RESUMO
OBJECTIVE: A survey related to iodine deficiency in the Republic of Srpska was first conducted in 1999 and resulted in the adoption of regulations concerning the quality of salt for human consumption. In order to reassess iodine status, we conducted the Republic of Srpska Iodine Deficiency Survey in 2006. DESIGN: The survey was conducted in a sample of 1,200 schoolchildren using parameters recommended by WHO, UNICEF and ICCIDD: palpation of thyroid gland, iodine urinary excretion, thyroid utrasonography and content of iodine in salt. RESULTS: The goiter prevalence in the total group indicated mild iodine deficiency in the Republic of Srpska, whereas urinary iodine excretion suggested iodine sufficiency. Only 35.7% of salt samples were adequately iodinated, 51.2% were hypo-iodinated and 13.1% were hyper-iodinated. Of the salt samples tested, 40.9% were iodinated using potassium iodide, despite the fact that this method of salt iodination is forbidden by regulations related to the quality of salt for human consumption. Higher prevalence of goiter and lower urinary iodine content was found in rural areas compared to urban ones, although the iodine content of salt did not differ between these two areas. CONCLUSIONS: It seems that the Republic of Srpska has progressed from moderate (1999) to mild iodine deficiency with a wide range in the urinary iodine excretion values. However, the salt for human consumption is of low quality. The higher prevalence of goiter and the lower urinary iodine values in rural areas compared to urban ones may be attributed to differences in salt usage and/or nutritional factors.