Prevalence of Thyroid Disorder in A Primary Care District Hospital of Nepal

Abstract

Introduction: Thyroid disorders are among the common endocrine disorders and may approximate diabetes in prevalence. District hospitals are in frontline to manage chronic disorders including thyroid. Primary care workforce of physicians and mid-level providers together deliver care in these hospitals. Few hospitals are equipped with tests to diagnose thyroid disorders. The objective of the study is to find the burden of thyroid disorder in a district hospital of Nepal.Methods: This was a descriptive cross sectional study conducted in Bayalpata Hospital. One year data from July 2017 to June 2018 was collected from the electronic health record system. Data was collected from 999 patients through convenient sampling where thyroid function test was done. Subgroup analysis was done on basis of gender, symptoms at presentation and comorbidities.Results: Prevalence of thyroid disorder in a district hospital of Nepal was 171 (17.11%) at 95% confidence interval, range occurring from 14% to 20%. Among them, 130 (76%) had hypothyroidism and 41 (24%) had hyperthyroidism. Prevalence of thyroid disorder among female was 147 (14.7%) and among male was 24 (2.4%). The most common symptom was depressed mood followed by nonspecific pain disorder, thyroid swelling, paresthesia and menstrual disturbances and common comorbidities reported were depression, diabetes, hypertension, anxiety disorder and chronic gastritis. Conclusions: Our study showed the burden of thyroid disorders in a primary care district hospital with hypothyroidism being more common than hyperthyroidism. Thyroid disorder must be addressed on time to lower the burden. However, most of the rural population of Nepal lack in matters of lack of resources. So, it is suggested for the need to equip the health centers with thyroid tests and integrated workforce of physicians and mid-level providers in care delivery of thyroid disorders.

Spectrum and Prevalence of Thyroid Diseases at a Tertiary Referral Hospital in Mogadishu, Somalia: A Retrospective Study of 976 Cases

“…Diabetes mellitus is associated with a higher prevalence of thyroid disease, and vice versa [ 24 ]. Studies in Nepal among thyroid comorbid DM were shown in category three after the depression and hypertension [ 25 ], although our study observed that 13% of thyroid patients had diabetes mellitus which was the first category before HIV and malaria.…”

Status of Thyroid Disorder among the Thyroid Function Test Samples Received in a Laboratory among Postmenopausal Women: A Descriptive Cross-sectional Study

“…Jayan et al, 11 Khatiwada et al 16 and Yadav et al 17 however have found a higher prevalence of 42% among female population in South Western Nepal and 40% in BPKIHS, Dharan and far Western Nepal respectively. In contrast, one of the study 18 in Far Western region of Nepal has revealed only 15% of thyroid dysfunction in females. In Indian population, an epidemiological study has reported higher prevalence of TD in females however lesser frequency than in Nepal accounting to 11.4%.…”

Study of technetium pertechnetate (99mTcO4) thyroid scintigraphy imaging among patients presenting with thyrotoxicosis at a tertiary care hospital in Kathmandu, Nepal

“…4 A study from eastern Nepal showed that out of a total of 599 patients , 13.68% were affected by hyperthyroidism whereas another cross sectional study done in a district hospital in Bayalpata ,Nepal showed thyroid disorders to be present in 17% of the study population with approximately one fourth having hyperthyroidism. 5,6 In a population survey done by Carlos et al involving almost 5000 non pregnant adults it was seen that subclinical hyperthyroidism was present in 5.33% where as true hyperthyroidism was seen in only 0.61%. 7 A population study in the US showed hyperthroidism to be be present in 1.3% (0.5% clinical and 0.7% subclinical).…”