Prevalence of permanent congenital hypothyroidism in Isfahan-Iran

Considering the importance to determine the reasons for the higher occurrence of congenital hypothyroidism [CH] in Iran, in this study we report the prevalence of permanent CH [PCH] in Isfahan province 7 years after initiation of CH screening program in Isfahan. In this cross sectional study, children with a primary diagnosis of CH studied. They clinically examined and their medical files were reviewed by a pediatric endocrinologist. Considering screening and follow-up lab data, radiologic findings and the decision of pediatric endocrinologists the final diagnosis of PCH was determined. A total of 464,648 neonates screened in Isfahan province. The coverage percent of the CH screening and recall rate was 98.9% and 2.1%, respectively. A total of 1990 neonates were diagnosed with primary CH. PCH was diagnosed in 410 neonates. The prevalence of PCH and transient CH [TCH] was 1 in 1133 and 1 in 294 live births. The most common etiology of CH was thyroid dyshormonogenesis. Though the prevalence of PCH is high, but the higher prevalence of CH in Isfahan is commonly due to cases with TCH. Hence, the necessity of determining new strategies for earlier diagnosis of patients with TCH is recommended

Establishment of health clinics as mass screening and referral systems for chronic non-communicable diseases in primary health care

This study aimed to establish a comprehensive screening and referral system for chronic non-communicable diseases [CNCD] in the routine primary health care, and to determine the prevalence of diabetes, pre-diabetes, metabolic syndrome, and dyslipidemia in adult population invited by public announcement to the Health clinics in Isfahan, Iran. This survey was conducted from March 2010, and the current paper presents data obtained until November 2011. To provide health services for prevention and control of CNCDs, with priority of type2 diabetes mellitus, Health clinics were established in different parts of Isfahan city with a population of approximately 2,100,000 in Iran. The general populations aged 30 years and above were invited to the Health clinics by public announcement. A total of 198972 participants were screened. The mean age of participants was 47.8 years [48.5 men, 47.3 women], with a range of 1 to 95 years old and standard deviation of 12.3 years [12.7 men, 12.1 women]. Overall, 22% of participants had impaired fasting glucose, 25% had hypercholesterolemia, 31% had hypertriglyceridemia, and 20% had metabolic syndrome. The high prevalence of dysglycemia and diabetes in our survey may serve as confirmatory evidence about the importance of mass screening and early diagnosis of CNCDs' risk factors. Our model of establishing Health clinics, as a comprehensive referral system in the routine primary health care can be adopted by Middle Eastern countries, where CNCDs notably diabetes are an emerging health problem