URINARY IODINE EXCRETION IS THE MOST APPROPRIATE OUTCOME INDICATOR FOR IODINE DEFICIENCY AT FIELD CONDITIONS AT DISTRICT LEVEL

To empower local authorities to plan and evaluate adequate interventio ns, appropriate iodine deficiency disorders (IDD) indicators need to b e identified. The aim of this study was to describe the magnitude and severity of IDD with different outcome indicators and associate them w ith functional indicators. Schoolchildren (n = 544) aged 8-10 y were a ssessed in 11 villages within five subdistricts of Malang District, Ea st Java, Indonesia. Outcome indicators of IDD were goiter size as meas ured by palpation and ultrasonography (USG), urinary iodine excretion (UIE) and serum thyroid stimulating hormone (TSH) concentration in blo od as well as functional indicators such as intellectual performance ( IQ: Catell's Culture Fair Intelligence Test) and anthropometric indice s. The total goiter rate (TGR) measured by palpation and USG were 35.7 and 54.4%, respectively. Based on UIE and TSH, the prevalence of iodi ne deficiency was 63.7 and 3.4%, respectively. In individuals, goiter, thyroid volume and UIE were associated significantly (r = -0.35; P < 0.001 and r = -0.30; P = 0.02 respectively). Among villages, TGR measu red by palpation was significantly correlated with thyroid volume (r = 0.61; P = 0.045) and UIE (r = 0.68; P = 0.021), whereas TSH was not s ignificantly associated with any of the observed indicators in individ uals or groups. Multiple regression analysis showed that USG (beta = - 0.67; P < 0.001) and UIE (beta = 4.39; P = 0.008) related significantl y with cognitive performance (IQ). The associations between IDD indica tors and cognitive performance and height-for-age Z scores suggest tha t socioeconomically advantaged children had better iodine status. We s uggest that UIE is the best indicator for local authorities to assess iodine deficiency.