Skip to main content Accessibility help
×
Home

Iodine status in a Sherpa community in a village of the Khumbu region of Nepal

  • Emma E Heydon (a1), Christine D Thomson (a2), Jim Mann (a2), Sheila M Williams (a3), Sheila A Skeaff (a2), Kami T Sherpa (a4) and John L Heydon (a5)...

Abstract

Objective

To assess the iodine status of Sherpa residents living in Kunde village, Khumbu region, Nepal.

Design

Prevalence of goitre was determined by palpation. Urinary iodine concentrations (UIC) were determined in casual morning samples, and thyroid-stimulating hormone (TSH) in finger-prick blood samples on filter paper. Dietary and demographic data were obtained via questionnaire, and selected foods analysed for iodine.

Setting

Khumbu region is an area of low soil iodine in Nepal, where the prevalence of goitre was greater than 90 % in the 1960s prior to iodine intervention.

Subjects

Two hundred and fifteen of 219 permanent residents of Kunde were studied.

Results

Overall prevalence of goitre was 31 % (Grade 1 goitre, 27·0 %; Grade 2, 4·2 %). When adjusted to a world population, goitre prevalence was 27 % (95 % CI 23, 32 %); Grade 2 goitre prevalence was 2·8 % (95 % CI 1·0, 4·6 %). Median UIC was 97 μg/l, but only 75 μg/l in women of childbearing age. Thirty per cent had UIC < 50 μg/l and 52 % had UIC < 100 μg/l, while 31 % of children aged <14 years had UIC > 300 μg/l. Ten per cent of participants had TSH concentrations >5 μU/ml.

Conclusions

The prevalence of severe iodine deficiency has decreased since the 1960s, but mild iodine deficiency persists, particularly in women of childbearing age. The consumption of high-iodine uncooked instant noodles and flavour sachets by school-aged children contributed to their low prevalence of goitre and excessive UIC values. This finding may obscure a more severe iodine deficiency in the population, while increasing the risk of iodine-induced hyperthyroidism in children. Ongoing monitoring is essential.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Iodine status in a Sherpa community in a village of the Khumbu region of Nepal
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Iodine status in a Sherpa community in a village of the Khumbu region of Nepal
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Iodine status in a Sherpa community in a village of the Khumbu region of Nepal
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author: Email christine.thomson@otago.ac.nz

References

Hide All
1.Hetzel, BS (2005) Towards the global elimination of brain damage due to iodine deficiency – the role of the International Council for Control of Iodine Deficiency Disorders. Int J Epidemiol 34, 762764.
2.World Health Organization/UNICEF/International Council for Control of Iodine Deficiency Disorders (2001) Assessment of Iodine Deficiency Disorders and Monitoring their Elimination: A Guide for Programme Managers. Geneva: WHO.
3.de Benoist, B, Andersson, M, Takkouche, B & Egli, I (2003) Prevalence of iodine deficiency worldwide. Lancet 362, 18591860.
4.Hetzel, BS (1989) The Story of Iodine Deficiency: An International Challenge in Nutrition. Oxford: Oxford University Press.
5.Zimmermann, MB (2004) Assessing iodine status and monitoring progress of iodized salt programs. J Nutr 134, 16731677.
6.Ibbertson, HK (1969) Himalayan goitre. Abbottempo 3, 3033.
7.Ibbertson, HK, Tait, JM, Pearl, M, Lim, T, McKinnon, JR & Gill, MB (1971) Endemic cretinism in Nepal. In Endemic Cretinism; Proceedings of a Symposium held at Institute of Human Biology, January 27–29, 1971, pp. 7188 [BS Hetzel and POD Pharoah, editors]. Goroka: Institute of Human Biology.
8.Ibbertson, HK, Tait, JM, Pearl, M, Lim, T, McKinnon, JR & Gill, MB (1972) Himalayan cretinism. Adv Exp Med Biol 30, 5169.
9.Ibbertson, HK (1973) Himalayan goiter. Acta Endocrinol Suppl 179, 1314.
10.Ibbertson, HK (1974) Goitre and cretinism in the high Himalayas. N Z Med J 80, 484488.
11.Litch, JA & Bishop, RA (1999) Iodine supplementation programme in Nepal. N Z Med J 112, 389390.
12.Jimba, M, Aitken, IW, Joshi, AB, Ohashi, T, Poudyal, AK & Wakai, S (2007) A challenge for monitoring iodine deficiency disorders in Nepal. Trop Doct 37, 106107.
13.Murdoch, DR, Harding, EG & Dunn, JT (1999) Persistence of iodine deficiency 25 years after initial correction efforts in the Khumbu region of Nepal. N Z Med J 112, 266268.
14.Gnat, D, Dunn, AD, Chaker, S, Delange, F, Vertongen, F & Dunn, JT (2003) Fast colorimetric method for measuring urinary iodine. Clin Chem 49, 186188.
15.Fecher, PA, Goldmann, I & Nagengast, A (1998) Determination of iodine in food samples by inductively coupled plasma mass spectrometry after alkaline extraction. J Anal At Spectrom 13, 977982.
16.Segi, M (1960) Cancer Mortality for Selected Sites in 24 Countries (1950–57). Sendai: Tohoku University School of Public Health, 1960.
17.World Health Organization/UNICEF/International Council for Control of Iodine Deficiency Disorders (1994) Indicators for Assessing Iodine Deficiency Disorders and Their Control Through Salt Iodization. Geneva: WHO.
18.Delange, F, de Benoist, B, Pretell, E & Dunn, JT (2001) Iodine deficiency in the world: where do we stand at the turn of the century? Thyroid 11, 437447.
19.Dunn, JT (2006) Iodine. In Modern Nutrition in Health and Disease, pp. 300311 [ME Shils and M Shike, editors]. Philadelphia, PA: Lippincott Williams & Wilkins.
20.Dunn, JT (2001) Correcting iodine deficiency is more than just spreading around a lot of iodine. Thyroid 11, 363364.
21.Wolff, J (2001) Physiology and pharmacology of iodized oil in goiter prophylaxis. Medicine 80, 2036.
22.World Health Organization/UNICEF/International Council for Control of Iodine Deficiency Disorders (1996) Recommended Iodine Levels in Salt and Guidelines for Monitoring their Adequacy and Effectiveness. Geneva: WHO.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed