Assessment of the current status of iodine prophylaxis in Bosnia and Herzegovina Federation

Assessment of the status of iodine prophylaxis was studied in 5,523 schoolchildren randomly selected in all cantons in Bosnia and Herzegovina Federation (BHF). According to the iodine content of household salt samples, all cantons of BHF were divided into two groups: Group A: 95.5% of the salt used is produced in the Tuzla plant, in which the salt is iodized at 5-15 mg KI/kg salt, and 4.5% of the salt used is produced in the Pag plant, in which the salt is iodized at 20-30 mg KI/kg of salt, and Group B: 19.9% of the salt used is produced in the Tuzla plant and 80.1% in the Pag plant. In Group A the amount of iodine in salt was significantly lower than in Group B (11.4 mg/kg vs 18.9 mg/kg, P<0.001). In Group A the prevalence of goiter was significantly higher than in Group B (32.6% vs 19.7%, P<0.001). The highest prevalence of goiter was in Bosnian Podrinje Canton (51.2%) and Central Bosnian Canton (42.6%) while the lowest was in West Herzegovina Canton (12.9%). Significantly higher concentrations of urinary iodine were found in Group B than in Group A (82.6 mug/l vs 75.2 mug/l, P<0.001). In Group A the percentage of urine samples below 50 <mu>g/l iodine was significantly higher than in Group B (35.6% vs 26.9%, P<0.001), but there was no difference in the percentage of urine samples with iodine values less than 100 <mu>g/l (70.7 mug/l vs 68.25 mug/l, P>0.05). We conclude that FBH is an iodine deficient area and that the improvement of iodine prophylaxis is urgently required, primarily by increasing salt iodine content to 20-30 mg/kg, in order to eradicate endemic goiter.