EPIDEMIOLOGIC SURVEY OF ENDEMIC GOITER AND CRETINISM IN GUIZHOU

An epidemiologic investigation on endemic goiter and cretinism in southeastern Guizhou province was carried out in 1979. The incidence of goiter in Shilong, Heba and Pingliang communes was 23.2%, 31.5% and 30.4% respectively. Qianling commune was taken as a nonendemic control with a goiter rate of 0.97%. The incidence of endemic cretinism was 5.2%, 3.1% and 2.8% for Shilong, Heba and Pingliang communes respectively. No endemic cretinism was discovered in Qianling commune. Female goiter patients were more than the male with a F/M ratio varying from 2.13 to 2.68. As an index of iodine nutrition, urine iodine excretion was very low, being 23.3 and 11.8 μg/gm creatinine for inhabitants of Heba and Pingliang communes, while that for the inhabitants of Shilong commune was normal (110.6 μg/gm creatinine) due to iodized salt prophylaxis. Qianling commune was also within the normal range (75.2μg/gm creatinine) not only because of the slightly higher drinking water iodine content but more important was the fact that they continued to use the iodine rich salt supplied from Sichuan province which contained as much iodine as 3.0-5.2 mg/kg. The thyroid131I uptake figures obtained in the 3 endemic communes correlated every well in a reversed fashion, that is, in the untreated Heba commune, the 24 hr thyroid131I uptake ran up to 72.5% and 68.3% for the children and adults. The 24 hr thyroid131I uptake was normal in Qianling commune being 48.3% for children and 37.7% for adults. Still lower figures (26.7% for children and 27.2% for adults) were obtained in Shilong commune after iodine repletion. The endemic maladies, goiter and cretinism can be easily prevented by persistent practice of iodization of the common sea salt in regions of iodine deficiency.