IODINE DEFICIENCY AND ENDEMIC GOITER IN THE LANGKLOOF AREA OF SOUTH-AFRICA

Objective. To quantify the prevalence of iodine deficiency and endemic goitre in the Langkloof area. Design. A cross-sectional study. Settin g. Four primary schools in four communities in the Langkloof, Subjects . 565 primary schoolchildren from Standard 2 to Standard 5. Outcome me asures. Clinical diagnosis of thyroid size by palpation, level of iodi ne in urine and drinking water samples, level of iodine in iodised sal t samples from the area, percentage of households with iodised salt on the premises, and anthropometric measures of body height and weight. Results. The prevalence of endemic goitre varied from 14.3% to 30.2% i n the four communities and, based on urinary iodine levels, the iodine deficiency ranged from mild to severe. Both iodised and non-iodised s alt were available at the local grocery stores but only small percenta ges of households had iodised salt in the house. The iodine content of drinking water was low. Anthropometric indices of undernutrition indi cated medium to high levels of stunting in three of the four communiti es, the worst being in the community with the highest goitre prevalenc e. Conclusions. Endemic goitre caused by iodine deficiency is a public health problem in the Langkloof, varying in severity from mild to sev ere in the different communities. The impact of mandatory iodisation o f table salt, introduced at the end of 1995, needs to be assessed in t hese communities.