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.
Design: 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.
Subjects: 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 mu g/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 mu g/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.