title: Iodine-deficiency disorders in the Aseer region, south-western Saudi Arabia: 20 years after the national survey and universal salt iodization.
abstract: OBJECTIVE
  To study (i) the current prevalence of iodine-deficiency disorders among schoolchildren in south-western Saudi Arabia after universal salt iodization and (ii) the iodine content of table salts and water.
  
  
  METHODS
  Cross-sectional study on a stratified proportional allocation sample of children. Thyroid gland enlargement was assessed clinically and by ultrasound scanning. Urine, table salt and water samples were taken to measure iodine content. Settings The Aseer region, south-western Saudi Arabia.
  
  
  METHODS
  Schoolchildren aged 8-10 years.
  
  
  RESULTS
  The study included 3046 schoolchildren. The total goitre rate amounted to 24·0 %. Prevalence of enlarged thyroid by ultrasound was 22·7 %. The median urinary iodine concentration of the study sample amounted to 17·0 µg/l. The iodine content of table salt ranged from 0 to 112 mg/kg; 22·5 % of the table salt samples were below the recommended iodine content (15 mg/kg) set by WHO. The total goitre rate increased significantly from 19·8 % among children using table salt with iodine content ≥15 mg/kg to reach 48·5 % among children using table salt with 0 mg iodine/kg. Analysis of water samples taken from schools showed that the majority of water samples (78·8 %) had an iodine content of 0 µg/l.
  
  
  CONCLUSIONS
  The study documented that 18 years after the national study, and after more than a decade of universal salt iodization in Saudi Arabia, the problem of iodine-deficiency disorders is still endemic in the Aseer region. Efforts should focus on fostering advocacy and communication and ensuring the availability of adequately iodized salt.
authors.affiliation: 1Department of Child Health,King Khalid University,Abha,Saudi Arabia.
authors.forename: Fuad I
authors.initials: FI
authors.lastname: Abbag
authors.affiliation: 2Department of Surgery,College of Medicine,Najran University,Najran,Saudi Arabia.
authors.forename: Saeed A
authors.initials: SA
authors.lastname: Abu-Eshy
authors.affiliation: 3Department of Community Medicine,King Khalid University,PO Box 641,Abha,Saudi Arabia.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Mahfouz
authors.affiliation: 1Department of Child Health,King Khalid University,Abha,Saudi Arabia.
authors.forename: Suliman A
authors.initials: SA
authors.lastname: Al-Fifi
authors.affiliation: 4Prince Sultan Bin Abdul Aziz Center for Research and Environmental Studies,King Khalid University,Abha,Saudi Arabia.
authors.forename: Hussein
authors.initials: H
authors.lastname: El-Wadie
authors.affiliation: 4Prince Sultan Bin Abdul Aziz Center for Research and Environmental Studies,King Khalid University,Abha,Saudi Arabia.
authors.forename: Samy M
authors.initials: SM
authors.lastname: Abdallah
authors.affiliation: 5Department of Radiology,College of Applied Medical Sciences,King Khalid University,Abha,Saudi Arabia.
authors.forename: Mustafa G
authors.initials: MG
authors.lastname: Musa
authors.affiliation: 6Department of Biochemistry,King Khalid University,Abha,Saudi Arabia.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Devansan
authors.affiliation: 6Department of Biochemistry,King Khalid University,Abha,Saudi Arabia.
authors.forename: Ayuub
authors.initials: A
authors.lastname: Patel
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D003677:Deficiency Diseases / Q000453:epidemiology* / Q000652:urine; D004032:Diet; D060766:Drinking Water / Q000737:chemistry; D005260:Female; D006042:Goiter; D006043:Goiter, Endemic / Q000453:epidemiology* / Q000652:urine; D006306:Health Surveys; D006801:Humans; D007455:Iodine / Q000032:analysis / Q000172:deficiency* / Q000652:urine; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D064167:Recommended Dietary Allowances; D012529:Saudi Arabia / Q000453:epidemiology; D017673:Sodium Chloride, Dietary / Q000032:analysis*
chemical_list: D060766:Drinking Water; D017673:Sodium Chloride, Dietary; C034024:iodized salt; D007455:Iodine
keywords: Drinking water; Iodine-deficiency disorders; Table salt; Urinary iodine content