initially estimated. Goiter rate in the total of the examined representative sample was 86%, whereas in the sample of children living at Caucasus, goiter rate reached 100%. According to WHO definitions, goiter is characterized as endemic whenever its rate is 5%. The respective urine iodine concentration levels in young students were exceptionally low (54mcg/L in the whole sample, 36 mcg/L in children of Caucasus, while <20 mcg>100 mcg/L:normal).
Given all the above, it became obvious that apart from measures of prevention and long-term substitution with iodide salt, immediate urgent administration should be warranted to the population groups with more severe iodine deficiency.
At December 1999, University of Patras, in corporation with a non-governmental organization, called «Doctors of the World» and co-financed by Office of Humanitarian Affairs of European Union and by Greek State Department, implemented emergent dispensation of an iodized preparation (Lipiodol caps 190mg) to 293.000 school children living at mountainous regions of Caucasus. On the whole, three campaigns of Lipiodol dispensation were accomplished: At December 1999, at May 2000 and at October 2000. Our team reassessed the results 6, 12 and 36 months after the first administration of Lipiodol, namely at spring 2000, autumn 2000 and spring 2003. The revaluation predicated that the results of the emergent intervention were fully satisfactory. Urine iodine levels rised from 36 to 68, 81 and 121 mcg/L after 6, 12 and 36 months respectively. On the other hand, goiter rate diminished from 99% to 54% and to 26% after 6 and 12 months of administration.
According to international standards and based on the above results, iodine status of the population was judged as satisfactory. Consequently, priorities were revaluated, hence maintenance of this beneficial situation was considered as top priority. Therefore, a new project was elaborated concerning the years 2006-2007.
Thereafter, iodized salt was administered to 300.000 children and adolescents in 4 doses of dispensation, while an informational campaign was accomplished, sensitizing about the effects of iodine deficiency as well as the need of household use of iodized salt.
Recent evaluation of the situation, carried out two years ago, revealed that daily iodine excretion to urine was found within normal limits, while goiter rate was less than 5% in these populations, which is accepted by international standards. Based on the above data, an updated laboratory for hormonal determinations equipped with ultrasound sonography apparatus was installed in Sheki, the capital of Azerbaijani Caucasus and was staffed with Azeri scientists (Endocrinologists and biochemists) trained at the University of Patras in management and treatment of iodine deficiency.
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