Why Not Children First? This article offers some ideas to help in formulating a new ethos in each country. One of the many issues discussed in relation to services for children is the elimination of Iodine Deficiency Diseases. An immediate focus on elimination of Iodine Deficiency Diseases can build confidence. Consumption of appropriate levels of iodine daily has already prevented millions of cases of mental retardation. Children have a right to reach their genetic potential through elimination of iodine deficiency. The elimination of IDD can be the greatest public health achievement since the eradication of small pox. It affects more people than polio and guinea worm. We know what to do; what it costs; how to do it: iodize common table salt.
by D.P. HAXTON [in Africa Topics 1997]
Letter to the editor: Topical Iodine, Breastfeeding, and Neonatal Hypothyroidism :
by C. ABRASSART, J.P. Chanoine, P. Bourdoux, & F. Delange [in Archives of Disease in Childhood {pages 106-107} vol. 63: 1988.]
Original Articles: Current Status of Endemic Goitre in Some Areas of Sub-Himalayan Belt: The prevalence of endemic goitre was assessed in 4,680 school children of Pilibhit (Uttar Pradesh), Simia, Mandi, Bilaspur and Sundernagar (Himachal Pradesh), Jammu & Kashmir, Champaran (Bilhar), Kamrup (Assam), Kohima (Nagaland) and Imphal (Manipur). The prevalence rate was 67.2% in Champaran, over 50% in Simla with an average figure of 31% for Himachal Pradesh, around 40% in Pilibhit, 25.2% in Imphal, 23.2% in Kamrup and in 5.3% in Kohima. The districts of Pilibhit and Kamrup are not receiving iodised salt as yet. The prevalence was higher during adolescence. The grade 3 and 4 goitres were observed in school children from areas uncovered by iodised salt.
These states were mainly dependent on the Goitre Control Programme of the Ministry of Health, for survey, legislations, supply of iodized salt, public awareness etc. The state health departments have not provided any iodine preparation in these affected areas even for treatment of grade 3-4 goitres. These observations suggest that endemic areas should be provided sufficient public awareness, immediate supply of iodised salt and safe drinking water, and calls for local iodization plants and raising the iodine level in salt.
by D. K. AGARWAL, & K.N. Agarwal [in Indian Pediatrics {pages 471 - 477} vol. 20: July 1983.]
Prevalence of Iodine Disorders Among School Children of Delhi: This study showed that IDD continues to be prevalent in mild endemic proportions. Compared to the results of previous surveys, the IDD rate have declined in the last few years. However, it continues to be an important public health problem in Delhi. It is essential to monitor the iodine content of salt on a regular basis. IDD control activities should be done every 3-5 years to monitor the progress achieved in eliminating IDD.
by Pandav, C.S., Mallik, A., Anand, K., Pandav, S., and Karmarker, M.G. [in The National Medical Journal of India {Pages 112-114}:Vol. 10, No. 3, May/June, 1997.]
Salt in Asia's Wound - Lack of Iodine is Still a Major Cause of Disease in India:
by Patel, Tara [in New Scientist {Page 17}, September 1988.]
Prevention of Iodine Deficiency Disorders in Kenya - A Preliminary Investigation of the Iodine Content of Salt on Sale in Western Kenya: Iodine deficiency disorders are known to be a potential problem for large numbers of people living in the highland areas of Western Kenya. The principal strategy for preventing these disorders is the fortification of table salt with potassium iodate. The present study shows that samples of salt purchased in small stores in Western Kenya, although labelled as containing iodine, contained a much lower concentration of iodine than desirable.
by D. J. ALNWICK [in East African Medical Journal {Pages 723-726} vol. 65:Number 11, November 1988.]
I disordini extra-tiroidei da carenza iodica. Qual e il real fabbisogno di iodio? (Extrathyroid Iodine Deficiency Disorders. What is the Real Iodine Requirement?):The authors report a recent review of the most important extrathyroid IDD in relation to: stomach, immune system, mammary glands, ovaries, arterial and articular system, epidermis and nervous system. All there organs concentrate about 80% of total body iodine in humans and animals, but the role of this extrathyroid iodine is not known. The hypothesis is that this iodine might have a specific antioxydant role, from primitive algae, which contain the highest level of iodine, and which were the first living cells to produce oxygen. So we believe that this phylogenetically ancient antioxydant role is important also in animals and humans. In fact the thyroid gland is only a phylogenetically modern organ, which was improved from primitive Chordates to more recent Mammalia. In the references are reported different studies on the antioxydant ability of iodine in rates and in humans.
by Venturi S., Guidi A., Venturi M. [Le Basi Razioneali Della Terapia (Journal of Italian Society of Pharmacology) {Pages 267-75}, 1996.]
Seven Deadly Sins in Confronting Endemic Iodine Deficiency, and How to Avoid Them:A useful personal view and up-date from Dr. John Dunn, who has provided technical advice and assistance to many UNICEF offices on IDD. The fact that the article was published in the Journal of Clinical Endocrinology and Metabolism and therefore presumable reaches many endocrinologists is noteworthy. The article should be of interest to everyone who is concerned with monitoring progress towards IDD elimination and sustaining the progress achieved.
by John T. Dunn [Journal of Clinical Endocrinology and Metablism {Pages1332-} 1996]
Addressing Micronutrient Malnutrition: This article was adapted from the paper "Best Practices in Addressing Micronutrient Malnutrition".
by J. McGuire [in SCN News No. 9]
TSH-Regulation and Goitrogenesis in Severe Iodine Deficiency: Since goitre prevalence increases sharply during the first two decades of life, age-related changes in adaptation of the thyroid to iodine deficiency may occur. In order to study this, we have measured serum levels of TSH, T4 and T3 in 217 subjects (age range 5 to 60 years) living in an endemic goitre area of North Algeria (group A) and in 64 control subjects living in the non-iodine deficient city of Algiers (group B). TRH tests were also preformed in 88 subjects from the goitrous area and in 30 controls.
Patients from group A had significantly higher serum TSH and T3 and lower serum T4 than those from group B. Analysis of group A by age groups revealed significantly higher TSH concentrations in the 2-9 years group and a moderate but significant decrease in the 50-59 years. No significant changes were demonstrated for T4 and T3.
In the goitrous area, the response of TSH to TRH was exaggerated and prolonged. /\TSH20 was inversely correlated with age. The different age groups showed a significantly progressive and continuous decrease of /\TSH20, /\TSH60, /\TSH120 from age 10-19 to age 50-59 years.
Our findings thus show a sharp increase of TSH during the first decades of life, which coincides with the phase of maximal growth of the thyroid gland. These results suggest that TSH plays a definate role in the genesis of endemic goitre. The subsequent progressive decrease of TSH secretion and reserve, with unchanged T4 and T3, imply a gradual development of autonomous activity in longstanding multinodular goitre.
by H. BACHATARZI, & M. Benmiloud [in Acta Endocrinologica {pages 21 - 27} vol. 103: 1983.]
Other Methods of Control of Iodine Deficiency Disorders:
by K. V. BAILEY [in Control of Iodine Deficiency Disorders in Africa-Report of the WHO/UNICEF/ICCIDD Yaounde, Cameroun, 23-25 March 1987AFR/NUT/99, April 1987.]
Oral Iodized Oil for Correcting Iodine Deficiency: Optimal Dosing and Outcome Indicator Selection:This article discusses a study from Algeria intended to better define the guidelines (using 5 indicators) for the use of iodized oil as a means of correcting iodine deficiency.
by MOULAY BENMILOUD, M.L. Chaoudi, R. Gutekunst, H. Teichert, W.G. Wood, & J.T. Dunn [in Journal of Clinical Endocrinology and Metabolism {p.20-24} vol. 79:1, 1994.]
Nutritional Problems of Developing Countries: This article describes selected aspects of the ecology and epidemiology of the major nutritional problems of developing countries, including both the primary risk factors for undernutrition and the functional consequences of nutritional deficiencies. Because of the presumed audience of this journal, particular attention is directed to relationships between nutrition and infection. Finally, the range of available nutrition intervention programs is briefly discussed, including a special section on IDD.
by Brown, K. and Solomons, N. [in infectious Disease Clinics of North America. vol. 5, 1991.]
The Micronutrient Forum:
Brief summary of The Micronutrient Forum, a symposium held to promote the exchange of information on policies and programs in Geneva, Switzerland Feb 15-16, 1993.
by HOWARTH BOUIS, & F.L. Trowbridge [in SCN News {p.28-32}9, Mid 1993.]
Iodine Deficiency Diseases in Switzerland One Hundred Years after Theodore Kocher's Survey: A historical review with some new goitre prevalance data: In certain regions of Switzerland, before prophylaxis, 0.5% of the inhabitants were cretins, almost 100% of schoolchildren had large goitres and up to 30% of the young men were unfit for military service owing to a large goitre. Iodization of salt was introduced in 1922 at 3.75 mg I per kg and the iodine content was doubled twice, in 1962 and in 1980, to the present 15 mg I per kg. In 1988, 92% of retail salt and 76% of all salt for human consumption (including food industry) was iodized, even though its use is voluntary. Urinary iodine excretion, previously between 18 and 64 mg per day, has now risen to 150 mg per day. No new endemic cretins born after 1930 have been identified. Goitre disappeared rapidly in newborns and school children, more slowly in army recruits and incompletely in elderly adults. In some Cantons (by constitution in charge of health and the salt monopoly) which allowed iodized salt only in 1952, disappearance of goitre lagged behind accordinly, proof that iodized salt was the cause of regression. The Swiss data provide evidence that isolated deafness, mental deficiency, and short stature, each without the other attributes of cretinism have also decreased. Adverse effects of iodized salt were minimal, possibly because the initial iodine content of salt was chosen very low. Iodization of salt has proved a highly cost-effective preventive measure in Switzerland.
by HANS BURGI, Z. Supersaxo, & B. Selz[in Acta Endocrinologica (Copenh) {pages 577 - 590} vol. 123: 1990.]
Childhood IQ Measurements in Infants with Transient Congenital Hypothyroidism:
OBJECTIVE In view of the fact that, during the first period of life, thyroid hormones are critical for brain development, we investigated whether even transient congenital hypothyroidism could affect the long-term intellectual development of affected infants.
DESIGN A case-control study of intellectual development, auxometric parameters and thyroid function per formed in late infancy in children with documented transient congenital hypothyroidism or hyperthyrotrophinaemia at birth.
PATIENTS Nine children born in an endemic goitre area who had short-term transient congenital hypothyroidism or hyperthyrotrophinaemia after birth (TCH) were studied and compared to nine matched children born in the same area at the same time but having normal thyroid function al birth (N).
MEASUREMENTS Global, verbal and performance IQs were evaluated on the Wechsler scale. Height, bone age, total and free thyroid hormones, thyroid volume, thyroglobulin, basal and TRH stimulated TSH were also measured.
RESULTS Height and bone age were similar in the two groups. Thyroid function tests were also similar in the two groups except for basal and TRH stimulated serum TSH and serum Tg which were higher in the TCH than in the control group. Global, verbal and performance lQs were systematically lower in the TCH than in the N group. (78.3±11.1 vs 90.9±14.2 , p<0.05; 84.4±15.4 vs 96.2±14.8, p NS; 75.0±8.5 vs 89.2±12.5, p<0.01 respectively).
CONCLUSION Infants born and living in an endemic goitre area, who had biochemical signs of thyroid hypo-function at birth, had a lower intelligence quotient at the age of 7-8 years than matched controls living in the same environmental conditions but with normal thyroid function at birth. The present findings strongly suggest that abnormalities in thyroid function at birth, even when transient, can adversely affect long-term intellectual development.
by FRANCESCA CALACIURA, G. Mendorla, M. Distefano, S. Castorina, T. Fazio, R.M. Motta, L. Sava, F. Delange, & R. Vigneri [in Clinical Endocrinology {pages 473-477} vol. 43: 1995.]
Iodination of Irrigation Water as a Method of Supplying Iodine to a Severely Iodine-Deficient Population in Xinjiang, China:
This article addresses the advantages and cost-effectiveness of water iodization as a means of supplying iodine in China.
by XUE-YI CAO, J. Xin-Min, A. Kareem, Z. Dou, M.A. Rakeman, Z. Ming-Li, T. Ma, K. O'Donnell, & et al.[in The Lancet {p.107-110} vol. 344: July 9, 1994.]
Timing of Vulnerability of the Brain to Iodine Deficiency in Endemic Cretinism:
This article discusses a study carried out in China which addressed the protective effects of iodine treatment on the fetal brain during different pregnancy periods.
by XUE-YI CAO, J. Xin-Min, Z. Dou, M.A. Rakeman, Z. Ming-Li, K. O'Donnell, T. Ma, & et al. [in New England Journal of Medicine {p.1739-44} vol. 331: Dec 29, 1994.]
Increased Recall Rate at Screening for Congenital Hypothroidism in Breast Fed Infants Born to Iodine Overloaded Mothers:
SUMMARY-Skin disinfection with povidine-iodine (PVP-I) is widely used in obstetrics. We evaluated the influence of PVP-I in mothers at delivery on the serum thyroid stimulating hormone concentrations of their infants at the time of screening for congenital hypothyroidism. The study covered 4745 infants who were either breast fed (3659, 77%) or bottle fed (1086, 23%); 3086 (65%) of them were born to mothers with no iodine overload (controls) and 1659 (35%) to mothers with iodine overload. Compared with the control group, the breast and bottle fed infants born to mothers with iodide overload had a shift of neonatal thyroid stimulating hormone concentration towards higher values. The shift was maximal in the breast fed infants with a 95 to 30 fold increase in the recall rate at screening for congenital hypothyroidism (serum thyroid stimulating hormone >50 mU/l) while in the bottle fed infants the recall rate was barely modified. In conclusion. the use of PVP-I in mothers at delivery induces a transient impairment of thyroid function in their infants, especially if breast fed. This situation is detrimental to screening for congenital hypothyroidism. Consequently, PVP-I is not recommended for obstetric use.
by J. P. CHANOINE, M. Bouvain, P. Bourdoux, A. Pardou, H.V. Van Thi, A.M. Ermans, & F. Delange [in Archives of Disease in Childhood {pages 1207-1210} vol. 63: 1988.]
Letter to the editor: Withdrawal of Iodinated Disinfectants at Delivery Decreases the Recall Rate at Neonatal Screening for Congenital Hypothyroidism:
by J. P. CHANOINE, A. Pardou, P. Bourdoux, & F. Delange [in Archives of Disease in Childhood {pages 1297-1298} vol. 63: 1988.]
Stability of Iodized Salt with Respect to Iodine Content:
This article discusses the results of a study of the stability of iodine in salt that is packed in bags and stored for 10 months.
by S. A. CHAUHAN, A.M. Bhatt, M.P. Bhatt, & K.M. Majeethia [in Research and Industry {p.38-41} vol. 37: Mar 1992.]
Lack of Simple Elements Puts Millions at Risk:
An article in full-color with a picture, diagram (of the thryoid gland) and global map (of IDD prevalence). The article has several sections:
- -Tackling a little-known epidemic
- -Iodine can't be synthesized
- -Effort to cost $ 75 million.
by BROWN DAVID [in Washington Post {Science/Nutrition} Mar 17, 1995.]
Combating Iodine Deficiency Disorders in Kenya: the Need for a Multi-disciplinary Approach:
Examines the possible causes of IDD in Kenya and emphasizes the potential effectiveness of a multi-disciplinary approach in the prevention and control of IDD. Table of contents is:
- Introduction
- Occurence and control of IDD in Kenya
- Possible role of goitrogenes in the etiology of IDD in Kenya
- Plan of therapy
- The need for a multi-disciplinary approach
- Conclusion
- Acknowledgements
- References.
by T. C. DAVIES [in International Journal of Environmental Health Research {p.236-243}4, 1994.]
Invited Commentary: Correction of Iodine Deficiency: Benefits and Possible Side Effects:
by F. DELANGE [in European Journal of Endocrinology {pages 542 - 543} vol. 132: ISSN 0804-4643; May 1995.]
Mother and Child, the Target Population in Conditions of Iodine Deficiency:
- -Incidence of iodine deficiency and brain damage
- -Mechanism of cretinism and retardation
- -Prevention.
- by F. DELANGE [in Journal of Endocrinology {Abstract # 18 (half page)} vol. 123 supplemental: November 1989.]
Reviews/Analyses: Iodine Deficiency Disorders in Europe:
Recent data on iodine excretion in the urine of adults, adolescents and newborns and on the iodine content of breast milk indicate a high prevalence of iodine deficiency (moderate in many cases and severe in a few) in many European countries. These cases may manifest as subclinical hypothyroidism in neonates and as goitre in adolescents and adults. Lack of iodine causes not only goitre, but also mental deficiency, hearing loss and other neurological impairments, and short stature due to thyroid insufficiency during fetal development and childhood. Although iodinated salt is available theoretically in most countries where it is needed, its quality and share of the market are often unsatisfactory. In many countries where only household salt is iodinated the iodine content has been set too low owing to an overestimation of household salt consumption. Governments are therefore urged to pass legislation and provide means for efficient iodination of salt wherever this is necessary.
by F. DELANGE, & H. Burgi [in Bulletin of the World Health Organization {pages 317 - 325} vol. 67:Number 3, 1989.]
Regional Variations of Iodine Nutrition and Thyroid Function During the Neonatal Period in Europe:
In order to evaluate further the possibility that transient hypothyroidism and hyperthyrotropinemia in newborn infants could result from a state of relative iodine deficiency, the urinary concentration of iodine, used as an index of the dietary intake of iodine was determined in casual urine samples collected in 1~_076 full-term infants aged 3-6 days in 1t cities in 10 different European countries and in Toronto, Canada. In addition, the results obtained by programs of systematic neonatal screening for congenital hypothyroidism in the same areas were compared. There were marked regional differences in iodine nutrition during the neonatal period in Europe (median urinary iodine: 16.2 mg/dl in Rotterdarn, the Nether-lands, and 1.1 mg/dl in Freiburg, FRG. A low iodine supply in newborn populations was accompanied by, and probably explained, an elevated frequency of transient disorders o thyroid function in young infants. Iodine prophylaxis is urgently needed in some European countries not only for the prevention of goiter, but mostly for the prevention of impairment of thyroid function during the critical period of brain development.
by F. DELANGE, P. Heidemann, P. Bourdoux, A. Larsson, R. Vigneri, M. Klett, C. Beckers, & P. Stubbe [in Biology of the Neonate {pages 322-330} vol. 49: 1986.]
Reduction of the Iodine Stores of the Thyroid in Iodine Deficient Newborns:
by F. DELANGE, P. Walfish, H. WIllgerodt, P. Bourdoux, L. Bachrach, & G. Burrow [in Hormone Research {Abstract # 297} vol. 31: 1989.]
An Agricultural Approach to Preventing Iodine Deficiency Disorders: effects of iodination of irrigation water on crop and animal production in China:
In 1992, iodination by dripping an aqueous solution of potassium iodate into irrigation water was instituted for the control of severe IDD in four rural villages. Results indicate that iodine-treatment of irrigation water increased iodine availability levels in crops and livestock.
by G. R. DELONG, X.M. Jiang, M.A. Rakeman, & et al. [in Food-Based Approaches to Preventing Micronutrient Malnutrition {p.35} 1996.]
Clinical Picture of Endemic Cretinism in Central Appennines (Montefeltro), Italy:
- 1. Abstract
- 2. Introduction
- 3. Patients and Methods
- 4. Results
- Myxedematous cretinism
- Neurologic cretinism
- Mixed cretinism
- 5. Discussion.
by L. DONATI, A. Anatonelli, F. Bertoni, D. Moscogiuri, M. Andreani, S. Venturi, T. Filippi, L. Gasperini, S. Neri, & Baschieri. L [in THYROID {Pages 283 - 290} vol. 2:Number 4, 1992.]
Prevalencia del Bocio, Eliminacion Urinaria de Yodo y Niveles de Tiroxina en Escolares Residentes en Areas Montanosas de Andalucia (Translation is "Urinary Excretion Levels of Iodine and Thyroxine, and the Prevalence of Goiter in Schoolchildren from Mountainous Areas of Andalucia"): En Español/In Spanish.
This article, with an abstract in English, is about a study conducted to investigate the prevalence of goiter, urinary excretion of iodine and serum thyroxine levels in school-children living in mountain areas in Andalucia.
by S. DURAN GARCIA, M. Rivas Fernandez, A. Torres Olivera, C. Costa Mestanza, B. Duarte Ortiz de Zarate, & F. Escobar del Rey [in Endocrinologia Organo de la Sociedad Espanola de Endocrinologia {p.15-22} vol. 34:2, Julio de 1987.]
Iodine Deficiency in Himalayas is Believed to Disable Millions:
by ERIK ECKHOLM [in New York Times {p. C3} Tuesday, April 2nd, 1985.]
Combatting Iodine Deficiency Disorders (IDD) in East Africa:
EDITORIAL [in East African Medical Journal {Pages 721-722} vol. 65:Number 11, November 1988.]
Prevention and Control of Iodine Deficiency Disorders:
EDITORIAL [in The Lancet {pages 433-434} vol. 2: August 23, 1986.]
Overview of Iodine Deficiency Disorders in Africa Epidemiology and Consequences of IDD:
by O. L. EKPECHI [in Control of Iodine Deficiency Disorders in Africa - Report of the WHO/UNICEF/ICCIDD Yaounde, Cameroun, 23-25 March 1987AFR/NUT/99, April 1987.]
Goitre and Iodine Deficiency in Spain:
by F. ESCOBAR DEL RAY [in The Lancet {pages 149 - 150} vol. 2: July 29, 1985.]
El Bocio Endemico en Dos Zonas de Guadalajara y su Evolucion Tras la Administracion de Aceite Yodado (Lipido) (Translation is "Endemic Goitre in Two Zones of Guadalajara and its Evolution After the Administration of Iodized Oil (Lipiodol)"): En Español/In Spanish.
This article, with an abstract in English, is from a study conducted among school-children (6-14 years of age) from Atienza and Molina de Aragon; which determined the prevalence of goitre, their urinary iodine and creatinine excretion levels, and circulating thyroxine levels.
by F. ESCOBAR DEL REY, J. Mallol, Turmo C., J.M. Jimenez Bustos, A. Garcia Garcia, Gomez Pan A., & G. Morreale De Escobar [in Endocrinologia Organo de la Sociedad Espanola de Endocrinologia {p.53-60} vol. 34:2, 1987 de Julia.]
Effects of Maternal Iodine Deficiency on the L-Thyroxine and 3, 5, 3'-Triiodo-L-Thyronine Contents of Rat Embryonic Tissues Before and After Onset of Fetal Thyroid Function:
Female rats were placed on a low iodine diet (LID) or LID supplemented with KI. They were mated 3-6 months later. Maternal and embryonic tissues were otained both before the onset of fetal thyroid function, at 11 and 17 days of pregnancy, and at 21 days of gestation. T4 and T3 concentrations were measured by RIA. T4 concentrations were very low in the plasma, liver and lung of LID dams and in all embryonic samples obtained from such mothers, namely 11-day-old embryotrophoblansts, 17-day-old placentas and embryos, 21-day-old placentas, embryos, plasma, liver, lung, and carcass (whole embryos minus the trachea, thyroid, blood, liver, and brain). T3 was low in 17-day-old placentas and embryos and in all fetal tissues obtained at 21 days of gestation from LID dams. These results show that when iodine deficiency is severe enough to result in very low maternal plasma T4 levels, embryonic tissues are deficient in T4 and T3 both before and after the onset of fetal thyroid function. This finding might be relevant to the etiopathology of human iodine deficiency disorders.
by FRANCISCO ESCOBAR DEL REY, R. Pastor, J. Mallol, & G. Morreale de Escobar [in Endocrinology {pages 1259 - 1264} vol. 118:4, 1986.]
Goitre and Iodine Deficiency in Europe:
The prevalence of endemic iodine-deficiency goitre in Europe has been reduced in many areas by the introduction of iodination programmes. Recent reports; however, show that goitre remains a significant problem and that its prevalence has not decreased in a number of European countries. Hetzel has pointed out that the high global prevalence of iodine-deficiency disorders could be eradicated within 5-10 years by introduction of an iodized salt programme. The current World Health Organization recommendation for iodine intake are between 250 and 300 m g/day.
by EUROPEAN THYROID ASSOCIATION, SUBCOMMITTEE FOR THE STUDY OF ENDEMIC GOITRE AND IODINE DEFICIENCY IN EUROPE[in The Lancet {pages 1289-1293} vol. 2: June 8, 1985.]
Endemic Goitre in Sri Lanka:
This survey examined 59,158 children from 87 schools in 17 out of 24 districts in Sri Lanka for goitre. The overall prevalence rate was 18.8%: 23.2% for girls and 14.0% for boys. Prevalence in districts varied from 30.2% in Kalutara to 6.5% in Matale. It was higher in rural than urban areas, and in inland than coastal areas. The sex ratio of prevalence rates was directly related and the ratio of palpable to visible goitre was inversely related to the severity of the endemic. It is suggested that for a rapid epidemiological assessment when the latter ratio is less than four, it is indicative of endemicity for public health purposes and calls for intervention. The iodination of salt is both practical and feasible in Sri Lanka.
by M. A. FERNANDO, S. Balasuriya, K.B. Herath, & S. Katugampola [in Asia-Pacific Journal of Public Health {pages 11 - 18} vol. 3:Number 1, 1989.]
100 Anos de Literatura sobre el Bocio Endemico en Espana (Translation is "100 Years of Literature about Endemic Goiter in Spain"): En Español/In Spanish. This article, with an abstract in English, is a bibliographic compilation carried out (1) to give a precise documental information for those wishing to review the subject, starting at a certain moment, and (2) to identify the histographic framework and to analyze the knowledge evolution of endemic goitre in Spain. The compiled literature is arranged in three chronological parts, with distinctive characteristics of each being described:
- 1. Old bibliography (1885-1921)
- 2. Modern bibliography (1922-1936)
- 3. Contemporary bibliography (1945-1986).
by L. FERREIRO ALAEZ, & F. Escobar del Rey[in Endocrinologia Organo de la Sociedad Espanola de Endocrinologia {p.4-12} vol. 34:2, 1987 de Julia.]
A New Approach to Combatting Iodine Deficiency in Developing Countries: The Controlled Release of Iodine in Water by a Silicone Elastomer:
This article addresses a new approach to IDD eradication using the controlled diffusion of iodine into well water supplies from a silicone elastomer.
by ALAN FISCH, E. Pichard, T. Prazuck, R. Sebbag, G. Torres, G. Gernez, & M. Gentilini[in American Journal of Public Health {p.540-545} vol. 83:4, April 1993.]
Thyroid Development and Disorders of Thyroid Function in the Newborn:
- 1. Normal Development of the Thyroid
- - Early Ontogenesis
- - Later Maturation
- - Adaptation to the Extrauterine Environment
- 2. Abnormalities of Thyroid Function in the Newborn
- - Abnormalities in Early Ontogenesis
- - Transient Disorders of Thyroid Function: Immaturities Related to Late Ontogenesis.
by DELBERT A. FISHER, & A.H. Klein [in The New England Journal of Medicine {pages 702 - 712} vol. 304:12, March 19, 1981.]
Alteraciones por Deficiencia de Yodo en Las Hurdes. II. Evaluacion del desarollo psicomotor de escolares(Translation is "Alterations due to Iodine Deficiency in Las Hurdes. II. An evaluation of Psychomotor development in schoolchildren"): En Español/In Spanish. This article, with an abstract in english, describes a study conducted among schoolchildren from a zone of Las Hurdes with very severe iodine deficiency. An evaluation of their mental development, psychomotor abilities, motor-perceptive maturation and personality traits was conducted.
by I. GARCIA, C. Rubio, E. Alonso, C. Turmo, G. Morreale De Escobar, & F. Escobar del Rey [in Endocrinologia Organo de la Sociedad Espanola de Endocrinologia {p.74-87} vol. 34:2, 1987 de Julia.]
Effectos de la Administracion Oral de Aceite Yodado Sobre la Prevalencia del Bocio, Eliminacio Urinaria de Yodo y Niveles de Tiroxina en Areas de Endemica Bociosa de Andalucia Occidental (Translation is "Effects of the Oral administration of Iodized Oil on the Prevalence of Goiter, Urinary Excretion of Iodine and Serum Thyroxine Levels in Areas of Endemic Goiter in Western Andalucia"): En Español/In Spanish. This article, with an abstract in english, is about a research aimed to study the effects of the administration of 2 ml of oral ultrafluid Lipidiol on the prevalence of goiter, iodine urinary excretion and serum thyroxide in a group of school-children living in three endemic areas in mountain zones from western Andalucia.
by S. GARCIA DURAN, B. Duarte Ortiz de Zarate, J.C. Alvarez Benitez, J.E. Hutardo Ayuso, & et el. [in Endocrinologia Organo de la Sociedad Espanola de Endocrinologia {p.23-28} vol. 34:2, 1987 de Julia.]
A Review of Iodine Deficiency Disorders in Kenya: Studies of endemic goitre in 4 separate geographical areas of Kenya showed a high prevalence of goitre and low urinary iodine excretion in the highlands east and west of the Rift Valley. There was a highly significant negative correlation between total goitre rates and urinary iodine excretion (r = -0.9987, p< 0.001). Despite a gradual decrease in goitre rates and an increase in urinary iodine between 1969 and 1984, endemic goitre remains an important health problem requiring urgent and effective measures for its prevention and control.
by W. GITAU [in East African Medical Journal {Pages 727-733} vol. 65:Number 11, November 1988.]
A Randomized Trial for the Treatment of Mild Iodine Deficiency During Pregnancy: Maternal and Neonatal Effects:
by DANIEL GLINOER, P. De Nayer, F. Delange, M. Lemone, V. Toppet, M. Spehl, J. Grun, J. Kinthaert, & B. Lejeune[in Journal of Clinical Endocrinology and Metabolism {Pages 258 - 269} vol. 80:Number 1, 1995.]
Micronutrient Deficiencies: Public Health Implications: This article discusses the metabolic inter-relationships between micronutrients and the co-existence of the different micro and macronutrient deficiencies.
by C. GOPALAN [in NFI Bulletin (Bulletin of the Nutrition Foundation of India) {p.1-5} vol. 15:3, July 1994.]
The Elimination of Iodine Deficiency Disorders (IDD) by Salt Iodization: A Great Opportunity for the Salt Industry: This presentation outlines several issues related to IDD: including the ecology of iodine, the impact of IDD and the issues surrounding iodized salt. Also discussed are national IDD programs, regional support, and the target of elimination.
by BASIL S. HETZEL [in Seventh Symposium on Salt, Volume Two {p.409-414} vol. 2: 1993.]
Occasional Survey: Iodine Deficiency Disorders (IDD) and their Eradication: Disorders resulting from severe iodine deficiency affect more than 400 million people in Asia alone. These disorders include stillbirths, abortions, and congenital anomalies; endemic cretinism, characterised most commonly by mental deficiency, deaf mutism, and spastic diplegia and lesser degrees of neurological defect related to fetal iodine deficiency; and impaired mental function in children and adults with goitre associated with subnormal concentrations of circulating thyroxine. Use of the term iodine deficiency disorders instead of "goitre" would help to bridge the serious gap between knowledge and its application. Iodised salt and iodised oil (by injection or by mouth)are suitable for the correction of iodine deficiency for 3-5 years. Iodised oil offers a satisfactory immediate measure for primary care services until an iodised salt programme can be implemented. The complete eradication of iodine deficiency is therefore feasible within 5-10 years.
by BASIL S. HETZEL [in The Lancet {pages 1126-1129} vol. 2: November 12, 1983.]
The Iodine Deficiency Disorders: Their Nature and Prevention: This is an introductory article to the iodine deficiency diseases and different control strategies.
by BASIL S. HETZEL, & J.T. Dunn [in Annual Review of Nutrition {p.21-38} vol. 9:21, 1989.]
Treatment of Endemic Goitre Due to Iodine Deficiency with Iodine, Levothyroxine or Both: Results of a Multicentre Trial:ABSTRACT- Preliminary clinical studies and recent in vitro investigations suggest that iodine administration may be an effective alternative in the treatment of the diffuse euthyroid goitre of iodine deficiency. Therefore a 12-month multicentre study was initiated in which 166 patients were randomly assigned to take either 150 micrograms levothyroxine day-1 (group A, n=61), 400 micrograms iodine day-1 (group B, n = 50), or a combination of 75 , micrograms levothyroxine and 200 micrograms iodine day-1 (group C, n=55) for 8 months with follow-up examinations at 4 and 8 months as well as 4 months after cessation of treatment Initially, thyroid volume, as determined by ultrasound, was not significantly different in the three groups. In all three groups, during treatment a significant and comparable mean decrease in goitre size was documented (-32.1% in group A,-37.3% in group B,-38.7% in group C). After cessation of treatment in group A mean thyroid volume again increased to near the baseline value (ù12.0% compared to the initial investigation), while the therapeutic effect was sustained in group B (ù32.5%). In group C, only a slight rebound effect was observed (-26.3% vs. baseline volume). Total thyroxine (T4) increased sharply and significantly in group A from 7.8 +/- 1.9 to 10.9 +/- 2.8 micrograms dl- after 8 months (P< 0.001), but only slightly, although significantly in group B (from 7.8 +/- 1.5 micrograms dl-1 to 8.9 +/- 1.6 , micrograms dl-1; P < 0.02). Striking differences between the three groups were evident in the changes of basal and thyrotropin releasing hormone (TRH) stimulated thyrotropin (TSH). After 8 months a sharp and significant decrease of TSH occurred in group A (from 1.2+/-0.53 to 0.4 +/- 0.74 , MicroU ml-1; P<0.001) and in group C (from 1-2 +/- 0.97 to 0.5 +/- 0.56 MicroU ml-1; P<0.001). In group B, TSH was also significantly lower (from 1.3 +/- 1.04 to 0.9 +/- 0.72, MicroU ml-1; P< 0.02), but remained significantly higher compared to group A and group C. Similar changes were observed when the TSH after TRH administration was calculated. After cessation of treatment, the values for basal TSH and TRH-stimulated TSH in the three groups were not significantly different from each other. They had increased to the initial values. Our data clearly show that iodine alone (400 micrograms day-1) or a combination of 75 micrograms levothyroxine and 200 micrograms iodine day-1 are at least equally as effective for goitre reduction as levothyroxine alone (150 micrograms day-1) and offers the further benefit of a sustained effect after cessation of therapy.
by G. HINTZE, D. Emrich, & J. Kobberling[in European Journal of Clinical Investigation {pages 527 - 534} vol. 19:Number 6, ISSN 0014-2972; December 1989.]
Goitre in India: Iodine Prophylaxis Falters:
by K. S. JAYARAMAN [in Nature {"News" section, page 205} vol. 304: July 1983.]
Tanzania to Achieve Universal Salt Iodation One Year Ahead of Goal:Synopsis of progress in Tanzania towards reaching the mid-decade goal of universal salt iodization. Includes the complete text of President H.E. Ali Hassan Mwinyi's speech given on April 21, 1994 when he officially launched a national IDD control and prevention campaign. Also includes the full text of the joint statement by the Ministeries of Health, Water/Energy/Minerals regarding salt iodization in Tanzania.
by FESTO P. (EDITOR) KAVISHE [in Nutrition News in Eastern & Southern Africa Region {p.5-10} vol. 1:2, June 1994.]
Iodine Deficiency and Neonatal Hypothyroidism: The incidence of neonatal hypothyroidism, as reflected in cord-blood thyroxine and thyrotropin levels, varied from 0.6% to 13.3% in iodine-deficient and normal regions of India (selected districs of Uttar Pradesh and Kerala and the city of Delhi), depending on the degree of environmental iodine deficiency. In populations with a high incidence of neonatal hypothyroidism, an increased prevalence of nerve deafness and a shift to the left in the distribution of IQ scores (toward lower scores) have been demonstrated. These indications of mild brain damage suggest that nutritional iodine deficiency can present in other ways than goitre or cretinism. Determination of the incidence of neonatal hypothyroidism using dried cord-blood spot screening appears to be the most useful and reliable method to assess the risk of brain damage in iodine-deficient areas.
by N. KOCHUPILLAI, C.S. Pandav, M.M. Godbole, & M.M.S. Ahuja [in Bulletin of the World Health Organization (WHO) {pages 547 - 551} vol. 64:4, 1986.]
Further Decrease in Thyroidal Uptake and Disappearance of Endemic Goitre in Children after 30 years of Iodine Prophylaxis in the East of Finland: Endemic goitre of moderate severity was mainly found in the east of Finland in the 1930's. Studies in the 1950's showed an average daily iodine intake of 65 - 70 mg in the west and 50 - 65 mg in the east of the country. The use of iodized salt was introduced in the late 1940's but added only 15 mg of iodine to the daily intake. In the late 1950's iodine prophylaxis was intensified and the use of salt containing 25 mg KI/kg was recommended. In 1978 about 95% of all household walt used in the Savonlinna area was iodized. This region in the east of Finland has been used as an area of surveilance and studies have been carried out there in 1959, 1969, and 1979. During this period the thyroidal uptake decreased from 67 to 23% in non-goitrous subjects and from 62 to 28% in goitre patients the difference between the two last figures being statistically significant. The goitre patients also had significantly higher serum thyroxine and triiodothyronine levels. During the same period the urinary excretion of stable 127I increased from 15 mg to about 250 mg a day. Concomitantly the goitre prevalence among school children has decreased. Having been in the early 1950's in most parts 15 - 30% it is now adequate and that the endemic is gradually subsiding.
by B-A LAMBERG, M. Haikonen, M. Makela, A. Jukkara, E. Axelson, & M. Welin [in Acta Endocrinologica {pages 205 - 209} vol. 98: 1981.]
The Myth of Goiter in Pregnancy:
A common belief is that pregnancy causes goiter. Forty-nine matched pairs each consisting of a pregnant and a nonpregnant woman were examined by means of a blind, multiple-observer design. In 22 pairs the pregnant woman had the larger thyroid, whereas in 20 pairs the opposite was true. In six pairs the thyroid glands were not palpable, and in one pair the thyroid glands were of equal size. Five pregnant and three nonpregnant women had clinically significant goiters None of the differences was statistically significant. No significance appeared when the data were controlled for race, age, body weight, or family history of thyroid disease. Therefore, goiter in pregnancy should be considered to be a pathologic condition in an iodine-replete population.
by RICHARD P. LEVY, D.M. Newman, L.S. Rejali, & D.A.G. Barford [in American Journal of Obstetrics and Gynecology {pages 701 - 703} vol. 137:Number 6, 1980.]
Endemic Goitre in the Island of S. Miguel (the Azores): A survey of endemic goitre in the island of S. Miguel (the Azores) was performed. The prevelance of goitre in school-children varied between 11 and 41%. In the most affected region, 16% of the adult males and 48% of the women had goitre, in some cases grade 3. The median urinary excretion of iodine was very low in school-children, varying between 10 and 49 m g I/g creatinine. The reasons for such a low iodine intake in the population of the oceanic island are the scarcity of fish in the diet and, possibly, the leaching of the soil of its iodine content due to high pluviosity.
by A. LOPES DE OLIVERIA, M.J. Goncalves, & L.G. Sobrinho [in Acta Endocrinologica {pages 200-203} vol. 111: 1986.]
Progress with Salt Iodization in China: The Elimination of Iodine Deficiency Disorder from 40% of the One Billion by Salt Iodization Programme:
This article discusses the current IDD situation in China, the history of salt iodization in China, and associated problems, and methods of amelioration.
by T. MA [in Seventh Symposium on Salt {p.427-9} vol. 2: 1993.]
Programs Against Micronutrient Malnutrition: Ending Hidden Hunger:This article provides a description of the nature and magnitude of the micronutrient malnutrition problem and a framework for action at the national level. Ideas include using communications, social marketing and advocacy. Several interventions are discussed, including dietary diversification, fortification, massive treatment and indirect methods. Also, several methods of monitoring and surveillance are described.
by G. F. MABERLY, F.L. Trowbridge, R. Yip, K.M. Sullivan, & C.E. West [in Annual Review of Public Health {p.277-301} vol. 15: 1994.]
Effect of Vagional Douching with Povidone-Iodine during Early Pregnancy on the Iodine Supply to Mother and Fetus:
ABSTRACT- Vaginal douching with polyvinylpyrrolidone iodine (PVP-I) during pregnancy results in maternal iodine overload and increases the iodine content of amniotic fluid. We evaluated the possible effects of this therapy on the thyroid of the fetus by investigating 62 women with a mean duration of amenorrhea of 20 weeks who solicited controlled abortion. Nineteen of them douched daily with PVP-I for 7 consecutive days before abortion (treated group). The other 43 [UVC1]women were not treated (control group). In both groups the iodine content was determined in the fetal thyroid and in amniotic fluid and maternal urine at the time of abortion. In addition, in the treated group the concentrations of iodine were also determined in amniotic fluid and urine before therapy and in urine after 4 days of therapy There were no differences in the concentrations of iodine in urine and amniotic fluid in the control group and in the treated group before therapy. In the treated group urinary iodine increased from 6.1 +- (SEM) 0.8 micrograms/dl before therapy to 91 +- 20 micrograms/dl after 4 days and to 153 +- 60 micrograms/dl after 7 days of therapy (p < 0.001). In parallel, iodine in amniotic fluid increased from 1.2 +- 0.2 micrograms/dl before therapy to 3.7 +- 1.3 micrograms/dl after 7 days (p < 0 05) ID both groups the thetreated group (from 1 to 7.7 micrograms) than in the control group (from I to 2.5 micrograms) p < 0.05. In iodine content of the fetal thyroid increased with gestational age. However, it increased more rapidly in conclusion, routine vaginal douching with PVP-I during early pregnancy induces maternal iodine overload and markedly increases the iodine content not only of the amniotic fluid but also of the fetal thyroid, as soon as the trapping mechanism of iodide by the thyroid has started to develop. In view of the well-documented hypersensitivity) of the fetal and neonatal thyroid to the blocking effect of excess iodide, the vaginal application of PVP-I is not recommended during pregnancy.
by I. MAHILLON, W. Peers, P. Bourdoux, A.M. Ermans, & F. Delange [in Biology of the Neonate {pages 210-217} vol. 56: 1989.]
Global Control of Iodine Deficiency Disorders Through the Iodization of Salt:
This article outlines the development and constraints of salt iodization and offers criteria for effective programs and examples of program development.
by M. G. VENKATESH MANNAR [in Seventh Symposium on Salt {p.415-420} vol. 2: 1993.]
Strategy for Establishment and Intensification of Salt Iodization Programmes in African Countries:
by M. G. VENKATESH MANNAR [in Control of Iodine Deficiency Disorders in Africa - Report of the WHO/UNICEF/ICCIDD Yaounde, Cameroun, 23-25 March 1987AFR/NUT/99, April 1987.]
Letter to the Editor: Role of Iodine in Delayed Immune Response:
by LORENZO MARANI, S. Venturi, & R. Masala[in Israel Journal of Medical Sciences {Page 864} vol. 21:Number 10, October 1985.]
Estudio Epidemiologico del Bocio Endemico en Poblacion Escolar Asturiana(Translation is "Epidemiologic Study of Endemic Goiter in Schoolchildren of the Asturias") En Español/In Spanish. This article, with an abstract in english, is about a survey performed in 6876 schoolchildren in Asturias to investigate the prevalence of goiter.
by E. L. MENDEZ TORRES, F.J. Diaz Cadorniga, J. Aranda Regules, P. Boix Pallares, J. Aller Granda, & A. Rabal Artal[in Endocrinologia Organo de la Sociedad Espanola de Endocrinologia {p.29-34} vol. 34:2, Julia de 1987.]
Enquete Sur la Prevalence du Goitre en France: En Français/In French (Translation is "Survey on the Prevalence of Goiter in France"):
En 1982, sur la Societe francaise d'endocrinologie a cree un groupe de travail destine a etudier la prevalence du goitre en France. Ce groupe a diligente des enquetes dans 13 academies.
by RENE MORNEX [in Bulletin de L'Academie Nationale de Medecine {pages 301 - 306} vol. 171:number 3, March 3, 1987.]
Consultative Meeting on Iodized Salt:
- -Service delivery
- -Delivery of Iodized oil supplements to preschool and school children in the cordelera administrative region
- -Training and Advocacy
- -Information Education Communication
- -Research.
by NCP BULLETIN [in NCP Bulletin {p.1/9} ISSN -0115-4265; January-June 1994.]
Iodine Deficiency and Salt Iodization: Editorial.
by NCP BULLETIN [in NCP Bulletin {p.2} ISSN -0115-4265; January-June 1994.]
Lao PDR Succeeds in Iodizing 80% of Salt:
by ANDREW NETTE [in First Call for Children: A UNICEF Quarterly {Page 7}Number 4, October - December 1995.]
Brief Communication: Endemic Goitre in Guinea-Bissau: A survey was performed of endemic goitre in the Oio, Gabu, and Cacheu regions of Guines-Bissau. Among adult women, the following prevalences of goitre were observed: 53% (Oio), 48% (Gabu), and 27% (Cacheu). For goitres of grades 2 and 3 only, the prevalence was 20% (Oio), 13% (Gabu), and 2% (Cacheu). No cretinism or cases of thyroid disfunction were found. The mean urinary iodine excretions in Oio, Gabu, and Cacheu were 17 mg/g, 24 mg/g and 33 mg/g creatinine, respectively.
by A. L. OLIVERIA, J.L. Batista, A.P. Silva, L.G. Sobrinho, & L.C. Rocha [in Bulletin of the World Health Organization {pages 347-348} vol. 69:3, 1991.]
Misconception of IDD Prevalence Obstacle to Strong Legislation:
This brief article addresses the problems that developing countries are having in passing anti-IDD legislation.
by PAMM [in PAMM News {p.2} Jan 1995.]
Towards the Elimination of Iodine Deficiency Disorders in India:
- 1. Assessment of the Problem
- 2. Strategies Available
- 3. Political Commitment
- 4. Advocacy
- 5. Legislation
- 6. Capacity Building/Training
- 7. Issues Related to Salt Iodization
- 8. Information Education and Communication
- 9. Monitoring
- 10. Community Participation
- 11. Building a Partnership
- 12. Sustainability.
by C. S. PANDAV, & K. Anand [in The Indian Journal of Pediatrics {Pages 545 - 555} vol. 62:Number 5, 1995.]
Iodine Deficiency in India: Reviews of Control Measures:
- 1. Introduction - National Goitre Control Programme, IDD
- 2. Constraints in Iodated Salt Distribution
- 3. Iodine Deficiency Disorders - Magnitude
- 4. Alternate Intervention Programmes.
by C. S. PANDAV, N. Kochupillai, M.G. Karmarkar, & L.M. Nath [in Indian Pediatrics {pages 325-329} vol. 23: May 1986.]
A Role for Non-governmental Organization in Monitoring the Iodine Content of Salt in Northern India(Resume disponible en Français): In English with resume in French.
This article discuss the feasability of using nongovernmental organizations (NGOS) to monitor the iodine content of salt. A Study was conducted in Uttar Pradesh, northern India, where IDD are endemic.
(In French = "Un role pour les organisations non gouvernementales dans la surveillance de la teneur du sel en iode dans le nord de l'Inde"). by C. S. PANDAV, S. Pandav, K. Anand, S.A. Wajih, S. Prakash, J. Singh, & M.G. Karmarkar [in Bulletin of the World Health Organization {pages 71-75} vol. 73: 1995.]
Sustaining Elimination of Iodine Deficiency Disorders: Editorial on sustaining elimination of IDD.
by C. S. PANDAV, H. Viswanathan, & D.P. Haxton[in The National Medical Journal of India {p.49-51} vol. 8:2, ISSN 0970-258x; March/April 1995.]
A Controlled Trial of Iodinated Oil for Prevention of Endemic Cretinism: A Long Term Follow-Up:
A double blind controlled trial designed to examine the effectiveness of intramuscular iodinated oil as a prophylactic for the nervous type of endemic cretinism, was begun in 1966 in the highlands of Papua, New Guinea. Infants born into the trial between 1966 and 1972 were followed up until 1982. The results showed that if the iodine supplement was given before conception the nervous form of endemic cretinism was prevented. Also a striking difference in the 15-year cumulative survival rate in favor of the test (iodinated oil) group was observed. Measures of motor function revealed that children born to mothers given an iodine supplement performed significantly better. This observation shows that iodine deficiency leads to sub-clinical as well as clinical defects. It also justifies the use of the term iodine deficiency disorder to cover the polymorphic nature of the abnormalities attributable to iodine deficiency.
by P. O. D. PHAROAH, & K.J. Connolly [in International Epidemiological Association {pages 68 - 73} vol. 16:Number 1, 1987.]
Maternal Thyroid Hormone Levels in Pregnancy and the Subsequent Cognitive and Motor Performance of the Children:
Serum levels of thyroxine and triiodothyronine during pregnancy were measured in women from a severely iodine deficient region in the highlands of Papua New Guinea. Subsequently the children born to these women were examined when aged 10 - 12 years and measures made of intellectual ability and motor competence. A significant correlation between these measures in the children and the maternal thyroxine but not maternal triiodothyronine level was observed. It is speculated that maternal thyroxine and not triiodothyronine may be essential for normal neurological maturation of the fetus before the fetal thyroid becomes functional.
by P. O. D. PHAROAH, K.J. Connolly, R.P. Ekins, & A.G. Harding [in Clinical Endocrinology {Pages 265-270} vol. 21: 1984.]
Maternal Thyroid Function and Motor Competence in the Child:
Serum thyroid horomone levels were measured in women living in an area of severe dietary iodine deficiency in a remote region of Papua, New Guinea. Levels of maternal hormone were found to related to the motor competence of the women's offspring, who were aged between six years and 11 years (10 months at the time of assessment). Motor competency in the children was measured by two tests of manual dexterity which demanded speed and accuracy in performance. A significant correlation was obtained between the children's motor performance and maternal serum thyrox
