Gupta Priyanka, Agrawal Pawan Kumar Bajaj, Gauchan Bikash
Department of Medical Services, Bayalpata Hospital, Nyaya Health Nepal-Possible, Achham, Nepal.
JNMA J Nepal Med Assoc. 2019 Mar-Apr;57(216):109-112. doi: 10.31729/jnma.4240.
Thyroid disorders are among the common endocrine disorders and may approximate diabetes in prevalence. District hospitals are in frontline to manage chronic disorders including thyroid. Primary care workforce of physicians and mid-level providers together deliver care in these hospitals. Few hospitals are equipped with tests to diagnose thyroid disorders. The objective of the study is to find the burden of thyroid disorder in a district hospital of Nepal.
This was a descriptive cross sectional study conducted in Bayalpata Hospital. One year data from July 2017 to June 2018 was collected from the electronic health record system. Data was collected from 999 patients through convenient sampling where thyroid function test was done. Subgroup analysis was done on basis of gender, symptoms at presentation and comorbidities.
Prevalence of thyroid disorder in a district hospital of Nepal was 171 (17.11%) at 95% confidence interval, range occurring from 14% to 20%. Among them, 130 (76%) had hypothyroidism and 41 (24%) had hyperthyroidism. Prevalence of thyroid disorder among female was 147 (14.7%) and among male was 24 (2.4%). The most common symptom was depressed mood followed by nonspecific pain disorder, thyroid swelling, paresthesia and menstrual disturbances and common comorbidities reported were depression, diabetes, hypertension, anxiety disorder and chronic gastritis.
Our study showed the burden of thyroid disorders in a primary care district hospital with hypothyroidism being more common than hyperthyroidism. Thyroid disorder must be addressed on time to lower the burden. However, most of the rural population of Nepal lack in matters of lack of resources. So, it is suggested for the need to equip the health centers with thyroid tests and integrated workforce of physicians and mid-level providers in care delivery of thyroid disorders.
甲状腺疾病是常见的内分泌疾病之一，其患病率可能与糖尿病相近。地区医院处于管理包括甲状腺疾病在内的慢性疾病的前沿。在这些医院中，由医生和中级医疗服务提供者组成的基层医疗团队共同提供医疗服务。很少有医院配备诊断甲状腺疾病的检测设备。本研究的目的是了解尼泊尔一家地区医院中甲状腺疾病的负担情况。
这是一项在巴亚尔帕塔医院进行的描述性横断面研究。收集了2017年7月至2018年6月来自电子健康记录系统的一年数据。通过方便抽样从999名进行了甲状腺功能测试的患者中收集数据。根据性别、就诊时的症状和合并症进行亚组分析。
在尼泊尔一家地区医院中，甲状腺疾病的患病率在95%置信区间为171例（17.11%），范围在14%至20%之间。其中，130例（76%）患有甲状腺功能减退症，41例（24%）患有甲状腺功能亢进症。女性甲状腺疾病患病率为147例（14.7%），男性为24例（2.4%）。最常见的症状是情绪低落，其次是非特异性疼痛障碍、甲状腺肿大、感觉异常和月经紊乱，报告的常见合并症有抑郁症、糖尿病、高血压、焦虑症和慢性胃炎。
我们的研究显示了一家基层医疗地区医院中甲状腺疾病的负担情况，甲状腺功能减退症比甲状腺功能亢进症更为常见。必须及时处理甲状腺疾病以减轻负担。然而，尼泊尔的大多数农村人口缺乏资源。因此，建议有必要为健康中心配备甲状腺检测设备，并建立由医生和中级医疗服务提供者组成的综合医疗团队来提供甲状腺疾病的护理服务。
