Background: Deficiencies of iodine, iron, and vitamin A are the 3 most comm
on micronutrient deficiencies in developing countries, although control pro
grams, when properly implemented, can be effective.
Objective: We investigated these deficiencies and their possible interactio
n in preschool children in the southern Blue Nile area of Sudan.
Design: Goiter, signs of vitamin A deficiency, and biochemical markers of t
hyroid, vitamin A, and iron status were assessed in 984 children aged 1-6 y
Results: The gaiter rate was 22.3%. The median urinary iodine concentration
was 0.79 mu mol/L and 19.38 of the children had a concentration >1.57 mu m
ol/L. Although serum thyroxine and triiodothyronine concentrations were wit
hin reference ranges, the median thyrotropin concentration was 3.78 mIU/L a
nd 44% of the children had thyrotropin concentrations above normal. The mea
n urinary thiocyanate concentration was high (259 +/- 121 mu mol/L). The pr
evalences of Bitot spots and night blindness were 2.94% and 2.64%, respecti
vely, and 32% of the subjects had serum retinol binding protein concentrati
ons <15 mg/L. A significant positive con elation was observed between thyro
tropin and retinol binding protein. Whereas 88% of the children had hemoglo
bin concentrations <1.86 mmol/L, only 13.5% had serum ferritin concentratio
ns below the cutoff of 12 mu g/L and 95% had serum transferrin concentratio
ns above the cutoff of 2.50 g/L.
Conclusions: Our results indicate that goiter is endemic in this region of
Sudan despite iodine sufficiency and that both anemia and vitamin A deficie
ncy are health problems in the area. Moreover, consumption of millet, vitam
in A deficiency, and protein energy malnutrition are possible etiologic fac
tors in this endemic area.