Normal Reference Values for Thyroid Uptake of Technetium-99m Pertechnetate for the Namibian Population

Objective: Historically; changes in normal thyroid uptake values for iodine have been reported in different geographical areas. These changes have been linked to geographical and chronological fluctuations in dietary iodine intake in different populations. Namibia is a country with mixed ethnicity; with access to dietary iodine in table salt. Despite historical reports on deviating normal thyroid uptake values (emphasising the importance of establishing local normal reference values); the relevant Namibian authorities have never revised these reference values; nor have local reference values been established. The aim of this study was to establish the normal reference values for thyroid uptake of technetium-99m pertechnetate in the Namibian population.Design: Participants who were considered to be euthyroid completed a questionnaire designed to exclude individuals with thyroid pathologies; as well as those with renal or heart disease.Settings and subjects: The study cohort consisted of 76 participants (58 women and 18 men); ranging in age from 39-81 years. The participants were of mixed ethnicity; consisting of Hereros; Ovambos; Damaras; Namas; Coloureds; Caucasians and other (non-Namibian immigrants); and were from Windhoek; Namibia. Studies were performed at the Windhoek Central Hospital.Outcome measures: Blood was drawn for thyroid hormone assessment. Participants were then given 100 MBq of technetium-99m pertechnetate intravenously; and their percentage thyroid uptake recorded after 20 minutes. Results: In this study; thyroid-stimulating hormone; triiodothyronine; and thyroxine levels were found to be 1.7 ?IU/ml; 4.9 pmol/ml and 10.3 pmol/ml; respectively. Analysis of the empirical data showed that the normal reference uptake value for technetium-99m pertechnetate in the studied population ranged between 0.04 .The fifth and 95th percentiles for pertechnetate uptake were 0.15; respectively.Conclusion: These results provide new evidence which supports the importance of periodical evaluation of normal thyroid uptake reference values for technetium-99m pertechnetate

The role of changing diet and altitude on goitre prevalence in five regional states in Ethiopia

Objective: Iodine Deficiency Disorders (IDD) as one of the leading nutritional problems has been increasing through time due to iodine deficiency; aggravating factors and IDD knowledge in many parts of Ethiopia. The effect of changing diet and altitude on goitre prevalence is assessed. Methodology: Randomly selected five regional states (Amhara; Oromiya; Tigray; SNNP and Benshangul-Gumuz) were used to conduct cross-sectional study on IDD. In each region cluster sampling method was applied to select study subjects. Low land and adjacent high land were independently sampled to investigate the role of altitude on goiter prevalence. Totally 6960 children and the same number of biological mothers of the children were included in the clinical examination for goiter and household interview. Urine samples were collected from children for urinary iodine examination/analysis (UIE). Besides; in all clusters qualitative data were collected on IDD knowledge and cassava introduction; cultivation and consumption. Results: Cassava consumption and living in high altitude were found to be risk factors for IDD. In the two regions (SNNP and Benshangul-Gumuz) among three where cassava is cultivated; those who consume cassava frequently were significantly (p0.001) affected by goitre than those consuming rarely or not. In the last thirty years cassava consumption has been increasing with the concomitant increase in goitre rate and other associated health problems. Acute cyanide intoxication in children from cassava meal was reported. In Amhara region; goitre rate was significantly (p0.05) higher in high altitudes than in low both for children and mothers. This was due to significantly (p0.01) low level of iodine intake in high lands than in low as indicated by UIE. Due to stigma; parents do not send goitrous children to schools and goitrous girls are not wanted for marriage. Conclusion: Besides low level of iodine intake; cassava consumption and living in high altitude were responsible for the observed variation and severity in goitre rates. IDD affects several dimensions of human life including school enrolment and marriage. Addressing IDD in-terms of salt iodization and training communities on cassava processing techniques to remove cyanide; awareness creation on IDD and soil conservation are highly recommended

Perturbations thyroidiennes dans la région à risque de Tanguieta

Les perturbations thyroidiennes sont connues pour etre un probleme de sante dans presque tous les pays du monde. Au Benin; rien n'est fait afin de comprendre l'ampleur et l'evolution de ces perturbations. But : Nous avons initie ce travail dans le but d'etablir le profil des differents types de perturbations. La ville de Tanguieta au Nord du Benin a ete choisie comme ville d'etude. Methode : nous avons recueilli le sang veineux chez 320 individus dans la population selectionnee selon les criteres bien definis (sexe; age profession) 51;87dans la commune urbaine de Tanguieta (Brouniessou et Biakou) et 48;13dans la commune rurale de Taiacou (Nafayoti et Tahongou). Les analyses suivantes ont ete realisees : Dosage de T3; T4 libre; TSH ultra sensible par la technique d'ELISA. Resultats : Les perturbations thyroidiennes apparaissent chez les deux sexes (32dans la population masculine et 46;11dans la population feminine). D'une facon generale 41;4des sujets preleves avaient une perturbation thyroidienne ; avec un taux de perturbations le plus elevee dans le village de Tahougou et le moins elevee dans le village de Brouniessou. Les perturbations thyroidiennes touchent les cultivatrices et menageres (48) les cultivateurs (35;84) et les eleves (32;61). Les perturbations thyroidiennes sont abondantes dans la ville et regions environnantes de Tanguieta. Elles touchent principalement les femmes (hypothyoidies : 19;68. 13;43des hommes entre 45-60 ans sont ont une hyperthyroidie. Les autres perturbations thyroidiennes (taux isolement eleves de T3; T4 libre ou TSH) sont evaluees a 7;5. Conclusion : Les perturbations thyroidiennes sont presentes dans cette region de Benin. Une etude approfondie sur les autres indicateurs biologiques (facteurs goitrigenes) permettra d'elucider profondement la question

Salt Iodisation in Port Harcourt Metropolis : a Survey of Households and Markets

Background: Consequent on the recognition of the public health importance of Iodine Deficiency Disorders (IDD); especially in developing countries; the goal of iodising at least 90of edible salts by 2000 was set at the 1990 World Summit for Children.Aim: To determine the salt iodisation level in Port Harcourt.Methods: In April 2000; using pre-tested questionnaires and MBI field test kits; traders from 8 markets and residents of 2181 households in Port Harcourt were interviewed and samples of their edible salts tested to determine their iodine content.Results: The major salt brands of the 336 market and 2182 household samples were Union Dicon (70.54and 25.52) and Cassava (11.9and1.92). About 17of salt samples tested from markets compared to 72.55from households; were of unknown brands (p=0.00000). Over 99of samples from markets and households (99.7and 99.13respectively) had 30 ppm of iodine. All 27 traders interviewed were ignorant of salt iodisation programme and IDD; 92.6had seen persons with 'goitre' but were ignorant of its causes and prevention.Conclusion: Salt iodisation at the point of production has proved effective in increasing the consumption of iodised salts in Port Harcourt despite the widespread ignorance of the programme and its importance in controlling IDD. That most of the salts had 30 ppm of iodine portends the danger of toxicity with long-term use. There is need for close monitoring to ensure the safety of the intervention and its sustainability

Monitoring the severity of iodine deficiency disorders in Uganda

Iodine deficiency disorders (IDD) cover a variety of pathological conditions including goitre; mental retardation and perinatal mortality in millions of individuals globally. IDD was initially identified as a problem in 1970 and was confirmed in 1991. In 1993; the Ugandan government introduced a policy of Universal Salt Iodization (USI) requiring all household salt to be iodized. After 5 years this study evaluates the USI programme. Objectives: To determine goitre prevalence rate; establish the proportion of household consuming iodized salt and determine the levels of iodine intake in the sample districts. Methods: A sample of 28880 school children aged 6-12 years from 72 primary school in 6 districts of Uganda was studied in October 1999. Goitre was established by palpation; salt iodine was analysed by thiosulphate titration; while urinary iodine was analyzed using ICCIDD recommended method F in which iodine is detected colorimetrically at 410nm. Results: The over all total goitre rate was 60.2down from 74.3 in 1991 and visible goitre was 30down from 39.2in 1991. The proportion of households taking adequately iodized salt was 63.8and the median urinary iodine was 310ug/L. Whereas 36of 95 urine samples analyzed in 1991 had urinary iodine below 50ug/L; only 5of the 293 urine samples studied in 1999 had the same urine levels. This represents a considerable improvement in iodine intake which is confirmed by the fact that 63.8of the study households consume adequately iodized salt. If maintained and evenly spread; this will enable Uganda to control IDD. Conclusion: USI has improved iodine intake in Uganda. However; iodine malnutrition is still a severe public health problem because some communities in this study such as in Kisoro still have low iodine consumption; while others such as Luwero now have iodine excess. The latter is likely to predispose to hypertthyroidism. Recommendation: The national set standard of household salt iodine of 100ppm be revised. Locally produced salt be iodized; and a national iodine monitoring programme be instituted to ensure evenly spread consumption of adequately iodized salt by all communities in the country

Epidemiologie et prise en charge therapeutique des goitres en milieu hospitalier a Ouagadougou

L'augmentation de volume du corps thyroide constitue un motif frequent de consultation au Burkina Faso. Cette etude porte sur 170 cas de goitres colliges en consultation de medecine interne a l'Hopital National de Ouagadougou et se propose d'apprecier les aspects epidemiologiques; cliniques; etiologiques et therapeutiques des goitres en milieu hospitalier dans une zone d'endemie. Dans cette etude; il ressort que les goitres sont surtout frequents dans le sexe feminin; de volume modere a eleve; et diffus et/ou nodulaires. Il s'agit de goitres anciens evoluant dans 75 pour cent des cas depuis plus de 1 an. 75 pour cent de ces goitres sont normofonctionnels et lorsqu'ils sont diffus; homogenes et jeunes; ils repondent bien au traitement medical avec une egale efficacite en utilisant l'iode (par voie voie orale ou en solution injectable) ou les hormones thyroidiennes a visee frenatrice. Les goitres nodulaires (nodule unique ou multiple) repondent mal a ce traitement; necessitant le recours a la chirurgie. Les resultats de ce traitement chirurgical sont bons mais il necessite le recours a une hormotherapie substitutive souvent definitive lorsque la resection a ete large (thyroidectomie totale ou subtotale). Le cancer thyroidien; a craindre devant les goitres anciens et devant tout nodule thyroidien froid a ete rarement observe (2 cas). Cependant la gravite de son evolution doit rendre systematique sa recherche devant tout goitre ou nodule suspect. L'importance de la carence en iode dans notre milieu exige un traitement preventif intensif en amont par l'administration d'iode

Iodine deficiency disorders in Dowa District

This study was carried out to serve as preliminary study for a possible wider population survey on the prevalence of iodine deficiency disorders. The results indicate that there is iodine deficiency in the pupils attending three schools in the three areas investigated. The high prevalence of both total goitre (65 percent) and visible goitre (8 percent) among the children; seems to indicate that areas of severe endemicity could exist in Dowa District

Iodine deficiency disorders (I.D.D.): a survey in Dowa District

In June 1990; a survey was carried out to give a preliminary impression of the degree of prevalence of iodine deficiency disorders in Dowa district. Results show that areas included in the study suffer from moderately severe iodine deficiency; there is a high prevalence of goitre; female children are more at risk; the long term soloution of adding iodine to all salth sold in the country would be likely to be of benefit

Essential micro-nutrients supplementation project; 1990-1992

The overall goal of the programme is to fight three major components of malnutrition in Malawi (iodine deficiency disorders; nutritional anemias and vitamin A deficiency)

Goitre control in Malawi: report of a consultancy

At the request of the Ministry of Health; the World Health Organization [WHO] sponsored a consultancy report to determine the geographical distribution of endemic goitre; prepare a programme of control; and study feasibility of research into its prevention

Prevention and control of iodine deficieny; studies on the effectiveness or orally administered iodized oil

A report of fieldwork activities in Ntcheu District during the period August 1990 - December 1991

Carence en iode et reproduction chez les femmes de l'Adamaoua

La malnutrition est aggravee par les deficiences en oligo-elements et l'une des formes les plus connues est la carence en iode qui donne des troubles divers. Cette carence atteint environ 160 millions de personnes en Afrique contre 300 millions en Chine; 200 millions en Inde; 100 millions en Indinesie; 60 millions en Amerique et quelques millions de cas en Europe. Les troubles dus a la carence en iode (TDCI) sont un probleme general qui touche 12de la population mondiale. Au Cameroun; l'enquete nationale sur les TDCI montre que 6 millions de personnes sur 11 millions sont atteintes; de meme que toutes les 10 provinces mais a des taux differentes de prevalence. Ainsi une forte endemicite est signalee a l'Extreme-Nord (Doukoula 75); au Nord-Ouest (64a Oshie et 59a Jakiri); dans l'Adamaoua (45dans Vina); dans Ouest (58dans le Noun) et une endemicite moindre dans l'Est (14a Batouri)