Assessment of the Diagnosis, Follow-up and Treatment Outcomes in Patients with Hyperthyroidism at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia
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2021-05
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Addis Abeba University
Abstract
Background:Hyperthyroidism is a disease condition characterized by increased synthesis and secretion of thyroid hormone by the thyroid gland. A diagnosis of hyperthyroidism is made based on clinical presentation and abnormality in TFT characterized by low level of TSH and elevated thyroid hormones Diagno singthedifferentformsofhyperthyroidismbasedonclinical manifestations andTFT alone is challenging.
Objective :To assess the diagnosis, followup and treatmentoutcomesin patients with hyperthyroidism at Endocrine Clinic, TASH.
Methods A retrospective follow-up study was employed to evaluate the diagnosis, follow-up and treatmentoutcomes of patients with hyperthyroidism at Endocrine Clinic, TASH. A census was performedto those patients who were aged 18 years and above, diagnosed to have hyperthyroidism onAntithyroid drug for more than 18 months on follow up from September 2009 to August 2012 E.C,excluding pregnant women. Patients’ response to different treatment options were evaluated. Also,factors associated with treatment outcomes were identifiedWhile descriptive statistics (mean,proportion, percentage and standard Deviations) were used to summarize the results, multivariatelogistic regression and chi square test were used as appropriate to check the association betweendependent and independent variables. Statistical significance was determined at a p value of < 0.05and CI of 95%.
Results In this study, a total of 230 patients with hyperthyroidism were involved, of which 208[ 90.4%] ofthem were female and 22[ 9.6%] were male. The female to male ratio was 9.4 to 1. The mean ageof the participants was 44 years +/-13 SD. In about 60 % of patients the duration of diagnosis ofhyperthyroidism was less than 04 years. The most common symptom and sign were palpitationand goiter accounting [89.6%] and [78.2%] respectively. Significant association was found with therapy and duration of treatments. Those patients who hadbeen following treatment for four years and above, were more likely to have improved outcome compared to those who were following their treatment for less than four year (AOR=2.869,CI=1.173-7.0211, p=0.021). In addition, those patients who were on initial combination therapy(Beta adrenergic blocker + ATD) were 2.189 times highly likely to have improved outcomescompared to those who took single therapy (ATD or Beta-adrenergic blocker) (AOR=2.189,CI=1.144-4.187, p=0.018).
ConclusionsIn this study, the most common cause of hyperthyroidism was TMNG and Treatment outcome was strongly associated with duration of hyperthyroidism and initial usage of combinationtherapy.
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Keywords
Hyperthyroidism, Toxic Multinodular Goiter, Graves’ Disease, Toxic Adenoma