Goiter Rate Research Articles

Minimally-Invasive Robotic-Assisted Resection for Intrathoracic Goiter – A Feasible Alternative to Thoracotomy and Sternotomy

Abstract Background Goiter is a common presentation in daily clinical practice. It usually grows slowly and in rare cases with intrathoracic extension. There is no clear definition of intrathoracic goiters. The incidence in the literature varies from 3% to 7%. Most intrathoracic goiters are localized in the anterior mediastinum, with less than 25% are localized in the posterior mediastinum. This presents a challenge for surgical resection. Traditionally, the intrathoracic portions have been resected via sternotomy for anterior goiters and thoracotomy for posterior goiters. With the increasing use of robotic surgery, new possibilities for minimally invasive surgery and especially robotic procedures have emerged. This may reduce morbidity and length of hospital stay. Aims The study aims to show that minimal-invasive, robotic-assisted resection for intrathoracic goiter is safe and feasible. Methods During the study period from January 2021 to December 2023, 548 thyroid operations were performed in our clinic. All operations were prospectively recorded in the Eurocrine registry and retrospectively analyzed. Goiter was defined as intrathoracic according to perioperative findings (caudal border not visible on sonography and/ or further preoperative investigations ordered). Primary and secondary endpoints were outcome, conversion rate, and incidence of intrathoracic goiter. Results In our clinic, 19/548 patients (3.5%) presented with intrathoracic goiter. 17/19 patients were operated via conventional cervical approach. In 2 patients, minimal-invasive robotic mobilization of the large posterior portion of the goiter was performed in combination with conventional cervical thyroidectomy. No conversion was required. Based on our cases, we present robotic intrathoracic thyroid mobilization as a novel technique to avoid thoracotomy. The rate of recurrent nerve palsy in intrathoracic goiter was 1/28 (3.5%) nerves at risk and occurred with conventional approach. No secondary bleeding or other complications were observed. Conclusion The minimal-invasive robotic approach seems to be a promising alternative to open procedures such as thoracotomy and can reduce morbidity and length of hospital stay.

Goiter Prevalence and Associated Factors among Women in Hargeisa, Somalila

Background: Goiter, which is associated with various risk factors, is highly prevalent in Hargeisa region of Somalia and is a serious health problem among women living in the region.Objective: This study aims to reveal the true extent of the problem, identify the causative factors and suggest preventive methods accordingly.Methods: A cross-sectional analysis was conducted on 270 female patients randomly selected from 1659 patients at Hargeisa Group Hospital (HGH), in Somalia, between January and August of 2022. The study sample was equally distributed between those with and without a diagnosis of goiter. Independent risk factors were identified by making comparisons between groups.Results: For the study group, dietary habits were identified as an important risk factor for the development of goiter. Patients who regularly consumed ‘cabbage’ - 188 (87.4%) had a higher rate of goiter compared to those who did not - 64 (47.4%); (p<0.001). Furthermore, those who consumed iodized salt regularly or more frequently - 54 (40%) were less likely to have goiter compared to those who did not - 128 (94.8%); (p<0.001). The use of non-iodized salt and cabbage consumption were identified as predictive factors for the development of goiter.Conclusion: Randomized studies with larger study groups should be conducted. The Minister of Health, health professionals and the media should work in cooperation to raise public awareness and take necessary precautions.International Journal of Human and Health Sciences Vol. 08 No. 02 Apr’24 Page: 192-197

A Clinico-epidemiological Study to Evaluate the Status of Iodine Deficiency Disorder in North 24 Pargana District of West Bengal

Background: Iodine deficiency disorders (IDD) being major public health problems in India, including WestBengal needs to be continuously monitored through recommended methods and indicators.Present study is aiming to assess the total goiter rate, urinary iodine excretion, iodine content of salts at households’ level among primary school children and to find association with the socio-demographic characteristics of the study population.Method: A school-based, cross-sectional study was conducted during March 2019 to August 2019 among 540schoolchildren of class three and four. Goiter was assessed by standard palpation technique, urinary iodineexcretion (UIE) was analyzed by wet digestion method and salt samples were tested by spot iodine testing kits.The total goiter rate (TGR) was 10.56 %. About 97.22 % of the salt samples tested were adequately iodized. Though consumption of iodized salt was adequate irrespective of socio demographic characteristics; goiter prevalence was significantly different with respect to mother’s education level. Median urinary iodine excretion was found to be with in normal range. Lastly, a comparison is made between indicators of IDD over years which showed significant fall of TGR % of North 24 Pgs and a significant increase of adequately iodized salt consumption from 2004 to 2019.Conclucion: 2019 resurvey of North 24 parganas indicates that the district achieved close to the goal of NIDDCP i.e. prevalence of IDD should be below 10%. It also proved that universal salt iodinization program has increased the household’s iodine consumption above national goal of 91.2%. Goiter prevalence is found to be less in children whose mother attend the education up to 12th standard and beyond.

A Rare Case of Anatomical Variation of Inferior Thyroid Artery Originated From the Brachiocephalic Trunk During Retrosternal Goiter Excision.

Vascular variations are prevalent among the human population. However, the occurrence of anatomical variations in the inferior thyroid artery originating directly from the brachiocephalic trunk (BCT) is exceptionally rare, as confirmed by numerous research studies. In addition, reliable departmental statistics reveal that the incidence rate of retrosternal goiter is approximately 19%. In this case study, the variation blood vessels in the neck were accidentally found and analyzed. Simultaneously, we conducted an analysis on the clinical significance of a rare anatomical variation. The study focused on a 60-year-old female patient who underwent a surgery for retrosternal goiter, during which it was discovered that the inferior thyroid artery originated from the BCT. Our report presented a unique case involving this particular combination of anatomical variations within the BCT. The anatomical variation reported in our study will effectively reduce the risk of patients and enhance our comprehension of this anatomy's characteristics, thereby avoiding the occurrence of iatrogenic complications.

Burden of Goitre and Urinary Iodine Status among Primary School Children in Kashmir, India-Evidence from a Population-Based Iodine Deficiency Disorder Survey.

Iodine deficiency is the leading cause of preventable brain damage, with 30% of the world's population suffering from iodine deficiency disorders (IDDs). The objectives of the study are to estimate the prevalence of goitre among schoolchildren in the age group of 6-12 years, to find out the proportion of households with adequately iodised salt, and to assess the dietary iodine intake by measuring urinary iodine levels in the urine samples of school-going children. A cross-sectional study was conducted in four pre-selected districts of the Kashmir division of Jammu and Kashmir in school-going children aged 6 to 12 years. Multi-stage 30 cluster sampling was used to select the study sample. For the selection of 30 clusters in each district, probability proportional to size (PPS) was employed. From each cluster, 90 children were selected. From a sub-sample of children in each district, 540 salt samples and 270 urine samples were also collected. A total of 10,800 children aged 6-12 years were examined. Grade I goitre was present in 1382 (12.8%) and 116 (1.07%) which were having Grade II goitre. The weighted prevalence of goitre for four districts was 12.6%, lowest for district Ganderbal and highest for district Shopian. Half of the population in all the districts consumed salt with iodine levels of <15 ppm. Urinary iodine levels <99.9 mg/L were present in 15.7% indicating mild to moderate iodine deficiency. Though the present survey showed some decline in the total goitre rate (TGR) from a prevalence of 14.8% in 2017 to 12.6% in 2022, it continues to be a public health problem of mild to moderate intensity in Kashmir. The salt consumed at the household level was inadequately iodised. Hence, efforts in IDD elimination activities need to be scaled up further with emphasis on iodised salt quality control and intensive education at the community level.

Analysis of iodine nutritional status of children aged 8-10 years in Zhejiang Province from 2016 to 2021

Objective: To analyze the iodine nutrition status of children aged 8 to 10 years in Zhejiang Province from 2016 to 2021. Methods: A multi-stage stratified sampling method was used to select non-residential children aged 8 to 10 years from 90 counties in Zhejiang Province. A total of 114 103 children were included in the study from 2016 to 2021. Direct titration method and arsenic-cerium catalytic spectrophotometry were used to detect salt iodine content and urinary iodine level, respectively, to evaluate the iodine nutritional status of children. Ultrasound was used to detect thyroid volume and analyze the current prevalence of goiter in school-age children. Results: The age of 114 103 children was (9.04 ± 0.81) years old, with 50.0% of (57 083) boys. The median of iodine content M (Q1, Q3) in children's household salt was 23.00 (19.80, 25.20) mg/kg, including 17 242 non-iodized salt, 6 173 unqualified iodized salt, and 90 688 qualified iodized salt. The coverage rate of iodized salt was 84.89%, and the coverage rate of qualified iodized salt was 79.48%. The proportion of non-iodized salt increased from 11.85% in 2016 to 16.04% in 2021 (χ2trend=111.427, P<0.001). The median of urinary iodine concentration M (Q1, Q3) in children was 182.50 (121.00, 261.00) μg/L, among which the proportions of iodine deficiency, iodine suitability, iodine over suitability, and iodine excess were 17.25% (19 686 cases), 39.21% (44 745 cases), 26.85% (30 638 cases), and 16.68% (19 034 cases), respectively. The median of urinary iodine concentration in children in inland areas [M (Q1, Q3): 190.90 (128.80, 269.00) μg/L] was significantly higher than that in children in coastal areas [M (Q1, Q3): 173.00 (113.00, 250.30) μg/L] (P<0.001). From 2016 to 2021, a total of 39 134 ultrasound examinations were conducted, and 1 229 cases of thyroid enlargement were detected. The goiter rate was 3.14% (95%CI: 2.97%-3.32%). The incidence of goiter in children in coastal areas [3.45% (95%CI: 3.19%-3.72%), 641/18 604] was higher than that in children in inland areas [2.86% (95%CI: 2.64%-3.10%), 588/20 530] (P=0.001). Conclusion: From 2016 to 2021, the iodine nutrition level of children aged 8-10 years in Zhejiang Province is generally suitable, and the rate of goiter in children meets the limit of iodine deficiency disease elimination standards.

Effects of iodine status on thyroid volume and goiter in children living in an iodine-replete area.

Adequate iodine intake is essential for growing children, and thyroid volume (Tvol) is considered as an indicator of iodine status. We investigated Tvol and goiter using ultrasonography (US) and their association with iodine status in 228 6-year-old children living in Korea. Iodine status was assessed using urine iodine concentration (UIC) and categorized as deficient (<100 μg/L), adequate (100-299 μg/L), mild excess (300-499 μg/L), moderate excess (500-999 μg/L), and severe excess (≥1000 μg/L). Tvol was measured using US, and a goiter on the US (goiter-US) was defined as Tvol greater than 97th percentile value by age- and body surface area (BSA)-specific international references. The median Tvol was 2.4 mL, larger than the international reference value (1.6 mL). The age- and BSA-specific goiter-US rates were 25.9% (n = 59) and 34.6% (n = 79), respectively. The prevalence of excess iodine was 73.7% (n = 168). As iodine status increased from adequate to severe excess, the goiter-US rate significantly increased (P for trend <0.05). The moderate and severe iodine excess groups showed higher risk of goiter-US (adjusted odds ratio (aOR) = 3.1 (95% CI: 1.1-9.2) and aOR = 3.1 (95% CI: 1.2-8.3), respectively; age-specific criteria) than the iodine-adequate group. Excess iodine was prevalent in Korean children, and their Tvol was higher than the international reference values. Goiter rate was associated with iodine excess, which significantly increased in the moderate and severe iodine excess groups. Further studies are warranted to define optimal iodine intake in children.

Iodine status of school-aged children in the changing context of universal salt iodization program during 1997–2018 in Chongqing, China

ObjectiveTo illustrate the changes of iodized salt usage, goiter rate of school-aged children and median urinary iodine concentration (MUIC) of school-aged children in Chongqing for the last 21 years. This study aims to estimate the variational provincial status of iodine nutrition and provide scientific evidence for fine-tuning and adaptation of the current program. MethodsDifferent number of families and school children aged 8–10 years from Chongqing during 1997–2018 participated in the study. UIC and iodine content in table salt were measured. Thyroid volumes of students were examined and goiter prevalence was calculated across years. ResultsThe median iodine content of table salt was negatively associated with years(r = −0.727, P < 0.01). The MUIC were decreased annually (ranged between 200 and 300 μg/L) and was negatively associated with year(r = −0.831, P < 0.01). Goiter of school-aged children in Chongqing was decreased from the highest rate of 23.58% in 1999 to 1.62% in 2018(Cochran-Armitage Trend Test: χ2=-30.695, P < 0.01). Thyroid volume were negatively associated with years(r = −0.962, P < 0.01) and had a positive relationship with MUIC 1997–2018 (r = 0.862, P < 0.01). ConclusionsThe consumption of adequately iodized salt can eliminate Iodine deficiency disorders (IDD) in children, but possible excessive iodine intake from salt could result in high urinary iodine excretion and even goiter. A systematic, well-designed and continual program monitoring is essential to ensure the adequacy of iodine fortification levels and to regularly change the iodine concentration in household table salt.

Relation between iodine nutrition and thyroid diseases in Qinghai, China.

To investigate the adult iodine nutrition and the prevalence of thyroid diseases in Qinghai Province, and analyze the correlation between iodine and thyroid diseases, so as to provide a basis for adjusting the salt iodization plan in Qinghai Province. Using cluster and stratified sampling method to select 2628 permanent residents over 18 years old in Qinghai Province for questionnaire survey, physical examination, thyroid color ultrasound, and laboratory index detection. 1. The coverage of iodized salt in adults is 99.71%. 2. The detection rates of thyroid disorders in adults were as follows: Clinical hyperthyroidism was 1.20%, subclinical hyperthyroidism was 0.20%, clinical hypothyroidism was 1.00%, subclinical hypothyroidism was 29.20%, and the goiter was 2.10%. The percentages positivity of TPO Ab, TG Ab, goiter was 9.80%, 9.20%, 2.10%, respectively. Among them single thyroid nodule was 6.40%, multi-nodule thyroid gland was 1.80%. 3. The percentages of mild iodine deficiency, moderate iodine deficiency, Severe iodine deficiency, adequate iodine intake (AI), more than adequate iodine intake (MAI)and excessive iodine intake (EI)were 8.41%, 2.17%, 0.26%, 33.22%, 28.35%, and 27.59%, respectively. The percentages of mild, moderate and severe iodine deficiency in urban populations (7.13%, 0.87%, 0.0%) were significantly lower than those in rural populations (9.81%, 3.59%, 0.56%) (P < 0.05), and the rates of adequate, more than adequate iodine intake in urban populations (36.03%, 30.93%) were significantly higher than that in rural populations (30.14%, 25.52%). The rate of excess iodine intake was higher in rural areas (30.38%) than in urban areas (25.04%). 4. The positive rates of subclinical hypothyroidism, goiter, TPO Ab and TG Ab in female adults (35.28%, 3.39%, 13.54%, 13.94%) were higher than those in male adults (23.58%, 0.96%, 6.266%, 4.79%). The detection rate of single thyroid nodules was higher in urban (8.01%) than rural populations (4.70%), while the detection rate of hypothyroidism, subclinical hypothyroidism, and goiter (0.58%, 25.84%, 1.38%) was lower than that in rural populations (1.52%, 32.96%, 2.96%) (P<0.05). 5. There was no statistical significance in the detection rates of clinical hyperthyroidism, subclinical hypothyroidism, subclinical hypothyroidism, goiter, thyroid nodules, TPO Ab and TG Ab positive rates in different iodine nutritional status (P>0.05). The positive rate of hypothyroidism in the iodine deficiency group is higher than in other iodine nutrition groups. The nutritional status of iodine in Qinghai Province is iodine excess. Subclinical hypothyroidism was detected at a high rate. Subclinical hypothyroidism, goiter, TPO Ab, and TG Ab were more common in female than in male. The proportion of mild, moderate, and severe iodine deficiency was higher in urban areas than in rural areas. The detection rate of thyroid nodules was higher in urban than in rural areas, and that of hypothyroidism, subclinical hypothyroidism, and goiter was lower than that in rural populations. The detection rate of clinical hypothyroidism was statistically significant in different iodine nutritional states (P< 0.05).

Analysis of clinical characteristics of thyroid phenotype in Pendred syndrome based on multiple databases.

This study aimed to provide statistical data support for the development of thyroid phenotype-related follow-up and reference for follow-up duration and project selection by analyzing the clinical characteristics of thyroid phenotype in Pendred syndrome (PDS) based on multiple databases. PDS-related pathogenic or possibly/pathogenic mutations were searched by Deafness Variation Database (DVD), ClinVar, and PubMed databases, the mutation sites were counted and the characteristics and thyroid phenotypes were analyzed. The median age of hearing phenotype onset in PDS cases reported in multiple databases was 1.0 (1.0, 2.0) years, the median age of thyroid phenotype onset was 14.5 (5.8, 21.0) years, and the median age that thyroid phenotype was more delayed than hearing phenotype was 10.0 (4.0, 17.0) years. There were significant differences in the distribution of onset time between the two phenotypes (Z=-4.560, p<0.01). In these patients, the positive rates of goiter, thyroid nodules, abnormal thyroid function, and perchlorate discharge test (PDT) were 78%, 78%, 69%, and 78%, respectively. Moreover, the number of thyroid phenotype-positive items in the genotype group with frameshift mutation was not significantly higher than that in the group without frameshift mutation (Z=-1.452, p=0.147). The early missed diagnosis of PDS may be due to the late onset of thyroid phenotype and the non-100% positive rate of examination items. Therefore, multi-item follow-up of the thyroid gland into adulthood will benefit patients. At present, the relationship between genotype and phenotype is still unclear, and prognosis cannot be determined according to genotype.

Prevalence of Iodized Salt Intake and Iodine Deficiency Disorders Status of Pregnant Women Visiting Bishoftu Hospital and Health Center for Antenatal Care

Iodine is an essential mineral for normal thyroid function, mammary gland development, and fetal and infant neurological growth. It is a trace element essential to human and animal health, and present in uneven and mostly insufficient quantities in the environment around the globe. Iodine deficiency disorders are among the major public health problems of the world, particularly in pregnant women of developing countries. In Ethiopia about 15.4% of households consume sufficient iodized salt. This study was designed to assess iodized salt intake and assess iodine nutrition status, to evaluate knowledge, attitudes and practice of iodine nutrition and to asses goiter rate of pregnant women attending Bishoftu clinic for antenatal care in Bishoftu town. The study participants (n=208) was randomly selected. Data over socio-demographic, and knowledge, attitude and practice about iodized salt was collected by interview. Goiter was assessed by palpation and graded according to the WHO guideline. In addition, spot urine sample was collected and the level of urinary iodine was determined following the Sandell-Kolthoff reaction. Iodine level in salt samples was determined by following iodometric titration methods. The prevalence of goiter was 8.7% (Grade 1 = 7.7% and Grade 2 = 1%). The median urinary iodine concentration was 194.3μg/l. The consumption of adequately iodized salt was 89%. This study was indicated as there was no problem of iodine deficiency in the study area.

Gambaran Kejadian Struma di RSU Negara Tahun 2019-2020

ABSTRACT&#x0D; Introduction: A goiter, also called a goiter, is a swelling of the neck due to enlargement of the thyroid gland due to thyroid gland disorders, which can be in the form of dysfunction or changes in the arrangement of the gland and its morphology can be in the form of diffuse or nodus Based on the results of research conducted, it is estimated that around 200 million people worldwide suffer from goiter. The results of research on goiter in Indonesia, show the prevalence of the total goiter rate (TGR) from 9.8% in 1998 to 11.1% in 2003. is still a public health problem in Indonesia and data on the incidence of goiters in Indonesia is still minimal. This study aims to obtain a description of the goiter based on age, gender, type of therapy.&#x0D; Method: This study used a retrospective descriptive study, the sample used was the State Hospital patient with goiter who met the criteria, the sample collection method used medical records which were then processed using the SPSS program, then presented in a table form.&#x0D; Result: Female patients were the most suffering from goiter (68.3%) in this study. The highest incidence of goiters in this study was the type of toxic goiter, namely 25 people (61%).&#x0D; Conclusion: The highest incidence of goiter in the type of toxic goiter, female sex, age 45-54 years, and most types of operative therapy.&#x0D; &#x0D; Keyword: Struma, Struma Nodusa, Goiter&#x0D;

Reference Intervals for Thyroid Hormones and Thyroid Volume in Children Aged 7 ~ 13 Years from Iodine-Sufficient Areas in Tianjin, China.

Reference intervals (RIs) for serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) suitable for local children are urgently needed in northern China. The reference interval for thyroid volume (Tvol) in Chinese children also differed greatly from that recommended by the WHO. This study aimed to establish TSH, FT3, FT4, and Tvol RIs suitable for children in northern China. A total of 1070 children aged 7 ~ 13 were recruited from iodine nutrition-sufficient areas in Tianjin, China, from 2016 to 2021. Four hundred fifty-eight children aged 7 ~ 13years, and 815 children aged 8 ~ 10years were eventually included to study RIs for the thyroid hormones and Tvol. RIs for thyroid hormones were established in accordance with the Clinical Laboratory Standards Institute (CLSI) document C28-A3 guidelines. Quantile regression was used to analyze the influencing factors of Tvol. RIs for TSH, FT3, and FT4 were 1.23 (1.14 ~ 1.32) to 6.18 (5.92 ~ 7.26) mIU/L, 5.43 (5.29 ~ 5.52) to 7.89 (7.66 ~ 7.98) pmol/L, and 13.09 (12.85 ~ 13.73) to 22.22 (21.61 ~ 22.51) pmol/L. There was no need to establish RIs by age and gender. Our RIs could increase the prevalence of subclinical hyperthyroidism (P < 0.001) and reduce the prevalence of subclinical hypothyroidism (P < 0.001). Body surface area (BSA) and age are correlated with the 97th percentile of Tvol (both P < 0.001). Our reference interval could increase the goiter rate in children from 2.97 to 4.96% (P = 0.007). The thyroid hormones' reference intervals suitable for local children should be established. In addition, BSA and age should be considered when establishing Tvol reference interval.

Survey on the prevalence and related factors of thyroid disorders in different iodine intake regions in China in 2015-2017

Objective: To observe the prevalence and related factors of thyroid diseases in different iodine intake areas from 2015 to 2017 after the implementation of national salt iodization policy in China for 20 years. Methods: A cross-sectional survey. Multi-stage stratified cluster random sampling was used to randomly select subjects meeting the inclusion criteria from 31 provinces, municipalities and autonomous regions in China from January 2015 to December 2017, and stratified by age and sex. The survey included questionnaire, physical examination and thyroid ultrasonography. At the same time, the concentrations of serum thyrotropin, thyroxine, thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TgAb) and urinary iodine were measured.To determine whether the patient has a certain thyroid disease according to the above results. Different iodine nutrition areas were defined according to urinary iodine concentration, and the influence of iodine nutrition status in different iodine intake areas on thyroid diseases was analyzed. Results: A total of 78 470 adults were included, including 39 893 in the area of moderate iodine, 28 779 in the area of adequate iodine, and 9 798 in the area of excessive iodine.In the above three regions, the prevalence of subclinical hyperthyroidism (hyperthyroidism) was 0.45% (95%CI: 0.39%-0.52%), 0.50%(95%CI: 0.35%-0.70%)and 0.27%(95%CI: 0.20%-0.35%), respectively, with statistical significance(χ²=6.92, P=0.003). The prevalence of subclinical hypothyroidism (hypothyroidism) was 11.36% (95%CI: 10.73%-12.02%), 13.57%(95%CI: 11.70%-15.69%) and 16.18%(95%CI: 12.41%-20.82%), respectively, with statistical significance(χ²=5.08, P=0.009). The prevalence rates of Graves' disease, TPOAb, goiter and thyroid nodule among the three regions were statistically significant (all P<0.05). There were no significant differences in the prevalence of clinical hyperthyroidism and clinical hypothyroidism and the positive rate of TgAb among the three regions (all P>0.05). Multivariate logistic regression model analysis showed that excess iodine was a risk factor for subclinical hypothyroidism (OR=1.24, 95%CI: 1.06-1.44), and a protective factor for thyroid nodules (OR=0.73, 95%CI: 0.57-0.94). Iodine overdose was a risk factor for subclinical hypothyroidism (OR=1.47, 95%CI: 1.08-2.01), while it was a protective factor for subclinical hyperthyroidism (OR=0.56, 95%CI: 0.41-0.77), and TPOAb positive (OR=0.93, 95%CI: 0.87-0.99), goiter (OR=0.33, 95%CI: 0.17-0.66) and thyroid nodule (OR=0.77, 95%CI: 0.61-0.97). Conclusions: There are significant differences in the prevalence of subclinical hyperthyroidism, subclinical hypothyroidism, positive TPOAb, thyroid nodule and goiter in different iodine intake regions. Different iodine intake levels have an effect on the incidence of thyroid diseases.

Goiter prevalence and iodine deficiency disorder among school-age children (6-12 years) in district Ganderbal of Kashmir valley.

Iodine deficiency is a major cause of brain damage in childhood which can be prevented. Dietary deficiency of iodine is mainly responsible for iodine deficiency. This study was done to determine the prevalence of goiter among school-aged group of 6-12 years in district Ganderbal. This was a cross-sectional study done among children of 6-12 years in district Ganderbal. Out of 2700 children examined, Grade 1 goiter was found in 90 (3.3%) children and Grade 2 goiter was found in 6 (0.3%) with a total goiter rate (sum of grade first and grade second) of 3.6%. On analyzing the urine samples, about 19.1% of the children had mild to moderate iodine deficiency. The study showed mild goiter prevalence in school-aged children of 6-12 years in the Ganderbal district of Kashmir valley. Continuous periodic surveys to assess the magnitude of the iodine deficiency disorders (IDD) should be undertaken to ensure that we achieve sustainable elimination of IDD in India.

Age, sex, religion and caste specific goitre prevalence in Murshidabad district of West Bengal, India

Goitre prevalence of selected population in respect of age, sex, religion and caste was evaluated in the Murshidabad district of West Bengal during post salt iodization phase. The study was carried out on 9321 school children in the age group 6-12 years of both sexes from randomly selected 26 representative localities from all 26 Community Development Blocks. Children were clinically examined for goitre. Result showed that the prevalence of goitre was found at endemic level. The overall goitre prevalence was found 22.1%. Besides palpable goiter (2.5%), the prevalence of visible goiter (19.7%) in school children was prevalent. A gradual increase in goitre rate was found from the age of 6 yr till the age of 8 yr followed by a short decline at the age of 9 yr to 12 yr. Goitre was most prevalent in Hindus (23.7%) than Muslim (21.4%) communities. Among the Hindus, general caste (20.8%) students suffered more than Scheduled caste &amp; Scheduled tribe (19.0%). These variations in goitre prevalence among different caste and religions might be due to their different environmental adaptability and dietary habit.

Time Series and Spatial Epidemiological Analysis of the Prevalence of Iodine Deficiency Disorders in China

ObjectiveTo recognize the spatial and temporal characteristics of iodine deficiency disorders (IDD), China national IDD surveillance data for the years of 1995–2018 were analyzed. MethodsTime series analysis was used to describe and predict the IDD related indicators, and spatial analysis was used to analyze the spatial distribution of salt iodine levels. ResultsIn China, the median urinary iodine concentration increased in 1995–1997, then decreased to adequate levels, and are expected to remain appropriate in 2019–2022. The goiter rate continually decreased and is expected to be maintained at a low level. Since 2002, the coverage rates of iodized salt and the consumption rates of qualified iodized salt (the percentage of qualified iodized salt in all tested salt) increased and began to decline in 2012; they are expected to continue to decrease. Spatial epidemiological analysis indicated a positive spatial correlation in 2016–2018 and revealed feature regarding the spatial distribution of salt related indicators in coastal areas and areas near iodine-excess areas. ConclusionsIodine nutrition in China showed gradual improvements. However, a recent decline has been observed in some areas following changes in the iodized salt supply in China. In the future, more regulations regarding salt management should be issued to strengthen IDD control and prevention measures, and avoid the recurrence of IDD.

Factors Associated with Goiter Incidence in Farmers in Kismantoro Sub-District, Wonogiri Regency

Background: Kismantoro Sub-district has been an endemic area of ​​severe goiter since 1982, with a total goiter rate of 35.5% until 2007, when was declared a mild endemic goiter area (TGR 10.79%). Monitoring in 2017 on salt circulating in Wonogiri exposed that there were still 26.01% of brands that did not meet the Indonesian national standard. Objective: This study aimed to analyze the factors associated with goiter incidence in Kismantoro Sub-district, Wonogiri Regency. Methods: This research applied analytic observational with a case-control design. The samples were 41 respondents in the case group and 41 respondents in the control group, taken by purposive sampling. The history of goiter was obtained from the medical records of Kismantoro Community Health Center. The data analysis method employed was logistic regression analysis. Results: The results showed a significant correlation between age (p 0.005, OR 5.88, 95%CI 1.53-22.62), gender (p 0.003, OR 0.15, 95%CI 0.04-0.58), and salt iodine content (p 0.007, OR 0.14, 95%CI 0.03-0.68) with the goiter incidence in farmers in Kismantoro. Moreover, the multiple logistic regression test results revealed that age was the most dominant variable influencing the goiter incidence (p 0.006, OR 8.103, 95%CI (1.799-36.499). Conclusion: There was a relationship between age and the goiter incidence, gender with the goiter incidence, and iodine content in household salt with the goiter incidence, the multiple logistic regression test results indicated that the age variable most influenced goiter incidence among farmers in Kismantoro Sub-District, Wonogiri Regency.

Assessment of Sustainable Elimination Criteria for Iodine Deficiency Disorders Recommended by International Organizations.

Enormous efforts have been made to evaluate the worldwide prevention and control of iodine deficiency disorders (IDDs). This study evaluated China's achievements in IDD prevention and control against WHO criteria for sustainable elimination of IDD. The study sample consisted of 556,390 school-aged children and 271,935 pregnant women enrolled in the 2018 China National IDD Surveillance. As a result, at the national level, median urine iodine concentration (MUIC) was 206.1 and 163.5 μg/l in children and in pregnant women, respectively. The proportion of households consuming adequate iodized salt (PHCAIS) was 90.2%. The prevalence rates of goiter in children and thyroid disease in pregnant women were 2.0 and 0.8%, respectively. MUIC showed significant non-linear increasing trends with increasing PHCAIS in both children and pregnant women. The prevalence of thyroid disease in pregnant women had a sharp decreasing trend with increasing PHCAIS. Of note, the prevalence of goiter in children and thyroid disease in pregnant women against MUIC both presented as significant U-shaped curves, with the lowest prevalence at 100–300 μg/l of MUIC in children and 150–250 μg/l in pregnant women. PHCAIS, MUIC, and the programmatic indicators at the national level were all above their cut-offs proposed in the 2007 Criteria. Evaluation by adding the prevalence of goiter (<5%) yielded the different results at the county level. Sustainable elimination of IDD has been achieved nationally. 2018 Chinese surveillance data support the expansion of global cut-offs for optimal iodine status in school-age children from 100–199 to 100–299 μg/l as recommended by others and the lower limit of MUIC (150 μg/l) in pregnant women also seems justified. Inclusion of goiter prevalence <5% in our analysis reduced the number of municipalities and counties which had achieved sustainable elimination of IDD.

Comparative Analysis of Five Correction Methods for Thyroid Volume by Ultrasound and Their Recommended Reference Values in Chinese Children Aged 8-10 Years.

Considering the influence of body's growth and development on thyroid volume (TVOL), whether five existed corrected methods could be applied to correct TVOL remains unclear, in terms of Chinese children's increased growth and development trends. This study aimed to compare the applicability of five correction methods for TVOL: Body Surface Area corrected Volume (BSAV), Body Mass Indicator corrected Volume (BMIV), Weight and Height corrected Volume Indicator (WHVI), Height corrected Volume Indicator 1 (HVI1) and Height corrected Volume Indicator 2 (HVI2); to establish the reference values for correction methods. The data of Iodine Nutrition and Thyroid Function Survey was used to analyse the differences in TVOL between normal and abnormal thyroid function children. Data of National Iodine Deficiency Disorders Survey were used to compare five correction methods and to establish their reference values. The median urinary iodine concentration of children surveyed were 256.1μg/L in 2009 and 192.6μg/L in 2019, respectively. No significant difference was found in TVOL and thyroid goitre rate between children with normal and abnormal thyroid function. In the determination of goitre, HVI1, HVI2, BSAV and BMIV all showed high agreement with TVOL, while the area under the ROC curve (AUC) of WHVI was relatively low for children aged 8(AUC=0.8993) and 9(AUC=0.8866). Most differences of TVOL between light and heavy weight, short and tall height children can be eliminated by BSAV correction. BSAV was the best method of TVOL correction in this research. Reference values were established for corrected thyroid volumes in Chinese children aged 8-10 years by sex.