THE CONTROL OF IODINE DEFICIENCY

Iodine deficiency is one of the commonest problems of human nutrition. It is primarily responsible for endemic goitre which affects over 200,000,000 people in the world. It is also associated with an increased incidence of thyrotoxicosis. Severe iodine deficiency is associated with endemic cretinism, a condition characterized by multiple neurological defects, including deaf mutism, diplegia and mental deficiency. Iodine deficiency is detected by determination of urine iodine excretion or radioactive Iodine uptake. Iodine deficiency can be corrected by iodization of salt, the administration of iodide tablets, the iodization of bread or the administration of Iodized oil by Intramuscular injection. Each method has its advantages and disadvantages, and examples are given of their use. A single intramuscular Injection of iodized oil has been shown to correct severe iodine deficiency in the Highlands of the Territory of Papua and New Guinea for nearly five years. The use of this agent has now spread to South America and India as well as other countries confronted with highland peoples living in remote villages. The cost is small—10 to 20 cents for a 2 to 4 ml adult dose. Results from a controlled trial in the Western Highlands of the Territory of Papua and New Guinea indicate that the neurological defects of endemic cretinism can be prevented by the administration of iodized oil. The findings suggest that the disease results from the effects of severe iodine deficiency during the first trimester of pregnancy. Iodine deficiency and its effects can now be prevented by several methods, each suited to different social situations. The elimination of this important cause of human disease in various countries is therefore now practicable.