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Goitre and iodine deficiency in Afghanistan: a case—control study

Published online by Cambridge University Press:  08 March 2007

Odile Oberlin ,
Emmanuelle Plantin-Carrenard ,
Odile Rigal  and
Caroline Wilkinson
Odile Oberlin
Affiliation:
Action Contre la Faim, 4 rue Niepce, 75014 Paris, France
Emmanuelle Plantin-Carrenard
Affiliation:
Centre Hospitalier Jacques Coeur, 145 avenue François Mitterand, 18000 Bourges, France
Odile Rigal
Affiliation:
Hopital Robert Debré, 48 boulevard Sérurier, 75019 Paris, France
Caroline Wilkinson*
Affiliation:
Action Contre la Faim, 4 rue Niepce, 75014 Paris, France
*
*Corresponding author:fax +33 1 43 35 88 00, email cwilkinson@actioncontrelafaim.org
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Abstract

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I deficiency is the leading cause of preventable mental retardation. A number of surveys in Afghanistan show goitre prevalence rates more than 20% amongst children and women. Access to iodised salt remains low, with disparate coverage by region, despite the recent implementation of a national salt iodisation programme. The objectives were to identify whether the presence of goitre is a satisfactory marker of I deficiency and to examine the relationship between goitre and thyroid function. A case–control study was carried out in children and women of childbearing age, stratified on the presence of goitre. Adequate levels of urinary I were observed in 6·8% of all the subjects, and amongst the subjects without goitre, this figure was only 9%. The presence of goitre was significantly associated with severe urinary I deficiency; however, the difference between the cases and controls was not as great as expected. An association between the presence of goitre and elevated thyroid-stimulating hormone (TSH) levels was observed, but 14% of the children without palpable goitre also showed abnormal TSH levels.Given that the majority of subjects showed some degree of I deficiency and that children without goitre may have elevated TSH levels, the absence of goitre is an insufficient indicator to determine adequate I status. The risk of subsequent development of goitre, in the currently non-goitre population, is elevated. This suggests that short-term I supplementation should be considered independently of the presence of goitre or urinary I level, until the access to and consumption of iodised salt is generalised.

Keywords

Iodine deficiencyGoitreAfghanistanThyroid-stimulating hormoneThiocyanate
Type
Research Article
Information
British Journal of Nutrition , Volume 95 , Issue 1 , January 2006 , pp. 196 - 203
Copyright
Copyright © The Nutrition Society 2006

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