Population Survey of Iodine Deficiency and Environmental Disruptors of Thyroid Function in Young Children in Haiti.

Julia E von Oettingen, Tesha D Brathwaite, Christopher Carpenter, Ric Bonnell, Xuemei He, Lewis E Braverman, Elizabeth N Pearce, Philippe Larco, Nancy Charles Larco, Eddy Jean-Baptiste, Rosalind S Brown

Journal: The Journal of clinical endocrinology and metabolism 2017;102(2):644-651

PMID: 27768855

Abstract

CONTEXT

Iodine deficiency is the leading cause of preventable neurodevelopmental delay in children worldwide and a possible public health concern in Haiti.

OBJECTIVE

To determine the prevalence of iodine deficiency in Haitian young children and its influence by environmental factors.

DESIGN

Cross-sectional study, March through June 2015.

SETTING

Community churches in 3 geographical regions in Haiti.

PARTICIPANTS

299 healthy Haitian children aged 9 months to 6 years; one-third each enrolled in a coastal, mountainous, and urban region.

MAIN OUTCOME MEASURES

Urinary iodide, serum thyrotropin (TSH), goiter assessment, and urinary perchlorate and thiocyanate.

RESULTS

Mean age was 3.3±1.6 years, with 51% female, median family income USD 30/week, and 16% malnutrition. Median urinary iodide levels were normal in coastal (145 μg/L, interquartile range [IQR] 97 to 241) and urban regions (187 μg/L, IQR 92 to 316), but revealed mild iodine deficiency in a mountainous region (89 μg/L, IQR 56 to 129), P < 0.0001. Grade 1 goiters were palpated in 2 children, but TSH values were normal. Urinary thiocyanate and perchlorate concentrations were not elevated. Predictors of higher urinary iodide included higher urinary thiocyanate and perchlorate, breastfeeding, and not living in a mountainous region.

CONCLUSIONS

Areas of mild iodine deficiency persist in Haiti's mountainous regions. Exposure to two well-understood environmental thyroid function disruptors is limited.

Copyright © 2017 by the Endocrine Society

Address: Division of Endocrinology, McGill University Health Center, Montreal, Quebec H4A 3J1, Canada.; University of Oxford, Oxford OX3 9OS, United Kingdom.; University of California, San Francisco, San Francisco, California 94143.; Pediatric Emergency Medicine, Dell Children's Medical Center of Central Texas, Austin, Texas 78723.; Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts 02118.; Fondation Haïtienne de Diabète et de Maladies Cardiovasculaires, Port au Prince HT6112, Haiti; and.; Boston Children's Hospital, Boston, Massachusetts 02115.
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