Iodine deficiency and endemic goitre in the Langkloof area of South Africa.

OBJECTIVE: To quantify the prevalence of iodine deficiency and endemic goitre in the Langkloof area. DESIGN: A cross-sectional study. SETTING: Four primary schools in four communities in the Langkloof. SUBJECTS: 565 primary schoolchildren from Standard 2 to Standard 5. OUTCOME MEASURES: Clinical diagnosis of thyroid size by palpation, level of iodine in urine and drinking water samples, level of iodine in iodised salt samples from the area, percentage of households with iodised salt on the premises, and anthropometric measures of body height and weight. RESULTS: The prevalence of endemic goitre varied from 14.3% to 30.2% in the four communities and, based on urinary iodine levels, the iodine deficiency ranged from mild to severe. Both iodised and non-iodised salt were available at the local grocery stores but only small percentages of households had iodised salt in the house. The iodine content of drinking water was low. Anthropometric indices of undernutrition indicated medium to high levels of stunting in three of the four communities, the worst being in the community with the highest goitre prevalence. CONCLUSIONS: Endemic goitre caused by iodine deficiency is a public health problem in the Langkloof, varying in severity from mild to severe in the different communities. The impact of mandatory iodisation of table salt, introduced at the end of 1995, needs to be assessed in these communities.