A new focus of endemic goitre in the Sudan

The prevalence of goitre in the town of Kosti, Central Sudan and the city of Khartoum was investigated on account of the increasing number of goitrous patients in the wards and out-patient clinics of Khartoum Hospital coming from the county of Kosti. The frequency of goitre among 7173 school children from Kosti was 74.8%, and was higher in girls (82.1%) than in boys (67.3%). The frequency among 7075 school-children of Khartoum was 17.5%. The mean urinary iodine excretion in subjects from Kosti was significantly lower (41.8 micrograms/g creatinine) than in those from Khartoum (83.6 micrograms/g creatinine) (p less than 0.001). The water content of iodine in Kosti was low (0.1 micrograms/1). There were no significant differences in the mean serum concentrations of triiodothyronine, thyroxine and thyroid stimulating hormone (TSH) between goitrous and non-goitrous subjects from Kosti. The mean serum level of TSH was higher in goitrous subjects from Kosti (5.2 +/- 1.4 mU/1) than in non-goitrous subjects from Khartoum. These data indicate a high prevalence of goitre in Central Sudan, mainly attributable to iodine deficiency, a fact which has not previously been recognized. Recent environmental goitrogenic factors might have modified the adaptation of the thyroid gland and promoted the occurrence of goitre.