Prevalence In Schoolchildren Research Articles

Low recovery rates stabilize malaria endemicity in areas of low transmission in coastal Kenya

The prevalence of Plasmodium falciparum malaria in African communities can be high and stable even in areas of relatively low transmission where people expose to only a few infectious bites per year. We show in this field study conducted in 30 sites along the coastal Kenya that prevalence in school children was consistently high, although there were many sites where transmission intensity measured by exposure to infectious bites was less than 10 per year. Statistical analyses revealed that prevalence was significantly correlated with the infectious exposure occurring 10–11 months previously, suggesting that long-lived infections were commonplace and one of the major contributors for the stability of malaria in these sites. Using mechanistic models of malaria transmission, we found that the association of high prevalence and low transmission could be due to low recovery rates. Therefore, significant reductions of malaria prevalence and burden require substantial reductions of the duration of acquired infections, even in areas that have quite low transmission intensities by the standards of sub-Saharan Africa. Infection control featured by active detection and drug treatment as well as vector control is critical to combat malaria in areas of relatively low transmission intensity.

Prevalência de acuidade visual reduzida nos alunos da primeira série do ensino fundamental das redes pública estadual e privada de Londrina-PR, no ano de 2000

Purpose: To analyze the prevalence of reduced visual acuity in students of elementary state public and private schools of Londrina's urban area; to compare the prevalence of reduced visual acuity in children of state public and private schools; to analyze and compare the prevalence of children wearing eye-glasses, and to describe the causes of reduced vision in this population. Methods: The visual acuity test was performed in 1688 school children of state public schools and in 611 school children of private schools. The children with visual acuity 0.7 or worse in one of the eyes were directed to a ophthalmic examination. Results: The reduced visual acuity prevalence in school children was 17.1% in state public schools, and 19.8% in private schools; this difference does not have statistical significance. The prevalence of children wearing eyeglasses was 2.4% in state public schools and 3.6% in private schools, without statistical significance between these results. The causes of reduced visual acuity were refractive errors, amblyopia, strabismus and other causes. Conclusion: The prevalence of reduced visual acuity in students of elementary state public and private schools was statistically the same, as well as the prevalence of children wearing eyeglasses. The causes of reduced visual acuity were refractive errors, amblyopia, strabismus, congenital cataract aphakia, zonular congenital cataract, persistent of the hyperplastic primary vitreous, optic nerve atrophy and macular disorder.

Iodine deficiency in Calabria: characterization of endemic goiter and analysis of different indicators of iodine status region-wide.

The distribution of goiter prevalence in schoolchildren (no.=13,984, age 6-14 yr), the neonatal TSH results obtained from the congenital hypothyroidism screening program and the urinary iodine excretion values (no.=284) were employed for the assessment of iodine deficiency in Calabria, a Southern Italy region. Data were collected during the years 1990-1996. In the inland territory, goiter prevalence ranged from 19 to 64%. At sea level, there was a great variability of goiter prevalence, with values varying from 5.3 to 25.7%. The analysis of the neonatal hypothyroidism screening program data (no.=21,078) showed a 14.8% frequency of TSH levels >5 microU/ml whole blood in newborns from the inland territory and a 14.1% frequency at sea level. Urinary iodine excretion resulted (mean+/-SD) 53.8+/-43.4 microg/l (range: <20 to 189 microg/l) in the inland territory and 89.6+/-59.8 microg/l (range: 26 to 333 microg/l) at sea level. Median urinary iodine excretion values in 13 villages or small towns of the inland territory ranged from 31 to 57 microg/l. In 2 major towns located at sea level, the median iodine excretion values were 72 microg/l in Crotone main city and 94 microg/l in Reggio Calabria main city. The data indicated that moderate, with pockets of severe iodine deficiency is present in the inland region while iodine supply varies from sufficient to marginally low in the coastal areas. Mild iodine deficiency was found in a major town located at sea level.

Iodine deficiency in Azerbaijan after the discontinuation of an iodine prophylaxis program: reassessment of iodine intake and goiter prevalence in schoolchildren.

The goal of this study was to assess the prevalence of iodine deficiency (ID) in Azerbaijan after the discontinuation of an iodine prophylaxis program by assessing the prevalence of goiter, iodine intake, and thyroid function. The study included 942 schoolchildren (475 boys and 467 girls) ages 8-14 years, from 13 distinct regions. The survey included the following: (1) clinical evaluation; (2) assessment of thyroid volume both by ultrasound and by palpation; (3) determination of iodide in a morning urine specimen using the classic Sandel-Kolthoff reaction in 347 schoolchildren; (4) determinations of thyrotropin (TSH), triiodothyronine (T3), thyroxine (T4), thyroglobulin (Tg), and anti-thyroid peroxidase (TPO) in serum (n = 165) and TSH in whole blood spotted on filter paper (n = 942). The prevalence of goiter for the whole country was determined by ultrasound (US) to be 86% and by palpation 66%, reaching 100% in the mountainous regions of Caucasus. The median urinary iodine excretion (UIE) was 54 microg/L, reaching level of 26 and 39 microg/L in the Caucasus region. In conclusion, according to the World Health Organization (WHO) classification, Azerbaijan now has mild to moderate ID (median UIE, 54 microg/L) and in the mountainous regions with severe ID. The high prevalence of goiter and the low UIE emphasizes the need for urgent medical reintervention. An iodination program is now implemented by our team in the mountainous regions under the auspice of the government of Azerbaijan.

A pilot survey of pain prevalence in schoolchildren

Abstract The present survey analyzed the prevalence of pain and its etiology in a sample of Spanish schoolchildren in relation to age and gender. The survey considered 571 students (57.8% girls) 6 to 15 years of age from two schools. A questionnaire was used to ask children about their present pain, their worst pain experience and the causes of both. Pain prevalence was 27.1% and no gender difference was seen but the younger group had a higher prevalence (32.7%). Most children (72.9%) were able to describe their present pain etiology, which was often related with medical illnesses (79.6%). Almost all children (90.5%) described their worst pain event and statistical differences (p < 0.001) were seen between younger (77.6%) and older children (95.6%). These differences by age were observed both in boys (p < 0.001) and girls (p < 0.05). The cause of the worst pain was significantly related with age (p < 0.001), and surgery and trauma events were more frequent in boys (p < 0.05). In conclusion, pain is a comm...

Monitoring the adequacy of salt iodization in Switzerland: a national study of school children and pregnant women

Several countries with long-standing salt iodization programs, including Switzerland, have recently reported declining and/or low urinary iodine (UI) levels in their populations. In Switzerland, in response to studies indicating low UI levels in children and pregnant women, the salt iodine level was increased in 1998 from 15 to 20 mg/kg. Our objective was to evaluate iodine nutrition in a national sample of Swiss school children and pregnant women 8 16 months after the increase in the salt iodine level. A 3-stage probability proportionate to size cluster sampling method was used to obtain a representative national sample of 600 children aged 6-12 y and 600 pregnant women. We then measured UI in both groups, thyrotropin (TSH) in pregnant women and thyroid volume by ultrasound to determine goiter prevalence in school children. The median UI (range) of the children and pregnant women was 115 microg/l (5-413) and 138 microg/l (5-1881), respectively. The median blood TSH concentration (range) of pregnant women was 0.6 mU/l (0.2-2.1). Based on the current WHO/ICCIDD normative data for thyroid volume, none of the children were goitrous, using either age/sex-specific or BSA/sex-specific cutoffs. The iodine status of the Swiss population is once again adequate, illustrating the value of periodic monitoring and prudent adjustments to the iodine level in salt. This approach could serve as a model for countries struggling to maintain dietary iodine intake in the face of shifting dietary habits and changes in the food supply.

Asthma prevalence in schoolchildren in a city in north-east Brazil.

Asthma is a disease of increasing prevalence all over the world. The objectives of this study were to describe the prevalence of asthma and aspects of its morbidity in schoolchildren in Recife, and to evaluate the relationship between maternal schooling and asthma prevalence during 1994-1995. This is part of an international, multicentre research project, the International Study of Asthma and Allergies in Childhood (ISAAC). In a cross-sectional design, a probabilistic sample of 1410 children of 6 and 7 years of age and 3086 teenagers of 13 and 14 years were studied by questionnaire. The yearly prevalences of asthma symptoms in these two groups were 27.2% (CI 95%: 24.9-29.5%) and 18.1% (CI 95%: 16.4-19.8%), respectively; the cumulative prevalences of diagnosed asthma were 20.4% (CI 95%: 17.8-23.0%) and 19.7% (CI 95%: 19.4-22.2%), respectively, and the prevalences of asthma according to severity were: mild--68.9% and 81.3%, moderate--24.2% and 13.5%, severe--6.80% and 5.3%. During the previous year, the frequencies of crises with sleeping disorder were 23.2% and 13.0% and of disorder that limited speech 9.6% and 4.8%, respectively. There was a significant relationship between maternal education and cumulative prevalence of symptoms in both groups. It is concluded that asthma is a common disease which causes much morbidity in schoolchildren in Recife. The results suggest a relationship between low maternal education and a greater prevalence of asthma.

A targeted, single-dose azithromycin strategy for trachoma.

To evaluate the impact of treating children with acute trachoma and their contacts with oral azithromycin. Open, uncontrolled, prospective evaluation of a community-based treatment strategy. Central Australian semi-desert Aboriginal community (1995-1996). 216 school- and pre-schoolchildren aged 6 months and up to 15 years. All children with acute trachoma and their contacts (co-resident siblings aged between 6 months and 15 years) received single-dose oral azithromycin suspension (20 mg/kg, to a maximum of 1000 mg). Prevalence of acute trachoma (World Health Organization trachoma diagnostic criteria). Trachoma prevalence at baseline was 42% (71/169) and 55% (18/33) for schoolchildren and pre-schoolchildren, respectively: 103 schoolchildren and 21 pre-schoolchildren, comprising 77 with follicular trachoma and their 47 contacts, were treated with azithromycin over an 8-week period. Acute trachoma prevalence in schoolchildren fell to 22% at 6-8 months (P < 0.0001) and was 31% at 12 months (P < 0.05 compared with baseline). Pre-schoolchildren were followed up for 6 months after treatment, and their trachoma prevalence fell from 55% to 25% (P < 0.05). Further treatment was given to children with trachoma at 12 months, and the point prevalence of trachoma for schoolchildren at 24 months was 34%. In contrast to mass-treatment strategies, significant reductions in trachoma prevalence at 6 months were achieved by screening 35% of community members (216) and treating 20% (124). The subsequent prevalence increases support the need for more comprehensive treatment programs, including health promotion and efforts to improve living conditions.

KECENDERUNGAN PREVALENSI KARIES GIGI PADA ANAK SEKOLAH DASAR DI SERPONG DAN JAKARTA BARAT

Until Pelita IV data on caries prevalence of school children was reported that children age 8 was 45.20% and children aged 14 was 72.76%. The purpose of this study was to evaluate the trend of caries prevalence of school children in Serpong and West Jakarta. This study was done on school children age 11-14 year in 6 schools (270 students) of Serpong and West Jakarta. The routine examination for dental caries examination and oral hygiene was carried out. The results show that the prevalence of caries of school children aged 14 years olg (77.78%) ws higher than those of age 13 and 12 years (68.63%) and the prevalence of caries of school children aged 11 years (48.33%) was lower than those of age 12 and 13 years. Further, the prevalence of caries of school children aged 12 years was the same as school children aged 13 years (68.63%). These data indicate that the prevalence caries of school children aged 11-14 years old have a trend to increase as follows as age of children.

Head Lice: Prevalence in Schoolchildren and Insecticide Resistance

Several small case studies have shown a therapeutic response for oral cotrimoxazole22xShashindran, C.H. et al. Br. J. Dermatol. 1978; 98: 699Crossref | PubMedSee all References22, oral and topical ivermectin23xGlaziou, P. et al. Trop. Med. Parasitol. 1994; 45: 253–254PubMedSee all References, 24xYoussef, M.Y. et al. Am. J. Trop. Med. Hyg. 1995; 53: 652–653PubMedSee all References, topical crotamiton25xKaracic, I. and Yawalkar, S.J. Int. J. Dermatol. 1982; 21: 611–613Crossref | PubMedSee all References25, and topical 1% copper oleate shampoo26xIannantuono, R.F. et al. Adv. Ther. 1997; 14: 134–139See all References26. We have also assessed the novel flea adulticides, fipronil and imidicloprid, and found them to be 97 and 100% effective in vitro against head and body lice (unpublished). Alternative carbamates such as propoxur or alternative organophosphates such as temephos27xMazzarri, M.B. and Georghiou, G.P. J. Am. Mosq. Control Assoc. 1995; 11: 315–322PubMedSee all References27 may be unaffected by the resistance mechanism against malathion. All these agents may have a place in the control of head lice. If a new agent is introduced into the human market, it is likely that head lice will eventually develop resistance. To reduce chronic use, and so slow the development of resistance, an option would be to have all insecticides available by prescription only. Strategies should be used to keep head lice levels to a socially acceptable minimum level. Strategies such as educational campaigns by community nurses, doctors and school teachers should promote head lice eradication. Although it is doubtful whether regular combing will cure a head lice infestation, it is likely to reduce the numbers of lice carried and should be promoted as the first line of treatment before insecticides. Children who fail to clear their infestations should be targeted by school nurses for treatment. All family members and classmates should be assessed for asymptomatic carriage. Ideally, all schoolchildren should be at separate desks during lessons to reduce transmission of head lice. Given the national rise in the prevalence of head lice and in insecticide sales, it is likely that the resistance phenomenon we have observed in Bristol and Bath is nationwide, and will require national changes in attitudes towards the treatment and surveillance of this ectoparasite.

Lack of malaria parasite transmission between apes and humans in Gabon.

The International Center for Medical Research (CIRMF) is located in an area highly endemic for malaria in southeastern Gabon, where humans and apes (gorillas and chimpanzees) are living in the same geographic area. The presence of the CIRMF primate center housing apes (59 chimpanzees and nine gorillas in 1994) within the city of Franceville provided an opportunity to investigate the capability of cross-transmission of malaria species from humans to apes. The main vector of human malaria, Anopheles gambiae, was found in the primate center and in a nearby populated area of Franceville. Despite high malaria transmission in humans of both Plasmodium falciparum and P. malariae (mean of 43% cumulative prevalence in schoolchildren), none of the apes were found infected with plasmodia during a six-month investigation. However, low antibody levels against sporozoite and blood stages of both P. falciparum and P. malariae were detected in a few chimpanzees and gorillas. These results demonstrate that only rarely would apes be bitten in the field by mosquitoes infected with human malaria parasites. In the case of infection proven by serology, we did not find any evidence that blood-stage malaria parasites were able to the gametocyte stage. The absence of any established malaria transmission cycle within the primate colony of CIRMF indicates that apes cannot be considered as animal reservoirs for human malaria parasites in this environment.

Longitudinal study on goiter prevalence and goitrogen factors in northeastern Sicily

A longitudinal study was carried out in an area of endemic goiter of north-eastern Sicily. Three different surveys (in 1977, 1983 and 1994) evaluated the epidemiological prevalence of goiter in schoolchildren of the endemic area (towns of Bronte, Troina and Maniaci) in comparison to an iodine sufficient control area (Catania). Biochemical studies were also performed on urinary iodine and thiocyanate (SCN) excretion and 131I thyroid uptake. In the town of Troina an experimental program of active iodine prophylaxis was carried out from 1979 to 1987 by iodinating the municipal water supply. The aim of this study was to evaluate the effect of an active iodine prophylaxis program in comparison to the "silent iodoprophylaxis" due to improved economic conditions and widespread introduction of industrially produced food. In the 1977-94 period a significant decrease of goiter prevalence in schoolchildren was observed in all areas where no active iodoprophylaxis had been introduced. An abnormal prevalence of goiter, however, was still present in Bronte (12.1%) and Maniaci (25.9%) schoolchildren in respect to Catania (0.7%). In Troina, goiter prevalence decreased from 52.2 to 6.1% after only five years of active iodine prophylaxis (1983). It increased to 8.4% seven years after the program was discontinued (1994). In all areas studied average urinary iodine excretion increased by 70-100 micrograms/day except in the more rural area at Maniaci. During the same period urinary SCN values decreased by 30-40% and were lower in Troina (non volcanic soil) than in other towns studied. The balance between iodine and SCN intake appears a relevant factor in the etiology of endemic goiter in these areas and the iodine/SCN ratio inversely correlated with goiter prevalence. The persistence of endemic goiter in spite of the important changes in life style and socio-economic conditions if compared to the dramatic amelioration obtained by an active iodine prophylaxis program, confirms the inadequacy of the silent iodine prophylaxis, and further supports the need of an immediate introduction of active iodine prophylaxis in the areas of endemic goiter in Sicily.

Current status of endemic goiter in Croatia: the results of a nationwide study (1995).

In the beginning of the nineties, 40 years after introduction of iodine prophylaxis in Croatia, on a basis of a frequent reports coming from general practitioners about the presence of a rather high prevalence of goiter among schoolchildren, a nationwide study was initiated with the aim to determine the real prevalence of goiter in the country. A total of 2856 schoolchildren of both sexes, aged 7-15 years, were included into the study. Investigations were designed in a way to cover most of geographical regions in Croatia and subjects were randomly selected. The prevalence of goiter in schoolchildren was assessed by palpation and in part by ultrasonography of the neck. At the same time urinary iodine excretion was measured and iodine content in salt samples was determined. The results have revealed the persistence of mild endemic goiter in inland parts of Croatia with the prevalence of 6-29% in the age group 7-11 years and those of 10-43% among the age group 12-15 years. The overall goiter prevalence in schoolchildren in Croatia fluctuates from 8% to 35%. Such prevalence, most probably due to less than optimum iodine intake, is unlikely to change until iodine content of the salt is increased from its present level of 10 mg of Kl per kg of salt.

20 OBESITY AMONG SCHOOL CHILDREN FROM URBAN CONCEPCION (CHILE)

We determine the prevalence of obesity among school children aged 6 to 14 years attending Municipal schools + private state subsidized schools (M+PSS) and private school (P) in urban Concepción. Conditioning obesity factors were analysed. 2302 school children were randomly selected by conglomerate. Obesity was diagnosed by the ratio Weight / height > 120% (NCHS reference data). Obesity among parents and relatives was assessed by means of a questionnaire. Data analysed by SAS sta package. Test X2 of independence and homogeinity. Overall prevalence in school children sampled: 21%. No differences between sexes. 12% Obesity at 14 years of age in males and 23.4% in females. (p<0.015). Males from P 25.6% and M+PSS 14.8% (p < 0.001). Among girls, only at 14 years of age there are differences between M+PSS (28,7%) versus P (15,7) (p<0.04). Obesity prevalence among parents of obese children: a single parent 22.2%, both parents 4.7%; control group 10.3% and 1.1% respectiely (p<0.001). 27% Obesity among brothers and sisters of obese children and 11.9% in controls (p < 0.001). No difference was found between obese and non obese children concerning divorced parent, a single child, parents schooling. School marks, physical activity, daily calorie intake were similar for both groups. The prevalence of obesity in our sample: 21%. Clustered by age and sex, girls are more obese at age 14. It was more prevalent among males attending P. Among girls there is only a difference at age 14, being more prevalent in M+PSS schools. Family background was the only conditioning factor. This study allows us to identify the groups at risk among school children and start preventive measures.

Attention deficit-hyperactivity disorder prevalence in school children: Comparison between DSM-III-R and neurologic criteria

Attention deficit-hyperactivity disorder prevalence in school children: Comparison between DSM-III-R and neurologic criteria

The Airedale schools survey: providing local information on smoking prevalence in schoolchildren

The Health of the Nation sets national targets for risk factor reduction. One of the resulting challenges is to develop local monitoring procedures to allow realistic local targets to be set, and evaluate progress towards achieving them. We report a survey of smoking prevalence in schoolchil dren using the setting of annual school nurse health interviews for secondary school pupils, Years 7 and 10. This type of initiative is a simple, reliable method for local monitoring of trends in smoking for this age group, and should aid targeting and evaluation of interventions to prevent smoking uptake.

Forty years of progress.

The celebration of the 40th anniversary of the National Institute of Dental Research (NIDR) provides an opportunity for reviewing the growth of dental research over the decades. The Institute owes its origin to public and professional concern over the dental health of Americans and the prospect that a Federal investment in dental research could pay off. The early years of the Institute were devoted to studies of fluoride and dental caries, with notable achievements in clinical trials of water fluoridation and caries microbiology. During the 1960s came the discovery that the periodontal diseases, like dental caries, were bacterial infections that could be prevented. Basic and clinical research expanded, and the research manpower pool grew with the addition of microbiologists, immunologists, salivary gland investigators, and other basic biomedical and behavioral scientists. The Institute created special broad-based Dental Research Institutes and Centers to foster interdisciplinary research, and continued to expand its research base. A national survey undertaken by NIDR in the late 1970s showed major declines in caries prevalence in schoolchildren. Recent NIDR surveys of adults and older Americans as well as a second children's survey have demonstrated overall improvements in oral health and a continued decline in childhood caries.(ABSTRACT TRUNCATED AT 250 WORDS)

Ahaptoglobinemia in African populations and its relation to malaria endemicity.

A study of the relations between plasma haptoglobin levels and malaria endemicity was carried out on selected specimens collected in 1980-1985 during studies on malaria transmission in various populations of the Brazzaville region of the Republic of the Congo. The prevalence of ahaptoglobinemia in school-children is 2.2% in Moungali and 2.9% in Poto-Poto, two districts of Brazzaville where malaria transmission intensity is less than one infective mosquito bite per person per year and malaria prevalence in schoolchildren is less than 10%. In contrast, ahaptoglobinemia prevalence is 48% in schoolchildren from the village of Djoumouna, where malaria transmission intensity reaches 1,000 infective bites per person per year and malaria prevalence in schoolchildren is 94%. Intermediate values, between 11.1% and 23.4% are observed in schoolchildren from Talangaï, Massina, and Linzolo, districts or villages where malaria transmission intensity is between 20 and 250 infective bites per person per year and malaria prevalence in schoolchildren is between 66% and 81%. These findings indicate that ahaptoglobinemia prevalence is correlated with the level of malaria endemicity and provide additional support for the hypothesis that malaria is the main cause of ahaptoglobinemaia in African populations. The haptoglobin system may be of considerable interest in the investigation of the mechanisms of anemia in malaria.

フッ化物口法を中心とした地域歯科保健管理の成果

A community dental health program was conducted in Maki Village (population was about 5, 000), Niigata Prefecture, for 10 years from 1974.This community dental health program consists of two parts: (1) fluoride mouth rinsing in nursery, elementary and junior high school and (2) detection and immediate treatment of initial caries extending the treatment from the children in low grades to those in high grades.In 1975, the Association of Dental Health for Children was organized for promoting this program in Maki Village.A comparison of caries prevalence was carried out among school children at baseline (1974), 5 years after (1979) and 10 years after (1984) in Maki Village, and the caries prevalence of school children in Maki Village (1984) was compared with that in Village S (1984). The school children in Village S had not used fluoride mouth rinsing.The results were as follows.1) In Maki Village, mean DMF teeth per children of the elementary and junior high school children was 3.67 (SE=0.11) in 1974, 1.93 (0.10) in 1979, and 0.93 (0.06) in 1984. Caries reduction rate was 75 % for 10 years, and this was highly significant statistically.The percentage of school children without carious teeth increased from 13 % in 1974 to 56% in 1984, and the percentage of school children with some decayed teeth was only 6% in 1984.2) The caries prevalence of the school children in Maki Village was lower than that in Village S. The difference of the percentage of children with DMF teeth and of mean DMF teeth was 35% and 69%, respectively.The good dental health in Maki Village was the result of the 10-year community dental health program of school-based fluoride mouth rinsing, and detection and immediate treatment of caries.The continuation of this program was supported by the Association of Dental Health for Children.

Prevention and treatment of endemic iodine-deficiency goiter by iodination of a municipal water supply.

A recently described method for the prevention and treatment of endemic iodine deficiency and goiter, introduction of iodine into a public water supply, was tested in Troina, a town of about 13,000 inhabitants in northeast Sicily. There, before initiation of the program, a goiter endemic of moderate severity was present, as evidenced by goiter prevalence of 55% in school children. Iodine deficiency in nongoitrous adults was indicated by daily urinary iodine excretion of 40.7 +/- 2.6 micrograms (mean +/- SE) and 24-h thyroid radioiodine uptake of 50.8 +/- 2.4%. Iodination of the water supply was initiated in November 1979 using a stream-splitting device that diverts a controlled fraction of the total water flow to a canister containing iodine crystals, where the water becomes saturated with iodine (approximately 300 mg/liter) before returning to the main stream. Except for a 15-month interruption during which governmental authorization of the program was being reconfirmed, treatment of the water has continued to the present time, initially at a level of 81 +/- 25 micrograms/liter (mean +/- SD) and since resumption at a level of 46.5 +/- 5 micrograms/liter. Iodination of the water was followed by a prompt and marked reduction in goiter prevalence, and by improvement in biochemical indices of iodine deficiency. By April 1983, overall goiter frequency in school children had declined to 6.1%, and large goiters (WHO Grade 2) had virtually disappeared. By January 1984, daily urinary iodine excretion had increased to 85.6 +/- 6.5 (SEM) micrograms and radioiodine uptake had decreased to 40.7 +/- 4.7%. Serum thyroid-related hormone concentrations were as follows (pretreatment vs. November-December 1983): T4, 5.8 +/- 0.3 vs. 8.4 +/- 0.3 microgram/dl; T3, 1.6 +/- 0.05 vs. 1.2 +/- 0.06 ng/ml; TSH, 3.7 +/- 0.2 vs. 2.2 +/- 0.1 microU/ml; all changes being statistically significant. By late 1983, serum T4, T3, and TSH values in Troina were almost identical to those in Catania, a community in which iodine deficiency is not present (goiter prevalence in school children, 2.2%). In contrast, in Troina serum T4 concentrations were significantly higher and serum TSH concentrations were significantly lower than those in Maniaci, a iodine-deficient town near Troina, in which the water was not iodinated. Iodinated water was well tolerated by the population of Troina, and no adverse effects of water iodination, including any increase in the frequency of hyperthyroidism, was observed. At present prices, the cost of the water iodination program in Troina would be approximately 4 cents (U.S.) per person per year.(ABSTRACT TRUNCATED AT 400 WORDS)