title: Endemic goitre and cretinism in the Simbai and Tep-Tep areas of Madang Province, Papua New Guinea.
abstract: In the late 1960s and early 1970s a mass campaign of iodized oil injections was carried out in Papua New Guinea as an interim measure to improve iodine status in the population and to prevent endemic goitre and endemic cretinism. Following informal reports of children with neurological abnormalities resembling endemic cretinism in two areas of Madang Province, the Simbai and Tep-Tep Subdistricts, surveys were conducted in these areas in 1985 to establish prevalence rates of goitre and cretinism in order to determine whether they had returned as public health problems. 42% of the Simbai population and 38% of the Tep-Tep population attended for examination. Amongst those surveyed, the visible goitre rate was low: 0.1% in the Simbai and 2.5% in the Tep-Tep area. Although the iodized oil patrols were carried out a decade previously, goitre does not seem to have re-emerged in the area to the levels reported previously. In the Simbai villages surveyed, there were nine individuals diagnosed as suffering from cretinism, three of whom were thought to have been born after the last iodized oil patrol in the area. In the Tep-Tep villages, eight subjects were diagnosed as suffering from cretinism, all of whom were thought to have been born before the iodized oil patrols. A number of younger children with neurological abnormalities which did not fulfil criteria for endemic cretinism were also seen in both areas. Because of the difficulties in diagnosing endemic cretinism in young children, it is not possible to conclude that endemic cretinism is no longer a problem in these areas. More work is needed to confirm the results of these studies. This will enable a rational control program to be designed and implemented.
authors.affiliation: Cambridge Health Authority, Fulbourn Hospital, England, UK.
authors.forename: P D
authors.initials: PD
authors.lastname: Pharoah
authors.forename: P F
authors.initials: PF
authors.lastname: Heywood
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003409:Congenital Hypothyroidism / Q000453:epidemiology* / Q000517:prevention & control; D006043:Goiter, Endemic / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D010219:Papua New Guinea / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence