Nodular goiter. Incidence, morphology before and after iodine prophylaxis, and clinical diagnosis.
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The Australian States in which endemic-goitre areas are known to exist are New South Wales, South Australia, Tasmania, and Victoria. These are the only States that have introduced legislation concerning the iodization of salt. Some evidence is available which suggests that parts of northern Queensland may also be mildly goitrous. Iodine prophylaxis, in the form of a 10-mg tablet of potassium iodide given weekly to pregnant and lactating women, infants, children, and adolescents, was introduced by the Australian Department of Health in 1947. The scheme started in Canberra, and was later extended to Tasmania and parts of Victoria.Goitre was first recognized in the European population of New Zealand in 1882. Many surveys have been made; the most extensive were undertaken in the 1920's, when some 90,000 school-children were examined. The highest figures were obtained in the Christchurch area.The average incidence of goitrous deformities has dropped from 62%, in 1925, to 25%, in 1951, owing to the disappearance of gross deformities, but the incidence of palpably enlarged goitres is still high. Iodized salt has been available since 1924, but is used by only about 80% of the population. Moreover, some of the salt is insufficiently iodized.The distribution of goitre in Melanesia is patchy. Areas in which more than 50% of the men and almost all the women have grossly enlarged thyroids adjoin goitre-free places. Insufficient surveys have been made to estimate the extent of the disease, but it is believed that goitre is a public-health problem in New Guinea. Active preventive measures have not yet been undertaken. Salt is in great demand in this region, and the author expresses the opinion that it should not be difficult to establish a satisfactory campaign on the use of iodized salt.
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