A cross-sectional survey of iodine deficiency disorders among school children (aged: 6–12 years) in Kashmir valley, Northern India

Abstract

Objectives of the Study: The objectives of the present study which was conducted in four districts of Kashmir valley (Anantnag, Baramulla, Budgam, and Srinagar) were to (1) estimate the “total goitre rate” (TGR) among schoolchildren in the age group of 6–12 years, (2) estimate the proportion of households with adequately iodized salt, and (3) to assess the dietary iodine intake by measuring urinary iodine levels. Study Design: Prospective, cross-sectional study. Methodology: The present study was conducted in the four districts of Kashmir Valley, namely Anantnag, Baramulla, Budgam, and Srinagar in March 2017. This was a school-based study among children in the age group of 6–12 years. For each district, 30 schools were randomly selected using Probability Proportionate to Size sampling. A total of 90 students (45 boys and 45 girls) were randomly selected from each school. Selected children were examined by trained doctors for the presence of goitre. Every 5th child in the school was selected for the collection of the salt sample from the child's house. Every 10th child in the school was selected for the collection of the urine sample for iodine estimation. Results: A total of 10,800 children in the age group of 6–12 years were examined in the four districts. The overall TGR for the four districts combined was 14.8%. The TGR was the highest in district Budgam (16.4%) and lowest in district Anantnag (13.8%). Across all districts, ≤1% of the examined children had a goitre of Grade II. In districts Baramulla, Budgam, and Srinagar, an increasing trend in TGR was observed with age. The median urinary iodine ranged from a minimum of 46.14 μg/L in district Baramulla to a maximum of 56.06 μg/L in district Anantnag. Conclusion: The TGR was high in all the four districts, way beyond the 10% iodine deficiency disorder control goal that was to be achieved by the year 2012. Moreover, the population level median urinary iodine was less than the recommended ≥100 μg/L in all the four districts. Except for district Anantnag, all three districts had median urinary iodine levels of <50 μg/L indicating moderate iodine deficiency.