Sameena Ghayur, Saima Siddiqui, M Maqbool Alam, Asma Shaukat, Farooq Ahmad Khan.
Spectrum of Iodine Deficiency in School Children of Rawalpindi.
Pak Armed Forces Med J Jan ;51(1):27-32.

Pakistan is recognized as one of the severely affected regions of the world regarding iodine deficiency disorders (IDD) and the Northern areas of Pakistan are highly endemic. According to a press release issued by UNICEF in 1994, IDD prevalence of 72% in a city like Islamabad was quoted. Hence a study was carried out to find the prevalence and severity of iodine deficiency disorders in school children of Rawalpindi based on the estimation of urinary iodine, serum thyroid stimulating hormone (TSH) levels and presence of goitre. School children aged 8-12 years were randomly selected from four different schools. The goitre was assessed by visual and palpation method. The blood was analyzed for TSH and spot urine for urinary iodine excretion. The values of TSH ranged between 0.5-7.39 mIU/l (within batch and between batch cv of 5.7 and 7.3% respectively). Only 4% children had TSH above the reference range (0.4-4 mUI/l). Low urinary iodine was found in 109 children which ranged between < 2-10 ug/dl. No significant difference was noted regarding the use of iodized salt in the children as the urinary iodine excretion was almost the same in the two groups. Goitre assessment showed a total goitre rate of 9.5% in the children (n=210). Reference range (8.6-18.2 ug/dl) for urinary iodine was established for urinary iodine in children with normal TSH (n=210). It is concluded that the severity of IDD is not more than 10% and definitely not high as already published.

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