Iodine deficiency is still an important health care problem in the world. In Italy, as in most European countries, it is responsible for the development of mild to moderate
endemic goiter. In 1995 we conducted a
goiter survey in the Gubbio township, an area of Umbria region in Italy, close to the Appenine mountain chain. This study demonstrated a high prevalence of
goiter in the middle schoolchildren population, indicating the presence of moderate
endemic goiter. Soon after, a
goiter prevention campaign aimed at implementing the consumption of
iodinated salt was started. In 2001, a second survey was conducted in the middle schoolchildren (age 11-14 yr old) of Gubbio and neighbour townships. Eight hundred thirteen subjects were studied. Data obtained in 240 age-matched children, studied in the same area in 1995, were used for comparison to monitor changes 5 yr after the beginning of
iodine prophylaxis. Thyroid volume was measured by ultrasonography. Gland volume was expressed in ml. A large population living in a
iodine-sufficient area, previously reported by others, was used as control. Urinary
iodine excretion was measured randomly in 20% of the children. The overall prevalence of
goiter decreased between 1995 and 2001 from 29 to 8%.
Goiter odds ratio (OR), corrected for age, was 4.0 (95% CI 2.8-5.9) for 1995 compared to 2001 (p<0.000). Mean thyroid volume in the matched populations was 7.6+/-2.5 ml in 1995 and 5.7+/-2.1 ml in 2001. Median
iodine urinary excretion increased from 72.6 to 93.5 mug/l, at the limit of statistical significance. Living in a rural area, no consumption of
iodized salt and familiarity for
goiter represented independent risk factors for
goiter development. This study was the first conducted in Umbria region and confirmed that an implementation campaign for
iodized salt consumption is a simple and useful instrument to prevent
endemic goiter and related diseases. A new survey to evaluate
goiter prevalence in the same area 10 yr after the beginning of
iodine prophylaxis is already planned.