Impact assessment of salt iodization on the prevalence of goiter in district Swat

Background: To eliminate Iodine Deficiency Disorders, (IDD) universal salt iodization is the widely practiced intervention. District Swat (a hilly area of NWFP, highly endemic for IDDs is selected as a first model district of the province for salt iodization program. Objectives: To find out the proportion of the families using iodized salt, iodine contents of the salts used by the families, urinary iodine levels in school children and the effect on goiter prevalence in Swat selected as a model district in 1998. Subject and Methods: The study was conducted in 960 children of both sexes, age 8-10 years in primary schools of district Swat in the year 2000. A replicate model used for base line study in 1998 was adopted. The students were clinically examined for goiter using palpation method. 960 edible salt samples for its iodine content and 240 urine samples for iodine level were analysed. Results: The overall goiter prevalence was found to be 52 and 45% in boys and girls respectively. 23% salt samples were found un-iodized, while in 25.6% the iodine content was less than 7ppm. The results revealed 18% decrease in total goiter rate and 35% increase in the use of iodized salt from the base line survey conducted in 1998, in school children of district Swat. Conclusions: The study revealed that since the area of Swat is still highly endemic for Iodine Deficiency Disorders, sustained efforts are required to ensure 100% salt iodization. (author)