Feasibility of thyroid ultrasonography in field studies in a developing country, Ghana.

This study was carried out to determine the feasibility of using ultrasonography for goitre estimation in the field situation. It is a cross sectional study that was conducted using community based cluster sample. Thyroid sonography was performed on 112 randomly selected school children aged 10 -15 years from two districts in the Greater Accra area of Ghana, using normative values for thyroid volume recommended by WHO/ICCIDD. The mean age of all subjects was 13.5 years+/-0.13 SEM. The male to female ratio was 1:1. The mean height and weight of the children were 1.5 metres+/-0.9 SEM and 38.1 Kg+/-0.7 SEM, respectively. The mean body surface area was 1.27 m2+/-0.2. There were no significant gender differences in their ages (13.6yrs+/-0.2 SEM, 13.4yrs+/-0.1 SEM, respectively) and height (1.50m+/-1.6 SEM, 1.46m+/-1.7 SEM, respectively). The girls (40.0kg+/-1.2 SEM) weighed more than the boys (35.6kg+/-1.1). The mean and median urinary iodine concentration were 82.4+/-8.5 SEM and 67.9 ug/l, respectively. All the children examined had normal thyroid sonogram. The thyroid volumes ranged from 3.6 ml to 15.3ml. The mean thyroid volume was 7.0ml+/-0.2 SEM and the thyroid volume was higher in the girls (7.5ml+/-0.3 SEM) than the boys (6.5ml+/-0.2 SEM). The criteria of thyroid volume per age and sex yielded a goitre prevalence of 1.8 %. In contrast, the criteria of thyroid volume by surface area yielded a goitre prevalence of 8 %. Our study has shown that it is feasible to employ ultrasonography for field studies to determine goitre prevalence in school children in a developing country such as Ghana. However, the best criteria for goitre in children in Ghana, requires to be confirmed in future studies.

Endemic goitre and urinary iodine levels in rural communities in the Bolgatanga and Builsa districts of the upper east region of Ghana.

OBJECTIVE: To ascertain the severity of IDD in some rural communities in upper east of Ghana and to urge the establishment of intervention and control measures for IDD. SUBJECTS AND STUDY DESIGN: A total of 1061 subjects, made up of about an equal number of children (8-14 years) and women of childbearing age (15-45 years) from seven Sekoti villages and five Builsa villages of the upper east of Ghana were examined for goitre by the palpation method. In addition, every tenth subject examined, provided urine for urinary iodine determination. RESULTS: 68.8% of the subjects had goitre; 9.9% had visible goitre. The goitre rates of the children from Builsa (77.2%) were significantly higher than those from Sekoti (59.1%) [z = 4.5; p < 0.001]. The overall prevalence of goitre and visible goire in women in the two areas were 70.8% and 15.4% respectively. The women of Sekoti had more goitres (76.6%) but less visible goitres (8.8%) than those of Builsa (63.5% and 21.9%) [p < 0.001). The median urinary iodine level for the two survey areas was 1.6 micrograms/dl. 72% of subjects and urinary iodine less 2 micrograms/dl/24% had urinary iodine levels in the range 2-5 micrograms/dl and the remainder had urine iodine in the range 5-10 micrograms/dl. CONCLUSIONS: These findings indicate severe IDD in Sekoti and Builsa areas requiring urgent action. Further studies are indicated to determine the cause(s) of the IDD endemia.