Evidence of endemic goiter and iodine deficiency in a mountainous area of Haiti.

Objective: To investigate reports of iodine-deficiency disorder in a specific area of Haiti.

Methods: In March 2008, this cross-sectional study was performed in an area 15 miles northeast of Jacmel, Haiti, within the Chaîne de la Selle Mountains. Before arrival of the study team, an announcement was made throughout local villages soliciting volunteers to meet at a central location. Of those who arrived, participants were selected in an attempt to sample individuals from all age groups, regardless of goiter status. After providing verbal informed consent, each participant was photographed and assigned a number to be used to protect privacy. An examiner performed palpation of the thyroid gland on each participant in accordance with World Health Organization criteria. Results of palpation were classified into 3 grades: grade 0, the thyroid gland was not palpable; grade 1, the thyroid gland was palpable but not visible; and grade 2, the thyroid gland was palpable and visible while the patient was in a normal position. Casual urine samples were collected from each participant and analyzed spectrophotometrically for urinary iodine concentration.

Results: Eighty-eight individuals aged 2 to 72 years participated in the study. Median urinary iodine concentration was 39 microg/L. Of the 88 participants, 82 (93%) were iodine deficient (18 [20%] were severely deficient), and 45 (51%) had goiter on physical examination, including 27 with grade 1 goiters and 18 with grade 2 goiters.

Conclusions: We have documented iodine deficiency with associated endemic goiter in this previously uninvestigated Haitian population, for which world health agencies currently lack definitive data. These data have potential implications for both the local area and the country as a whole where further evaluation and treatment are needed for persons at high risk for iodine-deficiency disorder.