Thyroid disorders in bangladesh: An epidemiological perspective

Selim, Shahjada; Kamrul-Hasan, AB. M.

doi:10.4103/bjem.bjem_14_23

Cited by 3 publications

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References 5 publications

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“…The prevalence of goiter reduced from 55% in 1993 to almost 7% in 2005. However, the prevalence of iodine deficiency remained high (almost 40% among school-age children and 42% nonpregnant, nonlactating women) ( 5 ).…”

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confidence: 99%

Approach to management of hypo and hyperthyroidism in Bangladesh: a nationwide physicians’ perspective survey

Selim,

Mustari,

Khan

et al. 2024

Front. Endocrinol.

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IntroductionThyroid disorders are common clinical conditions globally. The objective of the present study was to evaluate the physicians’ approach to the diagnosis and treatment of thyroid disorders in Bangladesh.MethodsThe present nationally representative cross-sectional study was conducted among 662 physicians of different levels (general practitioners as well as specialists) from different hospitals in Bangladesh from January to June 2023. A self-administered semi-structured questionnaire including information about demographics and practice patterns for the diagnosis and management of thyroid disorders was used for data collection. Descriptive statistics were used to analyze the data.ResultsThe American Thyroid Association (ATA) guidelines were the most commonly followed guidelines for the diagnosis and management of thyroid disorders (60%), followed by the American Association of Clinical Endocrinologists (AACE) guidelines (18%) and the European Thyroid Association (ETA) guidelines (9%). Serum TSH, free T3 and free T4 levels were the most frequently used diagnostic tests for the evaluation and follow-ups of both hypothyroid and hyperthyroid states in adults, pregnant women and children, followed by total T3 and total T4 levels. Other tests, such as anti-TPO antibody, anti-TG antibody, anti-TPO, ultrasound scan of the thyroid gland, etc., were rarely used by the participating physicians. Levothyroxine at a dose of 25 to 50 mcg and carbimazole at a dose of 30 to 45 mg were the most frequently used drugs for hypothyroid and hyperthyroid patients, respectively. Almost 65% of the physicians suggested routine thyroid function tests before surgery. In addition, more than 90% of the physicians agreed that thyroid screening for pregnancy, neonates, school children and adults would be mandatory.ConclusionThe majority of the physicians participating in our study followed relevant guidelines for the diagnosis and management of thyroid disorders in Bangladesh. However, there are still some gaps to be improved, as a good number of physicians did not follow specific guidelines for these disorders.

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Section: Introductionmentioning

confidence: 99%

Approach to management of hypo and hyperthyroidism in Bangladesh: a nationwide physicians’ perspective survey

Selim,

Mustari,

Khan

et al. 2024

Front. Endocrinol.

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Arsenic Toxicity and Thyroid Disorders – From Bangladesh’s Perspective

Shahid

2024

Bangladesh Journal of Endocrinology and Metabolism

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Demographic and Clinical Characteristics of Patients with Primary Hypothyroidism and Adequacy of Levothyroxine Replacement Therapy in Them: A Nationwide Study in Bangladesh

Kamrul-Hasan,

Mustari,

Hannan

et al. 2024

Bangladesh Journal of Endocrinology and Metabolism

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Background: Despite the huge burden of primary hypothyroidism in Bangladesh, no nationwide study has been conducted describing the demographic and clinical characteristics of these patients; data on the adequacy of levothyroxine (L-T4) replacement are also lacking. This study aimed to fill the knowledge gap. Materials and Methods: This cross-sectional study was conducted among patients with primary hypothyroidism attending the endocrinology outpatient clinics of several hospitals throughout Bangladesh from July 2023 to December 2023. Adults with primary hypothyroidism who had been on L-T4 replacement for at least 1 year were included. Data on their demographic and disease-related characteristics were collected. Serum thyroid-stimulating hormone (TSH) was measured; TSH 0.4–4.0 μIU/mL was considered the therapeutic target for nonmalignant thyroid cases. Results: Two thousand six hundred and forty-one patients (median age 37 years, 86.4% female, and median disease duration 5 years) were included. Hashimoto’s thyroiditis was the most common (40.9%) cause of hypothyroidism; 1.9% had differentiated thyroid cancer (DTC), and the etiology was not established in many (40.2%). Only 26.8% of patients had high adherence to L-T4. Among the non-DTC cases (n = 2590), over half (53.9%) had TSH within the target range, whether the disease was uncontrolled in the remaining 46.1% (TSH was below the target range in 5.6% and above the target range in 40.5%). Among the DTC cases (n = 51), only a few (9.8%) had a TSH within the target range; TSH was below and above the range in 2% and 88.2% of these patients, respectively. In the nonmalignant hypothyroid cases, vegetarian diet, smokeless tobacco use, disease duration >5 years, iron or calcium supplements consumption within 4 h of L-T4 intake, and low or medium adherence to L-T4 were associated with uncontrolled hypothyroidism. Conclusion: For nearly half of Bangladeshi patients with primary hypothyroidism, L-T4 replacement is not optimal. Physicians should address the barriers to reaching the therapeutic goal for these patients.

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Thyroid disorders in bangladesh: An epidemiological perspective

Cited by 3 publications

References 5 publications

Approach to management of hypo and hyperthyroidism in Bangladesh: a nationwide physicians’ perspective survey

Approach to management of hypo and hyperthyroidism in Bangladesh: a nationwide physicians’ perspective survey

Arsenic Toxicity and Thyroid Disorders – From Bangladesh’s Perspective

Demographic and Clinical Characteristics of Patients with Primary Hypothyroidism and Adequacy of Levothyroxine Replacement Therapy in Them: A Nationwide Study in Bangladesh

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