Diagnosis of Goiter by Primary Health Workers:Comparison of Two Methods

Iodine deficiency disorders (IDD) have been a major health problem in Iran. In order to train primary health workers (Behvarz) the diagnosis of visible goiter, two methods were compared. I: With head and neck in normal position; II: With extended neck. Behvarzes in 29 rural health centers in Ghazvin were trained method I an d30 were trained method II. 1541 school children in Ghazvin and 1532 in Abjar, aged 8 to lo years were examined by Behvarz and 2 weeks later by an endocrinologist. The results showed sensitivity of 69.3 and 42.0 positive predictive value of 76.3 and 51.8% and efficiency of 610 and 58.7% with methods I and II, respectively. It is concluded that Bchvarzes do better diagnosis with method II and they should be trained with extended meck for epidemiological detection of goiter.