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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

References

Afghan Ministry of Public Health and UNICEF National Progress toward Universal Salt Iodization. In Proceedings of the Conference on Accelerating Sustained IDD Elimination, (2003) 15–17Beijing, China.Google Scholar
Azizi, FIodine deficiency disorders in the Middle East. IDD Newsletters (2001) 17 33–39Google Scholar
Bachtarzi, H & Benmiloud, MTSH-regulation and goitrogenesis in severe iodine deficiency Acta Endocrinol (1983) 103 21–27Google ScholarPubMed
Bellis, GRoux, F & Chaventre, AEndemic cretinism in a traditional society in Mali: from the collectivity to the individual. Coll Antropol (1998) 22 23–30Google Scholar
Bernal, JAction of thyroid hormone in brain Endocrinol Invest (2002) 25 268–288CrossRefGoogle ScholarPubMed
Bleichrodt, N, Born, MPA metaanalysis of research on iodine and its relationship to cognitive developmentIn The Damaged Brain of Iodine Deficiency [JB Stanbury, editor]New York: Cognizant Communication Corporation (1994) 195–200Google Scholar
Buttfield, IHBlack, MLHoffmann, MJMason, EKWellby, MLGood, BFHetzel, BSStudies of the control of thyroid function in endemic goiter in Eastern New Guinea J Clin Endocrinol Metab (1966) 26 1201–1207CrossRefGoogle ScholarPubMed
Delange, FThe disorders induced by iodine deficiency Thyroid (1994) 107–128CrossRefGoogle ScholarPubMed
Delange, FHershman, JMErmans, AMRelationship between the serum thyrotropin level, the prevalence of goiter and the pattern of iodine metabolism in Idjwi Island J Clin Endocrinol (1971) 33 261–268CrossRefGoogle ScholarPubMed
Ermans, AMMbulamoko, NMDelange, F & Ahluwalia, RRole of Cassava in the Etiology of Endemic Goitre and Cretinism. Ottawa: International Development Research Centre (1980)Google Scholar
Fenzi, GFCeccarelli, CMacchia, ERivera, MDramaix, MLody, DNelson, GDelange, FErmans, AM & Thilly, CHReciprocalchanges of serum thyroglobulin and TSH in residents of a moderate endemic goitre area Clin Endocrinol (1985) 23 115–122CrossRefGoogle ScholarPubMed
Fierro-Benitez, RCazar, RStanbury, JBRodriguez, PGarces, FFierro-Renoy, F & Estrella, EEffects on school children of prophylaxis of mothers with iodized oil in an area of iodine deficiency J Endocrinol Invest (1988) 11 327–335CrossRefGoogle Scholar
Hetzel, BSIodine and neuropsychological development J Nutr 130. Suppl 2S (2000) 493S–495SCrossRefGoogle ScholarPubMed
Hollowell, JGLaFranchi, SSmallridge, RCSpong, CYHaddow, JEBoyle, CAWhere do we go from here? — Summary of working group discussions on thyroid function and gestational outcomes. Thyroid (20052004 15 72–76CrossRefGoogle Scholar
International Council for the Control of Iodine Deficiency Disorders, (2004). IDD Prevalence and Control Program Data http://indorgs.virginia.edu/iccidd/mi/idd_0.02.htmGoogle Scholar
Lazarus, JHParkes, ABJohn, RN'Diaye, M & Prysor-Jones, SGEndemic goitre in Senegal - thyroid function etiological factors and treatment with oral iodized oil Acta Endocrinol (1992) 126 149–154Google ScholarPubMed
Pardede, LVHardjowasito, WGross, RDillon, DHTotoprajogo, OSYosoprawoto, MWaskito, L & Untoro, JUrinary iodine excretion is the most appropriate outcome indicator for iodine deficiency at field conditions at district level J Nutr (1998) 128 1122–1126CrossRefGoogle ScholarPubMed
Peterson, SAssey, VForsberg, BCGreiner, TKavishe, FPMduma, BRosling, HSanga, AB – Gebre-Medhin, MCoverage and cost of iodized oil capsule distribution in Tanzania Health Policy Plan (1999) 14 390–399CrossRefGoogle ScholarPubMed
Pettigrew, AR – Fell, GSSimplified colorimetric determination of thiocyanate in biological fluids, and its application to investigation of the toxic amblyopias Clin Chem (1972) 18 996–1000CrossRefGoogle ScholarPubMed
Pharoah, POD & Connolly, KJA controlled trial of iodinated oil for the prevention of endemic cretinism: a long-term followup Intern J Epidemiol (1987) 16 68–73CrossRefGoogle Scholar
Plantin-Carrenard, ECattan, FAurengo, ADumerat, BFoglietti, MJ & Beaudeux, JLAnalytical aspects of the semiquantitative determination of urinary iodine using ferroin: value of rapid screening for iodine deficiency or excess Ann Biol Clin (Paris) (2004) 62 456–461Google ScholarPubMed
Thilly, CHDelange, FLagasse, RBourdoux, PRamioul, LBerquist, H & Ermans, AMFetal hypothyroidism and maternal thyroid status in severe endemic goiter J Clin Endocrinol Metab (1978) 47 354–360CrossRefGoogle ScholarPubMed
Tonglet, RBourdoux, PMinga, T & Ermans, AMEfficacy of low oral doses of iodized oil in the control of iodine deficiency in Zaire N Engl J Med (1992) 326 236–241CrossRefGoogle ScholarPubMed
United Nations International Children's Emergency Fund 2003 Afghanistan Multiple Indicator Cluster Survey New York: UNICEF (2004)Google Scholar
United Nations Standing Committee on Nutrition Report on the Nutrition Situation of Refugees and Displaced Populations Refugee Nutrition Information System (RNIS) Geneva: UNS/Standing Committee on Nutrition. (2002a) 38 41–49Google Scholar
United Nations Standing Committee on Nutrition Report on the Nutrition Situation of Refugees and Displaced Populations Refugee Nutrition Information System (RNIS) Geneva: UNS/Standing Committee on Nutrition. (2002b) 39 47–53Google Scholar
van den Briel, TWest, CEBleichrodt, Nvan de Vijver, FJAtegbo, EA & Hautvast, JGImproved iodine status is associated with improved mental performance of schoolchildren in Benin. Am J Clin Nutr (2000) 72 1179–1185CrossRefGoogle ScholarPubMed
Vanderpas, JBourdoux, PLagasse, RRivera, MDramaix, MLody, DNelson, GDelange, FErmans, AM & Thilly, CHEndemic infantile hypothyroidism in a severe endemic goitre area of central Africa. Clin Endocrinol (1984) 20 327–340CrossRefGoogle Scholar
World Health Organization Global Prevalence of Iodine Deficiency Disorders. WHO/UNICEF/ICCIDD Micronutrient Deficiency Information System working paperGeneva: WHO.1993) 1Google Scholar
World Health Organization Assessment of Iodine Deficiency Disorders and Monitoring of their Elimination; a Guide for Program Managers Geneva: WHO (1999)Google Scholar
Zimmermann, MAdou, PTorresani, TZeder, CHurrell, RLow dose oral iodized oil for control of iodine deficiency in children Br J Nutr (2000) 84 139–141CrossRefGoogle ScholarPubMed