Research and development section, International Clinical Laboratories, Addis Ababa, Ethiopia.
Director's Office, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Ethiop J Health Sci. 2020 May;30(3):347-354. doi: 10.4314/ejhs.v30i3.5.
Thyroid dysfunction accounts for majority of endocrine disorders. In sub-Saharan Africa Graves' disease and hypothyroidism have accounted for 13.1% and 8.8% while the burden of thyroid disorder has ranged from 6.18 to47.34% among countries in the Arab world. The cost for a primary thyroid test done to evaluate the gland function constituted a large proportion of the public health budget. For instance, 10 million thyroid functions have been done each year by laboratories which cost 30 million UK pounds, and they represent 8% of laboratory charge in the US. When a TSH-only protocol (guideline) was used, 95% of the requests were sufficient for diagnosis without requiring further tests, thereby resulting in 50% savings on FT4 reagent and reducing the annual TFT reagent cost by 25%. This is an original study, and its objective was to assess the ordering pattern of TSH tests and their cost-effectiveness in patients' samples referred to ICL from Addis Ababa health facilities between July2015 to June 2016.
An institution-based cross-sectional study design was utilized to study the ordering pattern of thyroid function tests using one-year retrospective data from ICL.
Thyroid profiles were ordered more frequently (49.5%) compared to TSH only (24.3%). An additional 2625.70 USD was paid by patients for individual components in the profile tests that turned out normal.
Guidelines advocate TSH as the initial test for thyroid dysfunction, but the use of a combination of tests is more common.
甲状腺功能障碍占内分泌紊乱的大多数。在撒哈拉以南非洲，格雷夫斯病和甲状腺功能减退症分别占 13.1%和 8.8%，而阿拉伯世界各国的甲状腺疾病负担范围从 6.18%到 47.34%不等。进行初级甲状腺检查以评估腺体功能的费用占公共卫生预算的很大一部分。例如，实验室每年要进行 1000 万次甲状腺功能检查，花费 3000 万英镑，占美国实验室费用的 8%。当使用 TSH 仅检测方案（指南）时，95%的检测请求足以进行诊断，而无需进一步检测，从而使 FT4 试剂节省 50%，每年的 TFT 试剂成本降低 25%。这是一项原始研究，其目的是评估 TSH 检测的开单模式及其在 2015 年 7 月至 2016 年 6 月期间送往 ICL 的来自亚的斯亚贝巴卫生机构患者样本中的成本效益。
采用基于机构的横断面研究设计，利用 ICL 的一年回顾性数据研究甲状腺功能检测的开单模式。
与仅 TSH 检测（24.3%）相比，甲状腺功能谱的检测更为频繁（49.5%）。在正常的检测中，患者为各个单独的检测项目支付了额外的 2625.70 美元。
指南主张 TSH 作为甲状腺功能障碍的初始检测，但联合检测的使用更为常见。
