Sporadic Goitre Prevalence and its Association with Iodine Deficiency in Drinking Water of Plain Areas of Hyderabad and Adjoining Areas, Pakistan

M. Rafi, S. Naz, M. M. Chaudhry


The enlargement of thyroid gland which is located in the human neck is known as goitre. When the supply of iodine to the thyroid gland is inadequate for the formation of sufficient quantities of thyroid hormones, goitre appears. In the present study prevalence and epidemiological risk factors of goitre in Hyderabad city and adjoining areas has been studied. The important findings of this study are summarized as follows: Females were seen to be more prone to develop goitre than males, with an overall female to male ratio of 5:1. In both sexes, the prevalence of goitre was the maximum in 15-25 year age group. Family history was positive in 22.45% cases. Of the goitre patients 77.22% belonged to Hyderabad city and 84.85% were sedentary by occupation. Goitre was more prevalent in surface water drinkers (80.75%) than in ground water consumers (19.25%), in the consumers of mine salt (67.54%) than that of sea salt (32.46%). The screening of goitre patients by blood chemistry revealed that 5.17% and 2.50% cases had hyperthyroid and hypothyroid respectively. Nodular non-toxic goitre was found in 6.71% cases, nodular toxic in 0.28% cases and solid adenoma/cyst in 24.41% cases were found. It seemed essential to examine iodine concentration in water of this area to ascertain whether the iodine deficiency is the cause of sporadic goitre. Iodine concentration in water is usually taken as an index of the iodine intake, therefore 100 water samples were collected and analyzed by ion selective electrode method. Water analysis results showed that iodine contents are within permissible limit i.e. not lower than 3µg/L. This indicates that iodine deficiency in water of study area is not an isolated epidemiological phenomenon for goitre genesis.

Full Text:



F. Delange, “The disorders induced by iodine deficiency”,

Thyroid, vol. 4, pp. 107-128, 1994.

B.S. Hetzel, “Iodine deficiency disorders (IDD) and their

eradication”, Lancet, vol. 2, no. 8359, pp. 1126-1129, 1983.

P. Laurberg, S.B. Nohr, K.M. Pedersen, A.B. Hreidarsson,

S. Andersen and I.B. Pedersen, “Thyroid disorders in mild iodine

deficiency”, Thyroid, vol. 10, pp. 951-963, 2000.

J.B. Stanbury, A.E. Ermans, P. Bourdoux, C. Todd, E. Oken,

and R. Tonglet, “Iodine-induced hyperthyroidism: occurrence and

epidemiology”, Thyroid, vol. 8, pp. 83-100, 1998.

0J.B. Stanbury, “The damaged brain of iodine deficiency”, New

York: Cognizantommunication Publ, 1994.

S.C. Vir, “Current status of iodine deficiency disorders (IDD) and

strategy for its control in India”, Ind. J. Paed., 6 vol. 9, pp. 589-

, 2002.

C. Gopalan, “Iodisation of common salt for control of IDD: not

the time to backtrack”, NFI Bulletin, 2, 2000.

R.F. Delange and B. Hetzel, Iodine deficiency disorder [Online], in the thyroid and its diseases, Endocrine education, Available

from:http://www.thyroidmanager.org/chapter20/20 frame. htm


J. Bernal and J. Nunez, “Thyroid hormones and brain

development”, Eur. J. Endocrinol., vol. 133, pp. 390-398, 1995.

J. Iskaros, M. Pickard and I. Evans, “Thyroid hormone receptor

gene expression in first trimester human fetal brain”, J. Clin.

Endocrinol. Metab., vol. 85, pp. 2620–2623, 2000.

B.S. Hetzel and I.D. Hay, Thyroid function, iodine nutrition

and fetal brain development, Clin. Endocrinol., vol. 11,

pp. 445-460,1979.

N. Koibuchi and W.W. Chin, “Thyroid hormone action and brain

development”, Trends Endocrinol. Metab., vol. 4, pp. 123-128,

S. Chan and M.D. Kilby, “Thyroid hormone and central nervous

system development”, J. Endocrinol., vol. 165, pp. 1-8, 2000.

T. Richard E,A. Marchel and K. Willem, “Development and

prevention of behaviour problem”, Book Edn., 2010.

M. Qian, D. Wang and W.E. Watkins, “The effects of iodine on

intelligence in children: a meta-analysis of studies conducted in

China”, Asia Pac. J. Clin. Nutr., vol. 14, no. 1, p. 32-42, 2005.

B. David and R. Nalubola, “The History of Food Fortification in

the United States: Its Relevance for Current Fortification Efforts in

Developing Countries,” Econ. Devel. Cult. Change, vol. 51,

pp. 37-53, 2002.

J. Zhao, P. Wang and L. Shang, “Endemic goitre associated with

high iodine intake”, Am. J. Public Health, vol. 90, p. 1633, 2000.

Ying-li Lu, Ning-jian Wang and L. Zhu, “Investigation of iodine

concentration in salt, water and soil along the coast of Zhejiang,

China”, J. Zhejiang. Univ. Sci. B., vol. 6(12), pp. 1200-1205,

E. Marqusee, C.B. Benson, M.C. Frates, P.M. Doubilet,

P.R. Larsen, E.S. Cibas and S.J. Mandel, “Usefulness of

ultrasonography in the management of nodular thyroid disease”,

Ann. Intern. Med., vol. 133, pp. 696-700, 2000.

F.N. Bennedbæk, H. Perrild and L. Hegedüs, “Diagnosis and

treatment of the solitary thyroid nodule. Results of a European

survey”, Clin. Endocrinol. (Oxf), vol. 50, pp. 357-363, 1999.

S.J. Bonnema and F.N. Bennedbæk, W.M. Wiersinga and

L. Hegedüs, Management of the nontoxic multinodular goitre: a

European questionnaire study”, Clin. Endocrinol. (Oxf), vol. 53,

pp. 5-12, 2000.

E.J. Supit and A.N. Peiris, “Interpretation of Laboratory Thyroid

FunctionTests: Selection and Interpretation”, South. Med. J., vol.

, pp. 481-85, 2002..

G.H. Daniels, “Amiodarone-Induced Thyrotoxicosis”, The J.

Clinical. Endo. &Metab., vol. 86, pp. 3-8, 2000.

G. Canaris, N. Manowitz, G. Mayor and E. Ridgway, “The

Colorado thyroid disease prevalence study”, Arch. Intern. Med.,

vol. 160, no. 4, pp. 526-534, 2000.

J. Hollowell, N. Staehling, W. Flanders, et al:, “Serum TSH, T4,

and thyroid antibodies in the United States population (1988 to

: National Health and Nutrition Examination Survey

(NHANES III)”, J. Clin. Endocrinol. Metab., vol. 87(2), pp. 489-

, 2002.

D. Becker, N.D. Charkes and H. Dworkin, “Procedure guideline

for thyroid scintigraphy”, J. Nucl. Med., vol. 37, pp. 1264-1261,

J.J. Richard and G.A. Junk, “Steam Distillation, Solvent

Extraction, and Ion Exchange for Determining Polar Organics in

Shale Process Waters”, Anal. Chem., vol. 56, pp. 1625-1628,

I.A. Worms and K.J. Wilkinson, “Determination of Ni2+ using an

equilibrium ion exchange technique: Important chemical factors

and applicability to environmental samples”, Anal. Chim. Acta.,

vol. 616, no. 1, pp. 95-102, 2008.

J.S. Edmonds and M. Morita. “The determination of iodine species

in environmental and biological samples”, Pure & Appl. Chem.,.

vol. 70, no. 8, pp. 1567-1584, 1998.

G.A. Kandhro and T.G. Kazi, “Evaluation of the Iodine

Concentration in Serum and Urine of Hypothyroid Males Using an

Inexpensive and Rapid Method”, Pak. J. Anal. Environ. Chem..

Vol. 10, pp. 67-75. 2009.

N. Iqbal, M.U. Haq and S.M. Khan, “Assessment of iodine

deficiency in school going children in Abbott Abad Pakistan”,

Specialist, vol. 15, no. 4, pp. 325-329, 1999.

R.K. Gakkhar and V.K. Bharadwaj, “Prevalence of goitre in school

going children in Jabalpur. Indian”, J. Pediatr., vol. 68, pp. 229-

, 2001.

B.T. David and B. Paul, “Remington: The science and practice of

pharmacy”, Google Book, 2006.

R. Fernando, MDP. Pinto and A. Pathmeswaran, “Goitrogenic

food and prevalence of Goitre in Sri Lanka”, Int. J. Internal

Medicine., vol. 1, no. 2, pp. 17-20, 2012.

DS. Mull, JW. Anderson and JD. Mull, “Cowdung, rock salt and

medical innovation in the Hindu Kush of Pakistan: the cultural

transformation of neonatal tetanus and iodine deficiency”, Soc. Sci

Med., vol. 30, no. 6, pp. 675-91, 1990.


  • There are currently no refbacks.