620 Asia Pac J Clin Nutr 2008;17 (4):620-628 Original Article Iodine deficiency disorders in Bangladesh, 2004-05: ten years of iodized salt intervention brings remarkable achievement in lowering goitre and iodine deficiency among children and women Harun K M Yusuf PhD 1 , A K M Mustafizur Rahman MSc 2 , Fatima Parveen Chowdhury MPhil 3 , M Mohiduzzaman MSc 4 , Cadi Parvin Banu MSc 4 , M Arif Sattar MSc 5 and M Nurul Islam PhD 6 1 Department of Biochemistry and Molecular Biology, University of Dhaka, Bangladesh 2 Control of Iodine Deficiency Disorders Project, Bangladesh Small and Cottage Industries Corporation, Ministry of Industries, Government of the People’s Republic of Bangladesh, Motijheel, Bangladesh 3 Institute of Public Health Nutrition, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Mohakhali, Bangladesh 4 Institute of Nutrition and Food Science, University of Dhaka, Bangladesh 5 Department of Mathematics and Statistics, World University of Bangladesh, Dhanmondi, Bangladesh 6 Department of Statistics, University of Dhaka, Bangladesh A survey was conducted to monitor the current status of iodine deficiency disorders in children aged 6-12 years and women aged 15-44 years in Bangladesh as measured by goitre prevalence and urinary iodine excretion. Conducted between September 2004 and March 2005, the survey followed a stratified multistage cluster sam- pling design to provide nationally representative data, with self-weighted rural-urban disaggregation. A total of 7233 children and 6408 women were examined for goitre and 4848 urine samples (2447 from children and 2401 from women) were analyzed for iodine. In addition, 5321 household salt samples were analyzed for iodine. In children, the total goitre rate (TGR) was 6.2%, compared to 49.9% in 1993 and the TGR among women was 11.7%, while in 1993 it was 55.6%. Prevalence of iodine deficiency (Urinary Iodine Excretion <100 μg/L) was 33.8% in children and 38.6% in women (compared to 71.0% and 70.2%, respectively in 1993). Iodine nutrition status in urban areas was considerably better than in rural areas. There was a clear inverse relationship between iodine deficiency and the coverage of households using adequately iodized salt (≥15 ppm). The findings of the survey revealed that Bangladesh has achieved a commendable progress in reducing goitre rates and iodine defi- ciency among children and women ever since the universal salt iodization programme was instituted 10 years ago. However, physiological iodine deficiency still persists among more than one-third of children and women, which points to the need for all stakeholders to redouble their efforts in achieving universal salt iodization. Key Words: Iodine deficiency disorders, goitre rate, iodine deficiency, household coverage with adequately iodized salt, Universal Salt Iodization INTRODUCTION Iodine deficiency disorders (IDD) are recognized as a major global public health problem. According to the latest estimates, about 2.5 billion people worldwide (38% of the world’s population) have insufficient iodine intake, of which 313 million are in the South-eastern Asian re- gion that includes Bangladesh. 1 Iodine deficiency is the single most preventable cause of neurological and intel- lectual impairment (cretinism) in the world. The Gov- ernment of Bangladesh is officially committed to IDD elimination through national, as well as international, commitments. In 1989, the Government of Bangladesh passed a law making it mandatory that all edible salt be iodized. The law stipulates that all salt for human con- sumption must contain 45-50 parts per million (ppm) of iodine at the time of production and not less than 20 ppm iodine at the time of retail, to ensure a minimum of 15 ppm iodine at the household level. Accordingly, a plan was undertaken to institute a Universal Salt Iodization Corresponding Author: Dr Harun K M Yusuf, FAO-National Food Policy Capacity Strengthening Programme, Food Planning and Monitoring Unit, Khaddya Bhaban, 16 Abdul Ghani Road, Dhaka-1000, Bangladesh. Tel: +880-2-8612721 (Res), 01819-195111, 01720-343872; Fax: +880-2-8615583, +880-2-7162528 Email: hkmyusuf2003@yahoo.com; harun.yusuf@nfpcsp.org. Manuscript received 10 April 2008. Initial review completed 10 October 2008. Revision accepted 21 October 2008.