ORIGINAL ARTICLE Goitre and urinary iodine excretion survey in schoolchildren of Kashmir Valley Shariq Rashid Masoodi*, Altaf Ali*, Arshad Iqbal Wani*, Mir Iftikhar Bashir*, Javaid Ahmad Bhat*, Syed Mudassar† and Abdul Hamid Zargar* *Department of Endocrinology and †Department of Clinical Biochemistry, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India Summary Background An extensive survey on schoolchildren in Kashmir Valley in 1995 showed a high prevalence of goitre, making it imperative to have a relook at our iodine status, 15 years postio- dization. Objective To study the total prevalence of goitre and urinary iodine excretion (UIE) in Kashmiri schoolchildren, 15 years pos- tiodization. Design A cross-sectional survey, covering 9576 schoolchildren, aged 5–15 years (5988 in 6–12 year age group) was conducted. Goitres were graded as per WHO/UNICEF/ICCIDD. UIE was measured by the arsenic acid reduction in ceric ions method and was estimated in 208 subsampled children. Results were compared with that of 1995 survey. Results The overall prevalence of goitre in the present study was 3Á8% (95% CI: 3Á4–4Á2) and 3Á7% (95% CI: 3Á2–4Á2) in those aged 6–12 years. No significant difference in prevalence of goitre was observed between boys and girls overall (3Á6% vs 4Á1%. P > 0Á2), nor in the 6–12 year age group (3Á3% vs 4Á0%, P > 0Á1). There was a significant trend of increasing prevalence of goitre with age (P < 0Á005). UIE ranged from 12 to 397 lg/g.creatinine (median, 104); 11% subjects had UIE of <50 lg/g.creatinine. Overall, preva- lence of goitre was significantly lower (3Á8% vs 45Á2%, P < 0Á001), and mean UIE was significantly higher (123Á6 Æ 5Á3 vs 49Á60 Æ 3Á55 lg/g.creatinine, P < 0Á001), compared to that in the 1995 survey. Conclusion The marked improvement in overall iodine nutri- tion in Kashmir Valley- one and a half decades after implementa- tion of salt iodization should encourage healthcare providers to make tangible efforts for implementation of iodization pro- grammes in areas with iodine deficiency. (Received 27 February 2013; returned for revision 11 March 2013; finally revised 18 April 2013; accepted 6 May 2013) Introduction Iodine deficiency is the leading cause of preventable brain damage. 1 Appropriate iodine intake is necessary to maintain normal thyroid function and prevent iodine deficiency disorders (IDD). The World Health Organisation estimates that 2Á2 billion people are at risk of IDD and has called for new efforts to eradicate the problem in the Member States with a high incidence of iodine deficiency. 1 A reso- lution has been accepted which urges a renewed cooperative effort to eliminate IDD. 2 IDD can easily be prevented by a simple and cost-effective measure of adding iodine to table salt. 3 Kashmir Valley in the north Indian state of Jammu and Kashmir has been a known iodine-deficient area. In 1995, we showed a prevalence of goitre of 45% along with very low uri- nary iodine levels in an extensive survey on schoolchildren. 4,5 In some highland areas of the valley, prevalence was as high as 77%. 6–8 Further studies revealed wide availability and consump- tion of noniodized salt along with lack of awareness about IDD in the valley; only one-third of the population in the valley were consuming iodized salt. 9 Thereafter, a massive campaign was ini- tiated for implementation of existing National IDD control pro- gramme by mobilizing the government machinery and civil society, and reinforcing an official ban on availability and sale of noniodized salt in Kashmir Valley. An awareness campaign regarding the magnitude of IDD and its easy and certain mitiga- tion through salt iodization was launched through print and electronic media among the public in general and medical fra- ternity in particular. In addition, help was sought from political, socio-religious and community leaders, making them partners in the awareness campaign. As universal salt iodization started get- ting implemented, gradually the dividends started emerging making it imperative to have a relook at our iodine status, pos- tiodization. This study presents the results from the first postio- dization goitre survey in Kashmir Valley, conducted to estimate residual prevalence of goitre and UIE among schoolchildren, approximately fifteen years after salt iodization was initiated. Methods This study, like our previous study, was conducted on school- children, aged 5–15 years; a total of 9576 students (5416 boys, Correspondence: Abdul Hamid Zargar, P.O. Box No. 1098, GPO, Srinagar 190001, Jammu & Kashmir, India. Tel.: +91 9419003209; E-mail: zargarah123@gmail.com © 2013 John Wiley & Sons Ltd 141 Clinical Endocrinology (2014) 80, 141–147 doi: 10.1111/cen.12247