MON-100 Prevalence of Goitre and Thyroid Disorders in Healthy School Children of Kashmir Valley. A Multistage Cross-Sectional Survey

Background There has been a gradual transition among pattern and prevalence of thyroid dysfunctions among paediatric population post iodisation phase making it imperative to look into it with periodic surveys. Objective To comprehend the existent thyroid disease burden along with goitre prevalence in healthy paediatric population of Kashmir Valley. Design It was a cross sectional survey including 666 healthy school children of Kashmir valley of the age 6-18 years out of which 421 were girls and 245 were boys. Goitre was graded as per WHO grading system. Thyroid function test (TFT-TSH, TT4, TT3) were measured in all study subjects. Urinary iodine excretion UIE was measured in 40 subsampled children. Results The overall prevalence of thyroid dysfunction (goiter and or abnormal TFT) among children was 7.8% (CI 5.9-10.1%) with a prevalence of 9.3% in females (CI 2.9-8.9%) and 5.3% (CI 6.7-12.4%) in males. The overall prevalence of goitre was 2.4% with a significant difference observed in boys and girls as all 16 children with goitre were girls. UIE ranged from 71 to 558ug/gm of creatinine (median,150). TFT results were available in 563 children with abnormal results observed in 6.6% (n=37) subjects. Most common TFT abnormality was subclinical hypothyroidism (SCH) with total of 4.3% while 1.6% subjects had overt hypothyroidism and 0.7% had subclinical thyrotoxicosis. Children with subclinical disease were observed and those with overt hypothyroidism were treated accordingly. Conclusions Total goitre prevalence has decreased in Kashmir Valley post iodisation and continues to decrease further when we compared with previous prevalence study by Masoodi et al 2013*. However, there is a need for periodic large-scale cross-sectional surveys to know the thyroid status of our population. The most frequent thyroid function abnormality in our survey was SCH which needs judicious management as treating these children strain out stretched health resources. *Masoodi S R et al. Goitre and urinary iodine excretion survey in schoolchildren of Kashmir Valley. Clin Endocrinol (Oxf) 2014;80(1):141–7.