Continuous Adequate Iodine Supplementation in Fars Province: The 2007 Goiter and Urinary Iodine Excretion Survey in School Children

Background: The iodine deficiency elimination program that began two decades ago resulted in Iran becoming an iodine deficiency disorders free country in the Middle East region. The present study was performed to evaluate the adequacy of iodine supplementation after 17 years of universal salt iodization in Fars province. Methods: In a cross-sectional study, 1200 schoolchildren (480 girls and 720 boys) aged 8 to10 years, were randomly selected from Fars province and evaluated in 2007. Goiter prevalence, urinary iodine excretion, and iodine content of household salts were measured and the data were compared with those obtained in 1996 and 2001. Results: Total prevalence of goiter was 1.3% (CI: 0.53-2.47) and no grade 2 goiter was found. One-tenth of the children enrolled for goiter assessment, were randomly selected for urinary iodine measurement. The median urinary iodine in these 120 schoolchildren was 159.4 µg/L (85.6-252.3), with 14.8% having urinary iodine excretion less than 50 µg/L. 98% of households were using purified iodized salt. 70% of households had appropriate salt storage and none of the household salts contained less than 15 µg iodide. Conclusion: Goiter prevalence has significantly decreased in the Fars province, 17 years after universal salt iodization. The median urinary iodine of schoolchildren was adequate as that reported in 1996 and 2001, indicating a well established sustainable iodine deficiency elimination program in the province