WM Wan Nazaimoon and S Rufifah Institute for Medical Research and Institute for Public Health, Ministry of Health, Kuala Lumpur
Malaysia following a national IDD survey in 1996, implemented universal salt iodization (USI) in Sabah and the majority of districts in Sarawak, but concluded IDD was not a public health problem in Peninsular Malaysia (1). However, subsequent studies showed otherwise. A study in rural Malay women of reproductive age living on the outskirts of Kuala Lumpur found a goiter prevalence of 23-24.5 %(2). Despite the use of a water iodination system to supply iodine to 26 schoold in the state of Terengganu, the median urinary iodine concentration (UIC) of children aged 8-10 years was only 75 ug/L, and was comparable to the median UIC of 73ug/L measured in children from schools without water iodination (3).
Hence to judge the need to institute USI for the whole of Malaysia, the ministry of Health did a national survey in 2008 to assess the IDD status in the country. First, a nationwide cross-sectional school based survey was done in all the 13 states and 3 federal territories and included 18078 school children aged 8-10 years from 445 primary schools registered under the Ministry of Education, Malaysia; 55.9% and 44.1% were from urban and rural areas respectively. Approximately 1200 school children were then randomly selected from both urban and rural schools from each state, and their UIC was determined using an in house micro-method(4).
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