title: Goitre and iodine deficiency in Afghanistan: a case-control study.
abstract: 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.
authors.affiliation: Action Contre la Faim, 4 rue Niepce, 75014 Paris, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Oberlin
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Plantin-Carrenard
authors.forename: Odile
authors.initials: O
authors.lastname: Rigal
authors.forename: Caroline
authors.initials: C
authors.lastname: Wilkinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000346:Afghanistan / Q000453:epidemiology; D017677:Age Distribution; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D005260:Female; D006042:Goiter / Q000453:epidemiology* / Q000503:physiopathology; D020073:Gravidity; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007361:Intelligence Tests; D007455:Iodine / Q000172:deficiency* / Q000652:urine; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D017678:Sex Distribution; D013961:Thyroid Gland / Q000503:physiopathology
chemical_list: D007455:Iodine