Spectrum of Endocrine Disorders in Central Ghana

Abstract

Background. Although an increasing burden of endocrine disorders is recorded worldwide, the greatest increase is occurring in developing countries. However, the spectrum of these disorders is not well described in most developing countries. Objective. The objective of this study was to profile the frequency of endocrine disorders and their basic demographic characteristics in an endocrine outpatient clinic in Kumasi, central Ghana. Methods. A retrospective review was conducted on endocrine disorders seen over a five-year period between January 2011 and December 2015 at the outpatient endocrine clinic of Komfo Anokye Teaching Hospital. All medical records of patients seen at the endocrine clinic were reviewed by endocrinologists and all endocrinological diagnoses were classified according to ICD-10. Results. 3070 adults enrolled for care in the endocrine outpatient service between 2011 and 2015. This comprised 2056 females and 1014 males (female : male ratio of 2.0 : 1.0) with an overall median age of 54 (IQR, 41–64) years. The commonest primary endocrine disorders seen were diabetes, thyroid, and adrenal disorders at frequencies of 79.1%, 13.1%, and 2.2%, respectively. Conclusions. Type 2 diabetes and thyroid disorders represent by far the two commonest disorders seen at the endocrine clinic. The increased frequency and wide spectrum of endocrine disorders suggest the need for well-trained endocrinologists to improve the health of the population.

Global epidemiology of hyperthyroidism and hypothyroidism

“…Recent hospital based studies from Ghana show that contrary to earlier reports, Graves' disease is not uncommon, comprising 54% of all cases of thyroid dysfunction 44 although there may be ascertainment bias. While this may be due to improvements in iodine nutrition subsequent studies in the aftermath of iodisation in Ghana has shown marked increases in the incidence of both Graves' disease and nodular disease suggesting a role for improved diagnosis 45 .…”

Spectrum of endocrine disorders as seen in a tertiary health facility in Sagamu, Southwest Nigeria

“…In this 3-year analysis of endocrine consultations at our endocrine clinic, DM, thyroid disorders followed by metabolic syndrome, and HPOs accounted for the highest reasons for endocrine consultations. This is similar to global reports of DM followed by thyroid disorders as the commonest causes of endocrinopathy worldwide 34…”

“…According to the World Health Organization data published in 2017, Nigeria is the 10 th country with the highest endocrine-associated mortality worldwide with mortality put at nearly 42,961 (2.11%),2 death rate is 19.56/100,000 deaths, while about 118 people die of endocrine disorders each day, an average of 1 death every 13 min 2. Factors contributing to high endocrine mortality include limited number of endocrinologists, missed or delayed diagnosis by nonspecialists, and priority given to infectious (communicable) diseases 34…”

“…In Ghana, the most common primary endocrine disorders are diabetes mellitus (DM), thyroid, and adrenal disorders at frequencies of 79.1%, 13.1%, and 2.2%, respectively 4. In United States, DM and its associated conditions are the most common endocrine disorders encountered followed by thyroid disorders, calcium and metabolic bone disorders, adrenals, reproductive disorders, and hypothalamic–pituitary disorders (HPOs) 5…”

Thyroid scintigraphy in the management of benign thyroid disease

“…1,2 Sarfo-Kantanka et al have reported that thyroid disorders are the second leading cause of endocrine morbidity in central Ghana with hyperthyroidism accounting for 9.2% of all cases seen in their endocrine service. 3 The same authors have reported that toxic multinodular disease is more common than thyrotoxicosis from diffuse goitre in Ghana. 4 In this paper, we aim to highlight the essential role of thyroid scintigraphy in the management of benign thyroid disease and alert clinicians in Ghana to the availability of this resource.…”