factors affecting sustainable iodine deficiency elimination in pakistan a global perspective

Journal of Epidemiology xxx (2017) 1e9 Contents lists available at ScienceDirect Journal of Epidemiology journal homepage: http://www.journals.elsevier.com/journal-of-epidemiology/ Review Article Factors affecting sustainable iodine deficiency elimination in Pakistan: A global perspective Rehman Mehmood Khattak a, c, *, e, Muhammad Nasir Khan Khattak b, e, Till Ittermann a, € lzke a, d Henry Vo a Institute for Community Medicine, Walther-Rathenau Str 48, Ernst Moritz Arndt University, D-17475, Greifswald, Germany Department of Zoology, Hazara University, Mansehra, Pakistan Department of Zoology, Islamia College Peshawar (CU), Pakistan d DZHK (German Centre for Cardiovascular Research), Partner Site, University Greifswald, Germany b c a r t i c l e i n f o a b s t r a c t Article history: Received 11 November 2015 Accepted 19 April 2016 Available online xxx Iodine deficiency remains a considerable challenge worldwide, even after decades of efforts to address the problem The aim of this review is to present the current situation in historically iodine-deficient Pakistan regarding iodine nutritional status and place it in a global perspective We collected relevant articles from online bibliographic databases and websites of concerned organizations that addressed prevalence of goiter/iodine deficiency and barriers to sustainable control We divided the studies into pre- and post-1994, a landmark year when Pakistan formally adopted the universal salt iodization (USI) programme Overall, 56 studies reported goiter/iodine deficiency prevalence in Pakistan Before 1994, six studies (30%) reported a goiter prevalence 70%, while nine studies (45%) reported a goiter prevalence between 30% and 70% Only five studies (25%) found a goiter prevalence less than 30%, of which only two studies reported prevalence