Iodine status in a Sherpa community in a village of the Khumbu region of Nepal.
OBJECTIVE
To assess the iodine status of Sherpa residents living in Kunde village, Khumbu region, Nepal.


METHODS
Prevalence of goitre was determined by palpation. Urinary iodine concentrations (UIC) were determined in casual morning samples, and thyroid-stimulating hormone (TSH) in finger-prick blood samples on filter paper. Dietary and demographic data were obtained via questionnaire, and selected foods analysed for iodine.


METHODS
Khumbu region is an area of low soil iodine in Nepal, where the prevalence of goitre was greater than 90% in the 1960s prior to iodine intervention.


METHODS
Two hundred and fifteen of 219 permanent residents of Kunde were studied.


RESULTS
Overall prevalence of goitre was 31% (Grade 1 goitre, 27.0%; Grade 2, 4.2%). When adjusted to a world population, goitre prevalence was 27% (95% CI 23, 32%); Grade 2 goitre prevalence was 2.8% (95% CI 1.0, 4.6%). Median UIC was 97 microg/l, but only 75 microg/l in women of childbearing age. Thirty per cent had UIC < 50 microg/l and 52% had UIC < 100 microg/l, while 31% of children aged <14 years had UIC > 300 microg/l. Ten per cent of participants had TSH concentrations >5 microU/ml.


CONCLUSIONS
The prevalence of severe iodine deficiency has decreased since the 1960s, but mild iodine deficiency persists, particularly in women of childbearing age. The consumption of high-iodine uncooked instant noodles and flavour sachets by school-aged children contributed to their low prevalence of goitre and excessive UIC values. This finding may obscure a more severe iodine deficiency in the population, while increasing the risk of iodine-induced hyperthyroidism in children. Ongoing monitoring is essential.
Heydon
Emma E
EE
Department of Medical and Surgical Sciences, University of Otago, Dunedin, New Zealand.
Thomson
Christine D
CD
Mann
Jim
J
Williams
Sheila M
SM
Skeaff
Sheila A
SA
Sherpa
Kami T
KT
Heydon
John L
JL
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004034:Diet Surveys; D005260:Female; D005527:Food, Fortified; D006043:Goiter, Endemic / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control / Q000652:urine; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007455:Iodine / Q000172:deficiency / Q000652:urine*; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D009752:Nutritional Status; D015995:Prevalence; D012737:Sex Factors; D017673:Sodium Chloride, Dietary; D011795:Surveys and Questionnaires; D013972:Thyrotropin / Q000097:blood*; D014131:Trace Elements / Q000172:deficiency / Q000652:urine; D055815:Young Adult
D017673:Sodium Chloride, Dietary; D014131:Trace Elements; C034024:iodized salt; D013972:Thyrotropin; D007455:Iodine