Median Urinary Iodine Level Research Articles

Iodine nutritional status and goiter prevalence in 6–12 years primary school children of Saurashtra region, India

Iodine deficiency disorder (IDD) or goiter is the cause of preventable brain damage, mental retardation, and stunted growth and development in children. This study aimed to detect the prevalence of IDD in Rajkot district, India by testing urinary iodine excretion levels and iodine salt intake of school children. A cross-sectional study was conducted in 2940 school children of both sexes aged 6-12 years from 14 talukas subdivisions of the district. Thirty clusters were selected by using cluster sampling technique. Goiter was assessed in all the studied children along with biochemical analysis of iodine in 420 urine samples and iodine content in 840 edible salt samples in the studied area. Goiter was reported from all talukas subdivisions of the studied area. Goiter prevalence ranged from 1% to 35%, and the overall prevalence was 8.8% (grade 1: 7.6%; grade 2: 1.2%), indicating a mild public health problem. In the study areas, 18.1% of the population showed a level of urinary iodine excretion <50 microg/L. The median level of urinary iodine in the studied areas was 110 microg/L (range 10-415 microg/L). The iodine level of more than 15 ppm was found in 81% of salt samples tested at the household level. There is mild goiter prevalence in primary school children of Rajkot district, which is due to the inadequate iodine intake or content from salt at the household level.

Modern concepts about idine intake for pregnant and lacting women (by the example of regional studies)

The aim of this study was to offer the optimal levels of daily iodine intake during pregnancy and lactation. One-stage epidemiological survey was carried on in two cities: Nizhny Novgorod (n = 220) and Smolensk (n = 119). The pregnant women were divided into two groups: Group 1 (n = 161) – KI (200 micrograms/day) and Group 2 (n = 178) – KI (300 micrograms/day). Reearch methods included: ultrasound examination of a thyroid, urinary iodine concentration (UIC) measuring, analysis of thyroid stimulating hormone (TSH), free thyroxin (fT4), thyroperoxidase autoantibody (AT-TPO). After 3 months of iodine prophylaxis during pregnancy the median UIC increased to 259,6 (pNN = 0.00) and 120,8 µg/l (pSm = 0.00) in the 2nd group, and in the 1st group the iodine excretion in urine has compounded 96.9 (pNN = 0.00) and 83.5 µg/l (pSm = 0.00). In Nizhny Novgorod during lactation there was an insufficient concentration of iodide in urine in group 1 and in group 2 there were normal indexes of a median urinary iodine – 88.6 and 123.2 µg/l accordingly (p = 0.00). In Smolensk the median UIC was dropped, however in 1st group it was statistically significant (p = 0.03), median urinary iodine was 41.1 and 70.3 µg/l in groups 1st and 2nd accordingly (p = 0.04). The median UIC &gt;100 µg/l has been noted at 10.5% of women in the 2nd group, and in the 1st group of patients by sufficient UIC has not been detected. Consequently, the median level of urinary iodine indicate optimal iodine nutrition during pregnancy and lactation and the requirement of iodine is at least 300 µg/day.

Iodine nutrition status among schoolchildren after salt iodisation

Earlier studies done in Sri Lanka have indicated the importance of iodine deficiency as a public health problem. The universal salt iodisation programme has been implemented since 1995. The goals of salt iodisation are reduction of the goitre rate to <5% in school-aged children, to maintain the median urinary iodine level in the population between 100-200 microg/L and >90% of households using iodised salt. To estimate the goitre prevalence, the urinary iodine level, and measure the household iodised salt consumption pattern by Province. A school-based study of 6574 randomly selected children in the age group 8-10 years, from 263 schools was assessed for goitre by palpation. The concentration of urinary iodine levels was measured in 2630 of these children. Estimation of iodine in the 6181 samples of salt used in households of the schoolchildren was also assessed by test kits. The prevalence of goitre in the Provinces varied from 16.3% to 26.2%. The median urinary iodine levels were above the cut-off point of 100 microg/L in all Provinces except in Uva. The highest median urinary iodine level was reported in North Central Province (231.3 microg/L). Overall, 35.4% of the children had urine iodine levels in the 'ideal' range (100-199.9 microg/L); 30.6% with lower values (<100 microg/L) indicated iodine deficiency and 16.3% with higher values (< 300 microg/L) indicated excessive iodine intake. Only 49.5% of households had used adequately iodised salt. This study showed that iodine deficiency still exists in Uva Province, and that more than adequate iodine levels were found in the North Central Province. The level of permitted salt iodine at household level needs to be revised.

Iron Deficiency Anemia and Iodine Prophylaxis in Pregnant Women

The aim of this study was estimate the influence of Iron Deficiency Anemia (IDA) on efficiency of the iodine prophylaxis for pregnant women, and also to offer the optimal levels of daily iodine intake during pregnancy and lactation. Materials and methods: serum thyroid stimulating hormone (TSH), free thyroxin (fT4), AT-TPO concentrations, urine excretion of iodine, levels of hemoglobin (Hb), hematocrit (Ht), red blood cell (RBC), mean corpuscular hemoglobin (MCH), serum iron levels and serum ferritin were measured. The volume of thyroid gland was defined by ultrasonography. The pregnant women were divided into two groups: Group 1 (n = 111) – KI (200 micro# grams/day) and Group 2 (n = 109) – KI (300 micrograms/day). Results: Median urinary iodine was 140,8 μg/l. During pregnancy there was an authentic rising of a median urinary iodine to 259,6 μg/l in group 2 (p = 0,0000) and in group 1 the iodine excretion in urine was more low than at a stage of screening and has compounded 96,9 μg/l (p = 0,002). During lactation there was an insufficient concentration of iodide in urine in group 1 and in group 2 there were normal indexes of a median urinary iodine – 88,6 and 123,2μg/l in groups 1st and 2nd accordingly (p = 0,004). In the third trimester 21,5% of women had a latent deficiency of iron. Authentic correlation between indexes of an iron deficiency anemia and iodine deficiency has not been detected. Conclusion: The median level of urinary iodine indicate optimal iodine nutrition during pregnancy and lactation and the requirement of iodine is at least 300 μg/day. In our research the negative influence of iron deficiency anemia on the efficiency of iodine prophylaxis during pregnancy has not been detected.

Persistence of severe iodine-deficiency disorders despite universal salt iodization in an iodine-deficient area in northern India

The aim of the present study was to determine the impact of universal salt iodization (USI) on the prevalence of iodine deficiency in the population of an area previously known to have severe iodine deficiency in India. In a cross-sectional survey, a total of 2860 subjects residing in fifty-three villages of four sub-districts of Gonda District were examined for goitre and urinary iodine concentration. Free thyroxine and thyroid-stimulating hormone levels were also measured. Salt samples from households were collected for estimation of iodine content. A reduction in goitre prevalence was observed from 69 % reported in 1982 to 27.7 % assessed in 2007. However, 34 % of villages still had very high endemicity of goitre (goitre prevalence >30 %). Twenty-three per cent of households consumed a negligible amount (<5 ppm) and 56 % of households consumed an insufficient amount (5-15 ppm) of iodine from salt. Although there was an overall improvement in iodine nutrition as revealed by decreased goitre prevalence and increased median urinary iodine levels, there were several pockets of severe deficiency that require a more targeted approach. Poor coverage, the use of unpackaged crystal salt with inadequate iodine and the washing of salt before use by 90 % of rural households are the major causes of persisting iodine-deficiency disorders. This demonstrates lapses in USI implementation, lack of monitoring and the need to identify hot spots. We advocate strengthening the USI programme with a mass education component, the supply of adequately iodized salt and the implementation of complementary strategies for vulnerable groups, particularly neonates and lactating mothers.

Tiroiditis posparto: incidencia y estudio de los posibles factores asociados en las embarazadas de una zona de salud

Background and objective Our objective was to evaluate the presence of postpartum thyroiditis (PPT) in a group of pregnant euthyroid women. Material and method This study was prospective and descriptive in nature and was carried out over the course of three years in an urban Health District in Toledo, Spain. Information recorded included height and weight, tobacco use, previous consumption of oral contraceptives, and numbers of pregnancies and abortions prior to the current gestation. Levels of Thyroid Stimulating Hormone (TSH), free Thyroxin (FT4) and thyroid peroxidase antibodies (TPOAb) were determined during the first trimester and 3 and 6 months postpartum. A urine sample was collected for determination of iodine levels. Thyroid ultrasonography was performed on all pregnant subjects concurrently with analytical sample collection at 3 months of pregnancy and 3 months postpartum. Results The sample contained 157 pregnant women, of whom 25 (15.9%) developed PPT. Of these, 44.0% were positive for TPO antibodies in the first trimester, compared to 4.5% of the subjects who did not develop PPT ( P<.001). At the end of the first year, 5 (20%) were still afflicted with hypothyroidism. The complete study group of pregnant women displayed a median urinary iodine level of 135 μg/L. A minor BMI was found in the PPT subjects when compared with the rest of the study group (21.7 vs 24.5; P=.000). A greater frequency of PPT was found in Rh-negative women (33.3 vs 12.2%; P=.015). Conclusions The incidence of PPT exceeded that previously reported. We have only found a significant correlation between PPT and BMI and Rh factor. Based on the high incidence rate detected in our Health District, an active search for cases of PPT might be justified.

FAKTOR DETERMINAN KEJADIAN GONDOK DI DAERAH PANTAI JAWA TIMUR

The Iodine Deficiency Disorders (IDD) is one of the serious nutritional issues in Indonesia. The survey of IDD in Province of East Java, found that Total Goiter Rate (TGR) in 2003 was higher than 1998 (24.8% and 16.3%) respectively). Iodine deficiency is the main factor of goiter incidence but, there were other factors which could cause the goiter incidence, such as trace element (selenium and zinc) deficiency and exposure of pollutant such as nitrate. The objective of the research is to analyze an association between the trace element andpollutant with the goiter incidence. This research was the cross sectional design, compare goiter and non-goiter respondents. Twenty pupils developing goiter were taken randomly from the goiter population and twenty pupils not suffering of goiter were also taken randomly from the non-goiter population. The median urinary excretion iodine (UEI) levels were higher in the goiter respondents compared with the non-goiter. This might be caused by administration of relatively new iodine capsule to the goiter respondents compared with the non-goiter. The average blood nitrate levels were higher in the in the goiter compared with the non-endemic respondents (575. 75 ± 108.01pg/l :419.45 ± 120.35 pgf I) and there was statistically significant relationship (p &lt; 0.01). According to logistic regression, it can be drawn that the nitrate is determinant factor of coastal area goiter. The goiter prevention program should not be limited to iodine intake, but also include other relevant factors, especially to food and drink nitrate contamination.

The Prevalence of Thyroid Dysfunction in Elderly Cardiology Patients with Mild Excessive Iodine Intake in the Urban Area of São Paulo

OBJECTIVES:To evaluate the prevalence of thyroid dysfunction in elderly cardiac patients in an outpatient setting.SUBJECTS AND METHODS:A total of 399 consecutive patients (268 women, age range 60–92 years) who were followed at Heart Institute were evaluated for thyroid dysfunction with serum free T4, TSH, anti-Peroxidase antibodies, urinary iodine excretion measurements and thyroid ultrasound.RESULTS:Hyperthyroidism (overt and subclinical) was present in 29 patients (6.5%), whereas hypothyroidism (overt and subclinical) was found in 32 individuals (8.1%). Cysts were detected in 11 patients (2.8%), single nodules were detected in 102 (25.6%), and multinodular goiters were detected in 34 (8.5%). Hashimoto’s thyroiditis was present in 16.8% patients, most of whom were women (83.6%). The serum TSH increased with age and was significantly higher (p= <0.01) in patients, compared to the normal control group. No significant differences in serum TSH and free T4 values were observed when patients with atrial fibrillation (AF) where compared with those without arrhythmia. The median urinary iodine levels were 210 μg/L (40–856 μg/L), and iodine levels were higher in men than in women (p<0.01). Excessive iodine intake (urinary iodine >300 μg/L) was observed in one-third of patients (30.8%).CONCLUSIONS:Elderly patients have a higher prevalence of both hypo- and hyperthyroidism as well as thyroid nodules when compared with the general population. About one-third of the older patients had elevated urinary secretion of iodine and a higher prevalence of chronic Hashimoto’s thyroiditis. It is recommended that ultrasonographic studies, tests for thyroid function and autoimmunity should be evaluated in elderly patients.

Tracking progress toward elimination of iodine deficiency disorders in Jharkhand, India

Research question:What is the current status of Iodine Deficiency Disorders (IDD) in the state of Jharkhand?Objectives:(1) To determine the status of iodine deficiency in the state. (2) To determine the availability and cost of adequately iodized salt at the retail shops. (3) To study the perceptions of the community regarding iodine deficiency, salt and iodized salt.Design:A cross-sectional community-based survey.Study setting:Thirty clusters selected through the probability proportion to size (PPS) sampling in the state of Jharkhand.Study participants:Children aged 6-12 years, households, retail shopkeepers and opinion leaders.Study tool:Quantitative and qualitative methodology using a pretested questionnaire and focus group discussion used to carry out the community-based survey.Results:Total goiter rate (TGR) was 0.9%. Median urinary iodine level was 173.2 µg/L. The proportion of individuals with urinary iodine levels less than 100 and 50 µg/L were 26.4% and 10%, respectively. Slightly less than two-thirds (64.2%) of the households were found to be consuming adequately iodized salt as measured by titration (greater than 15 ppm). Iodized salt was available across the state and the cost varied between Re. 1 and Rs. 8 per kilogram. A common belief among the community was that iodized salt is equivalent to refined packet salt that is further equivalent to expensive salt.Conclusion:The results of the present survey show that the iodine nutrition in the state of Jharkhand is optimal. Considering that the consumption of adequately iodized salt should increase from 64.2% to the goal of more than 90%, sustained efforts are required in this place to consolidate the current coverage of adequately iodized salt and increase it to greater than 90%.

Iodine Nutritional Status Among School Children in Selected Areas of Howrah District in West Bengal, India

This article is a study on iodine nutritional status among 1627 school children aged 6-12 years, along with biochemical analysis of iodine of 200 urine samples, 50 drinking water samples and 175 salt samples carried out in certain randomly selected areas of the district Howrah in Gangetic West Bengal. Results indicate that the entire region is clinically goitre endemic having goitre prevalence 38%; however the median urinary iodine level was 25 microg/dl indicating no biochemical iodine deficiency, 70% salt samples had a recommended level of iodine and the region was found to be environmentally iodine sufficient. Consumption of dietary goitrogen and hard drinking water may have the possible role for the persistence of endemic goitre in the region.

Iodine nutritional status of children in North East India

To assess the iodine nutritional status of school children in selected areas of Imphal West District of Manipur where endemic goitre and associated iodine deficiency disorders (IDD) are prevalent in the post-salt iodization period. A total of 961 school children in the age group 6-12 yrs of both sexes were clinically examined for goiter from three study areas- one from rural block and two from urban areas. One hundred twenty urine samples were analysed for iodine and thiocyanate respectively. One hundred and five edible salt samples were also collected from the households to evaluate the iodine content. Drinking water samples from different sources were collected and iodine level was analysed to study the bioavailability of iodine in the region. The total goiter rate was 34.96% (Grade 1- 32.15%; Grade 2- 2.81%) showing that IDD is a severe public health problem. The median urinary iodine levels in the studied areas were in the ranges from 12.5-17.5 microg/dl indicating no biochemical iodine deficiency in the region. Mean urinary thiocyanate level was 0.839+/-0.33 mg/dl showing that the people consume sufficient foods containing thiocyanate precursors. About 82% salt samples had iodine level more than 30 ppm and the iodine content in salt samples less than 15 ppm was only about 3% indicating the salt samples at house hold contain adequate iodine. Iodine content in drinking water samples ranged from 1.8-2.6 microg/l showing that the studied region is environmentally iodine deficient. Inspite of the consumption of adequate iodine, the existing goiter prevalence among school children during post salt iodization phase ensures that environmental factors other than iodine deficiency may have the possible role in the persistence of endemic goiter in the population. The role of thiocyanate in this regard may not be ruled out.

Iodine status, thyroid function, thyroid volume and thyroid autoimmunity in patients with type 1 diabetes mellitus in an iodine-replete area

To analyze the prevalence and clinical significance of thyroid autoimmunity, thyroid volume and iodine status in patients with type 1 diabetes mellitus compared with age and sex matched healthy controls, in an iodine-deficiency improved area. Fifty-eight patients with type 1 DM, 30 female and 28 male, who attended the pediatric endocrinology clinic of Karadeniz Technical University Hospital were included into the study. They were compared with 58 healthy children matched for sex and age. Routine thyroid function parameters, thyroid autoantibodies (TPOAb, TGAb and TRAb) and urinary iodine excretion were measured and thyroid volume was determined by ultrasonography (US). Twenty-six patients (44.8%) in diabetic patients and 20 subjects (34.5%) in the control group had thyroid autoantibody positivity. TPOAb and TGAb positivity were significantly high in diabetic patients (P=0.01 and P=0.032, respectively). Thyroid US revealed a thyroid volume of 6.6+/-3.5 ml (median 6.4 ml, range 1.117.2 ml) in the diabetic patients compared with 3.7+/-2 ml (median 3.1 ml, range 0.8-8.6 ml) in the control group (P=0.0001). Median urinary iodine levels of both groups were clearly above the threshold level for iodine deficiency, but 26 patients with type 1 DM (44.8%) and 16 controls (27.5%) had urinary iodine excretion below 100 microg/L, and 21 (36.2%) of diabetic patients and two subjects (3.4%) of the control group were consistent with severe iodine deficiency. No significant differences were noted in diabetic patients in terms of age, duration and metabolic control of the disease and thyroid volume when compared according to the autoantibody presence. Additionally, there were no significant differences between the iodine deficient and iodine sufficient diabetic patients in terms of age, sex, duration of disease, HbA1c, thyroid hormones and thyroid volumes. Thyroid autoimmunity was lower in patients with iodine deficiency (38.4% vs. 50%), but not statistically significant. We found that type 1 DM patients had larger thyroid volume compared with healthy control groups, and a large portion of them had the markers of autoimmune thyroid disease and iodine deficiency. Surprisingly, we found that a large portion of the healthy children had TRAb positivity. We proposed that TRAb must be considered in community surveys or prevalence studies of autoimmune thyroid disorders in iodine-replete areas. Additionally, prospective longitudinal studies are needed to determine the clinical significance of TRAb positivity in diabetic patients.

Déficit de yodo y función tiroidea en una población de mujeres embarazadas sanas

Studies from Spain suggest that the intake of iodine in pregnant women is below nutritional requirements. This study was designed to determine iodine intake and its relation with thyroid volume during pregnancy in women from southeast Spain. A total of 520 healthy pregnant women were studied during the full three trimesters of their pregnancy. A control group was composed of 373 non-pregnant women. The following variables were measured: TSH, FT3, FT4, thyroglobulin, antiperoxidase antibodies, urinary iodine levels, and thyroid volume. Median urinary iodine levels were below 100 g/l in the controls and the pregnant women during their first trimester. These levels rose progressively and significantly over the second and third trimesters. Thyroid volume increased during the second and third trimesters compared with the first. TSH levels were lower during the first trimester compared to controls, and increased significantly during the third trimester. FT4 levels fell significantly during the third trimester. There was a significant negative correlation between TSH levels and thyroid volume (r = 0.22; p = 0.005). Iodine intake in pregnant women in Malaga is low. The results suggest a deficit in thyroid function secondary to iodine deficiency, which is worsened as pregnancy advances. The data support the convenience of systematic administration of an iodine supplement in healthy pregnant women.

Endemic goiter prevalence survey in Brazilian schoolchildren 6 to 14 years old, 1994-1996

To determine the national and state-level prevalence of endemic goiter associated with iodine deficiency in schoolchildren between 6 and 14 years of age in Brazil, based on data from a national survey carried out from 1994 to 1996. Thyroid inspection and palpation were performed on 178,774 schoolchildren between 6 and 14 years of age, in all the states of Brazil. A subsample was selected to measure the iodine content in their urine as well as the iodine content of the table salt used for cooking in their homes. The last survey before this one was carried out in 1975. We found an 86% decrease in the median prevalence of grade 1 and 2 grade 2 goiter, from 12% to 1%. In 21% of the municipalities, the observed prevalence was zero. From the 16,803 urine samples collected for iodine measurement, 7,702 were matched with the corresponding clinical record (a loss of 54%). The median urinary iodine level was 14.0 micrograms/dL, and without a significant correlation with the clinical data on goiter. The median iodine excretion level for the population in the states of Acre, Amapá, and Tocantins was equal to or below 9.0 micrograms/dL. In three municipalities, urinary iodine was below 2.5 micrograms/dL in all the samples: Paranã (in the state of Tocantins), Conceição (Paraíba), and Nova Roma (Goiás). The supplementary iodine found in the salt collected from households (458 samples collected) was below recommended levels, with 50% of them below 20 mg/kg (20 ppm). In 7% of the samples, the level of iodine was below 10 mg/kg of salt, even in salt-producing states such as Rio Grande do Norte. There is evidence goiter is expanding to parts of Brazil that more recently have been opened up for agriculture, with children in those areas being exposed to low levels of supplementary iodine in the salt used for cooking. We found an increased risk of goiter in areas with deficient iodine supplementation (< 10 mg/kg) (odds ratio = 1.85; Cornfield 95% confidence interval: 1.68-2.03).

Dietary intake and iodine deficiency in women of childbearing age in an Orang Asli community close to Kuala Lumpur, Malaysia

A cross-sectional study was conducted in order to determine the prevalence of iodine Deficiency Disorders (IDD) and associated factors in women of childbearing age. The study was conducted in a small Orang Asli (indigenous Malay) community, 46 km south-east of Kuala Lumpur, Malaysia. Women without children or who were not pregnant with their first child were excluded. Of the 45 women eligible, four women did not participate as they were absent from the village for the duration of the study. Thyroid palpation and urinary iodine Level were used to determine the prevalence of IDD. The consumption of foods rich in iodine was determined using a food frequency questionnaire. The study population had a high prevalence (32.4%) of goitre and a very low median urinary iodine level (14.5 +/- 11.5 mu g/L, n = 34). This corresponds to 'severe iodine deficiency' according to World Health Organization classifications. Freshwater fish was the most frequently consumed iodine source. Cassava, which is considered goitrogenic due to its thiocyanate content, was a staple food and was consumed daily by 43% of the participants. Most staple foods were locally produced. Women with goitre had significantly Lower protein and energy intakes than did there without. The IDD prevalence found in this study was similar to the prevalence reported in remote Malaysian communities. Possible factors contributing to IDD in various other studies were dependence on locally produced foods from potentially iodine deficient soils, frequent consumption of cassava, and low intake of seafood. Although this Orang Asli community was close to Kuala Lumpur and not remote, these factors were reflected in the current study. This implies that 'pockets' of LDD in Peninsular Malaysia may be more widespread than previously thought and highlights the need for further investigation of IDD in Peninsular Malaysia.

Iodine deficiency disorders in the Maldives: A public health problem

Because the Maldives is a country of islands it has been assumed, until now, that iodine deficiency disorders (IDD) are not a public health problem. However, no systematic scientific survey has been carried out to assess the status of IDD in the Maldives. This study represents the first IDD survey by the Government of the Republic of Maldives in association with UNICEF Maldives. Undertaken during June and July 1995, the survey adopted the EPI 30 Cluster sampling technique, as recommended by the Joint WHO/UNICEF/ICCIDD Consultation. Based on population proportion to size, a total of 30 clusters were chosen from sampling frames of all 200 islands. A total of 30 schools and 2834 children aged 6-12 years were surveyed. The total goitre rate was 23.6%, with grade 1 goitre contributing 22.5% of this figure. The prevalence of goitre was greater in girls (26.6%) than in boys (20.7%). The median urinary iodine level was 6.7 µg/dL and 65.5% of children had urinary iodine levels below 10 µg/dL. It is evident from this survey that IDD is a public health problem in the Maldives. Hence, efforts to control IDD should be instituted. The most common method of iodine supplementation is iodised salt. As tested in a non-representative sample of 39 salt samples, only 8% of salt had adequate iodine levels of approximately 15 p.p.m. Because all the atolls are affected there is a need to introduce universal salt iodization in the country.

Iodine deficiency disorders among school children in upper Egypt: an epidemiologic study

Iodine deficiency disorders (IDD) are the world's single most significant cause of preventable brain damage and mental retardation. Data regarding IDD in upper Egypt are scarce and even lacking. The aim of the present work was to study the prevalence of IDD and some potential risk factors in upper Egypt. Using a two-stage cluster sampling technique, 6750 school children aged 8-10 years were screened for IDD through clinical examination of the thyroid gland and determination of urinary iodine, from three governorates in upper Egypt, namely Al-Minya (population of 3.3 million), Assyut (population of 2.9 million), and Suhag (population of 3.1 million). Iodine was determined in samples of soil and drinking water. Overall, the prevalence rate of goitre was 34.6 per cent. The median urinary iodine level for children with goitre was 5.04 micrograms/dl compared to 14.81 micrograms/dl among children free of goitre. Multiple logistic regression analysis showed that certain groups of school children were much more likely to develop goitre. They included females (OR = 3.07, 95 per cent CI = 2.78-3.39), children in households where drinking water had an iodine content of less than 0.5 microgram/100 ml (OR = 3.44, 95 per cent CI = 3.09-3.89), and children living in places where soil content of iodine was less than 0.2 microgram/100 g (OR = 2.67, 95 per cent CI = 2.30-3.10). We conclude that IDD is a severe public health problem in upper Egypt. The present situation in upper Egypt necessitates an urgent intervention programme.

Use of iodinated bread for preventing endemic goiter in regions with moderate and slight iodine deficit

Iodination of foodstuffs is one basic trend in prevention of iodine deficit and diseases caused by it. The production of iodine salt is rather expensive, and hence, another highly prevalent foodstuff was chosen as "iodine carrier": bread. Bread is traditional food in Russia and its consumption is stable throughout the year. Bread baking is centralized in the majority of regions of our country. It is manufactured at rather large bakeries and delivered even to the most faraway regions. In order to solve the practical problems of baking iodinated bread, a pilot experiment was carried out in 1993-1995 in the Pavlovsky Posad district near Moscow (a region with moderate and slight iodine deficiency). The experiment was sponsored by the UNICEF (UN Childhood Foundation) and included development of the formula of bread iodination and assessment of this method of iodine prophylaxis. According to the proposed formula, 60 mg of potassium iodide is to be added per 100 g of flour; such a dose covers the daily requirement of an organism in iodine, provided 500 g of bread is consumed daily. The efficacy of iodinated bread was assessed from the time course of renal excretion of iodine and incidence of thyroid enlargement in 162 schoolchildren aged 7 to 14 at a boarding school in the town of Pavlovsky Posad, who were given 300 g of bread daily, and in 178 schoolchildren aged 9 to 11 living in the rural regions, eating about 100 g daily. After 3 months the median level of urinary iodine increased from 4.8 to 12.6 pg% in town and from 3.0 to 6.2 pg% in the country. After 9 months the levels of urinary excretion of iodine were the same, moreover, the incidence of thyroid enlargement decreased in both groups. Hence, the tasks of pilot experiment were fulfilled: a method for bread iodination has been developed and introduced at bakeries and its efficacy in normalization of iodine supply validated.

Iodine deficiency disorders among primary-school children in Kafr El-Sheikh, Egypt

The prevalence of iodine deficiency in primary-school children in Kafr El-Sheikh governorate was assessed. A total of 2250 primary-school children aged 8-10 years were selected by a two-stage cluster sampling technique. The results revealed that the prevelance rate of goitre was 27.1% and it was significantly higher in females [29.2%] than males [25.1%]. The median urinary iodine level was 6.7 micro g/dl and 3.9 micro g/dl for grade 1 and grade 2 goitre respectively. It was concluded that iodine deficiency is a public health problem of moderate severity in primary-school children in Kafr El-Sheikh governorate. This necessitates an intervention programme through salt iodization