RESUMO
To compare different indicators of iodine deficiency disorders [IDD] in school children from study sites in Bangladesh Indonesia, Guatemala, and the United States. Cross-sectional surveys were performed in Savar, Bangladesh; Sukabumi, Indonesia; San Pedro Sacatepequez, Guatemala; and Atlanta, United States. In each study site, school children were assessed for thyroid size by palpation and thyroid volume by ultrasonography, urine specimens collected for iodine concentration, and finger stick blood specimens spotted onto filter paper for assessment of thyroid stimulating hormone [TSH] and thyroglobulin [Tg]. Weights and heights were collected in all sites except Guatemala. Between 305 to 518 school children were surveyed in each site. Indicators based on thyroid size tended to indicate more severe levels of iodine deficiency compared to urinary iodine based on WHO/UNICEF/ICCIDD criteria. TSH levels appeared to correlate well with other indicators of IDD whereas Tg did not. In these study sties, it appeared that urinary iodine, thyroid volume [based on body surface area], palpation, and TSH were consistent in identifying the Bangladesh site as having the highest prevalence of IDD, followed by sites in Indonesia, Guatemala, and the United States. The prevalence of goiter indicated more severe levels of IDD compared to urinary iodine levels. Tg was not significantly different between the study sites