Prevalence of goitre and goitrogenic factors in healthy tribal children from Southern Rajasthan

Background and objectives Despite universal salt iodisation (USI), goiter remains endemic in various regions worldwide, including India. We assessed goiter prevalence and goitrogenic factors in tribal children from Southern Rajasthan. Methods Community-based cross-sectional study conducted in 30 schools across Udaipur district (December 2021-December 2022). A total of 1599 tribal children aged 6-18 y were examined for goiter using World Health Organization (WHO) criteria. Thyroid function tests and complete blood count were performed in 1447 children. A nested case-control study compared 100 goitrous and 100 non-goitrous children for autoimmunity (anti-TPO antibodies) and micronutrient deficiencies (iron, selenium, and vitamin B 12). Results Overall goiter prevalence in the tribal children was 13.07% [95% confidence interval (CI): 11.57%-14.57%] with a median urinary iodine concentration (MUIC) of 195.8 µg/L, indicating iodine sufficiency. The most common thyroid dysfunction was subclinical hypothyroidism (SCH) (11.47%). Anti-TPO positivity was significantly higher in goiterous children (68% vs. 52%, P =0.02; Odds Ratio=1.96). Among children with and without goiter, iron deficiency (61% vs . 65%), vitamin B 12 deficiency (58% vs. 55%) and selenium deficiency (22% vs. 29%) showed no significant differences. The overall prevalence of anemia in the entire population was 35.93%. Interpretation and conclusions Goiter remains prevalent among iodine-sufficient tribal children. Presence of autoantibodies emerged as the primary goitrogenic factor, while the micronutrient deficiencies were prevalent in both goitrous and nongoitrous but showed no significant association with goiter. High prevalence of anemia needs to be addressed.