To study the total goitre rate (TGR), urinary iodine concentration (UIC) and salt iodine content among schoolchildren in a previously endemic area for severe iodine deficiency disorder (IDD).

Cross-sectional epidemiological study.

The study was carried out in the Gonda district (sub-Himalayan region) of North India.

Nine hundred and seventy-seven schoolchildren (6–12 years) were studied for parameters such as height, weight, UIC and salt iodine content. Thyroid volume (TV) was measured by ultrasonography to estimate TGR.

The overall TGR in the study population was 2·8 % (95 % CI 1·8, 3·8). No significant difference in TGR was observed between boys and girls (3·5 % v. 1·9 %, P = 0·2). There was a non-significant trend of increasing TGR with age (P = 0·05). Median UIC was 157·1 μg/l (interquartile range: 94·5–244·9). At the time of the study, 97 % of salt sample were iodised and nearly 86 % of salt samples had iodine content higher than or equal to 15 part per million. Overall, TGR was significantly lower (2·8 % v. 31·0 %, P < 0·001), and median UIC was significantly higher (157·1 v. 100·0 μg/l, P < 0·05) than that reported in the same area in 2009.

A marked improvement was seen in overall iodine nutrition in the Gonda district after three and a half decades of Universal Salt Iodisation (USI). To sustainably control IDD, USI and other programmes, such as health education, must be continuously implemented along with putting mechanisms to monitor the programme at regular intervals in place.

To study the associations between intakes of iodine and water chemicals and the thyroid gland status of schoolchildren living in the coastal city of Port Sudan.

In our previous nationwide study on goitre, it was observed that the prevalence of goitre was high in Port Sudan city despite high urinary iodine excretion. A cross-sectional study including schoolchildren aged 6–12 years was designed. Measurements determined the prevalence of goitre, urinary iodine concentration and thiocyanate secretion in casual urine samples, serum levels of thyroxine, triiodothyronine, thyroid-stimulating hormone and thyroglobulin, as well as the levels of Cl–, F–, Ca2+, Mg2+ and total hardness of drinking water.

Schoolchildren (n 654) aged 6–12 years.

Port Sudan city is located at the western bank of the Red Sea. The city is surrounded by a mountainous area known as the Red Sea Hills. It is the main sea port in the Sudan, inhabited by ethnically and socio-economically heterogeneous populations.

The prevalence of goitre in Port Sudan was 34·86 % while the median urinary iodine concentration was 46·4 μg/dl. Out of thirty-one pupils from Port Sudan, twenty-four (77·42 %) were found to have urinary iodine concentration greater than 30 μg/dl and twelve (38·71 %) had different degrees of biochemical hypothyroidism. Excessive concentrations of Cl–, Ca2+, Mg2+ and water hardness (369·2, 116·48, 60·21 and 539·0 mg/l, respectively) were detected in drinking water samples collected from Port Sudan that exceeded levels permitted by the WHO.

The coastal city of Port Sudan is a goitre-endemic area. In contrast to other Sudanese cities in which endemic goitre is related to iodine deficiency, goitre in Port Sudan is associated with iodine excess. Water chemicals seemed to have no effects on thyroid status.

The aim of the present study was to determine the impact of universal salt iodization (USI) on the prevalence of iodine deficiency in the population of an area previously known to have severe iodine deficiency in India.

In a cross-sectional survey, a total of 2860 subjects residing in fifty-three villages of four sub-districts of Gonda District were examined for goitre and urinary iodine concentration. Free thyroxine and thyroid-stimulating hormone levels were also measured. Salt samples from households were collected for estimation of iodine content.

A reduction in goitre prevalence was observed from 69 % reported in 1982 to 27·7 % assessed in 2007. However, 34 % of villages still had very high endemicity of goitre (goitre prevalence >30 %). Twenty-three per cent of households consumed a negligible amount (<5 ppm) and 56 % of households consumed an insufficient amount (5–15 ppm) of iodine from salt.

Although there was an overall improvement in iodine nutrition as revealed by decreased goitre prevalence and increased median urinary iodine levels, there were several pockets of severe deficiency that require a more targeted approach. Poor coverage, the use of unpackaged crystal salt with inadequate iodine and the washing of salt before use by 90 % of rural households are the major causes of persisting iodine-deficiency disorders. This demonstrates lapses in USI implementation, lack of monitoring and the need to identify hot spots. We advocate strengthening the USI programme with a mass education component, the supply of adequately iodized salt and the implementation of complementary strategies for vulnerable groups, particularly neonates and lactating mothers.