Assessment of Iodine Nutrition of School Children in Gonda, India, Indicates Improvement and Effectivity of Salt Iodization.

OBJECTIVE To study the total goiter rate (TGR), urinary iodine concentration (UIC), and salt iodine content among school children in a previously endemic area for severe iodine deficiency disorder (IDD). DESIGN Cross-sectional epidemiological study. SETTING The study was carried out in the Gonda district (sub-Himalayan region) of North India. PARTICIPANTS Nine hundred and seventy-seven school children (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. RESULTS 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% vs. 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 (IQR: 94.5-244.9). At the time of the study, 97% of salt sample were iodized and nearly 86% of salt samples had iodine content higher than or equal to 15 ppm. Overall, TGR was significantly lower (2.8% vs. 31.0%, p<0.001), and median UIC was significantly higher (157.1 vs. 100.0 μg/L, p<0.05) than reported in the same area in 2009. CONCLUSIONS A marked improvement was seen in overall iodine nutrition in the Gonda district after three and a half decades of USI. To sustainably control IDD, USI and other programs such as health education, must be continuously implemented along with putting mechanisms to monitor the program at regular intervals in place.