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Goitrous endemic in Guinea

M Konde¹, Y Ingenbleek, M Daffe

¹Department of Food Sciences, University Louis-Pasteur Strasbourg, France.

Lancet (London, England)

|December 17, 1994

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Iodine deficiency in Guinea causes widespread goiter (thyroid swelling) and endemic cretinism, affecting 70% of adults and 55% of schoolchildren. Urgent public health measures are needed to address this severe health crisis.

Area of Science:

Endocrinology
Public Health
Nutritional Science

Background:

A significant goitrous region was identified in the Republic of Guinea.
Goitre prevalence reached 70% in adults and 55% in schoolchildren, with some cases present at birth.

Purpose of the Study:

To investigate the causes and extent of a severe endemic goitre and cretinism outbreak in Guinea.
To assess the role of iodine deficiency and dietary factors in the observed health issues.

Main Methods:

Conducted a prevalence study of goitre and endemic cretinism in the affected population.
Measured urinary iodine and thiocyanate concentrations to assess iodine deficiency and dietary goitrogen intake.
Evaluated overall nutritional status and general health of the inhabitants.

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Main Results:

Iodine deficiency was identified as the primary cause, with 69% of inhabitants below the critical urinary iodine threshold.
Substantial thiocyanate intake (27% exceeding 10 mg/L) likely exacerbated iodine deficiency.
Endemic cretinism (myxoedematous form) affected approximately 2% of goitrous patients.

Conclusions:

The region in Guinea represents the epicenter of West African goitre and cretinism, necessitating immediate public health interventions.
Dietary factors, including thiocyanates and flavonoids, likely contribute to the severity of iodine deficiency disorders.
The population exhibits borderline euthyroid status with a tendency towards hypothyroidism, highlighting the urgent need for iodine supplementation programs.