ENDEMIC GOITER AND CRETINISM IN THE SIMBAI AND TEP-TEP AREAS OF MADANG PROVINCE, PAPUA-NEW-GUINEA

In the late 1960s and early 1970s a mass campaign of iodized oil injec tions was carried out in Papua New Guinea as an interim measure to imp rove iodine status in the population and to prevent endemic goitre and endemic cretinism. Following informal reports of children with neurol ogical abnormalities resembling endemic cretinism in two areas of Mada ng Province, the Simbai and Tep-Tep Subdistricts, surveys were conduct ed in these areas in 1985 to establish prevalence rates of goitre and cretinism in order to determine whether they had returned as public he alth problems. 42% of the Simbai population and 38% of the Tep-Tep pop ulation attended for examination. Amongst those surveyed, the visible goitre rate was low: 0.1% in the Simbai and 2.5% in the Tep-Tep area. Although the iodized oil patrols were carried out a decade previously, goitre does not seem to have re-emerged in the area to the levels rep orted previously. In the Simbai villages surveyed, there were nine ind ividuals diagnosed as suffering from cretinism, three of whom were tho ught to have been born after the last iodized oil patrol in the area. In the Tep-Tep villages, eight subjects were diagnosed as suffering fr om cretinism, all of whom were thought to have been born before the io dized oil patrols. A number of younger children with neurological abno rmalities which did not fulfil criteria for endemic cretinism were als o seen in both areas. Because of the difficulties in diagnosing endemi c cretinism in young children, it is not possible to conclude that end emic cretinism is no longer a problem in these areas. More work is nee ded to confirm the results of these studies. This will enable a ration al control program to be designed and implemented.