THE PREVALENCE OF GOITER AND CRETINISM IN A POPULATION OF THE WEST IVORY-COAST

Iodine deficiency is a major public health problem in. developing coun tries. The main areas where goitre is prevalent have been identified b ut the different degrees of severity and the populations affected have not. Most countries are now attempting to obtain reliable and more ex tensive data. A pilot study was carried out in the Ivory Coast in orde r to improve epidemiological knowledge of iodine deficiency and collec t the information required to set up an elimination programme. The aim of this study was to assess the prevalence of goitre and cretinism an d to measure the main biochemical indicators of thyroid function (T3, T4 and TSH). The study involved 1433 people identified from a census. The prevalence of goitre was 50.3%. There was a significant difference between the examined ethnic groups: 52.7% of the Yacouba and 28.6% of the non-Yacouba had goitre. The most affected age group was 15 - 45 y ear The predominance of women demonstrated the susceptibility of women at child-bearing age to develop the condition. The prevalence of cret inism was approximately 1.5%. Through the assessment carried out using a grid of clinical indicators, it was possible to identify 10 cases o f laboratory proven myxedematous cretinism due to hypothyroidism. The concentration of iodine in foodstuffs was below the limit of detection (< 7.5 mu g/kg) and iodine could not be detected in the water (< 1 mu g.l) The biological profile of the population was affected to a very limited extent with a mean value (+/- standard deviation) for TSH of 1 .93 (+/- 1.56) mIU/l (0.1 - 4.0) and a free T4 value of 10 (+/- 3.46) pmol/l (8.2 - 20). These initial results confirm the high prevalence o f endemic goitre and the low iodine content of the soil, water and foo d in the investigated region. The study will be complemented by a nutr itional investigation to improve the understanding of iodine balance, after which an appropriate action plan will be proposed.