Iodine deficiency among goiter patients in rural South Sudan

Prevalence and determinants of goitre among children of South Kordofan state, Sudan, 2021: an urgent need for effective implementation of universal salt iodisation

OBJECTIVE

This study aimed to determine the prevalence and determinants of goitre among children aged 6-12 years at South Kordofan state.

DESIGN

This was a cross-sectional facility-based study.

SETTING

The study was conducted in twenty villages of South Kordofan state during a medical mission.

PARTICIPANTS

All 575 school-age children (6-12 years) who attended the medical day were examined for clinical assessment of goitre.

RESULTS

The prevalence of goitre among children of South Kordofan was 42·8 % (grade 1: 15·7 %, grade 2: 27·1 %). Only 24·2 % of caregivers reported using iodised salt. Mothers working as farmers (OR: 3·209, CI 95 % 1·437, 7·167; P = 0·004) and children of Darforian tribes (OR: 21·799, CI 95 % 2·566, 185·226; P = 0·005) were found to be significantly associated with higher prevalence of goitre among children. This contrasts with children of African tribes, where they were found to have less goitre prevalence (OR: 0·432, CI 95 % 0·213, 0·875; P = 0·02). Iodised salt utilisation (OR = 0·523, CI 95 % 0·320, 0·854; P = 0·01) was found associated with a lower prevalence of goitre.

CONCLUSION

Even though National Iodine Deficiency Disorders control programs were initiated in Sudan more than 25 years ago, the prevalence of goitre among children in South Kordofan state was alarming (42·8 %). Efforts to improve access to iodised salt, increase utilisation and raise awareness are urgently needed.

First Clinical Nutrition Outpatient Consultation: A Review of Basic Principles in Nutritional Care of Adults with Hematologic Disease

Methods

A bibliographic survey was carried out between 2020 and 2022 using two databases: PubMed/MEDLINE and Scientific Electronic Library Online (SciELO) and the information source Academic Google, irrespective of language or geography.

Results

In the first nutrition consultation (FNC), there should be an investigative direction focused on nutritional interventions in the short, medium, and long term. The record in the patient's medical record is relevant for carrying out the consultation, according to the recommendations of the normative councils of medicine and nutrition. The main steps to be followed are the investigation of the presence of food allergies and intolerances; the drugs/nutritional supplements in use; changes in the digestive tract; the presence or absence of picamalacia; and socioeconomic and lifestyle data. In addition, it is necessary to carry out laboratory evaluations, semiological assessment, anthropometric assessment, and assessment of food consumption. In the end, the nutritional approach should be composed of calculation of energy and macronutrient and micronutrient needs, intervention in nutritional status deviations, nutritional guidelines, and nutritional therapeutic planning of return, focusing on adherence to treatment.

Conclusion

The first nutrition consultation may represent investigative steps that help the clinical nutritionist in the management, allowing a longitudinal and specific nutritional therapeutic planning for patients assisted in large reference centers for hematological disease.

A contemporary analysis of goiters undergoing surgery in the United States

INTRODUCTION

We identified disparities and at-risk populations among patients with goiters undergoing thyroidectomy.

MATERIALS AND METHODS

The National Inpatient Sample (NIS) database was queried for patients with goiter who underwent thyroidectomy between 2009 and 2013. Multivariable logistic regression was used to determine factors associated with goiters undergoing thyroidectomy.

RESULTS

The study consisted of 103,678 patients with thyroidectomy and a goiter diagnosis, which included: simple goiter (n = 7,692, 7.42%), nodular goiter (n = 73,524, 70.92%), thyrotoxicosis (n = 14,043, 13.54%), thyroiditis (n = 1,248, 1.20%), and thyroid cancer (n = 7,169, 6.92%). Factors associated with operation for simple goiter included age >65 years (AOR 1.43 [1.15-1.79]), black race (AOR 1.35 [1.14-1.58]), and being uninsured (AOR 2.13 [1.52-2.98]). Patients with cancerous goiters undergoing thyroidectomy were less likely to be Black (AOR 0.38 [0.31-0.48]) or uninsured (AOR 0.25 [0.07-0.89]).

DISCUSSION

Understanding disparities within populations undergoing thyroidectomy for goiter may allow for targeted efforts to more effectively treat goiters nationwide.

Is iodine deficiency still a problem in sub-Saharan Africa?: a review

Iodine is an essential trace mineral, vital for its functions in many physiological processes in the human body. Both iodine deficiency (ID) and excess are associated with adverse health effects; ID and excess iodine intake have both been identified in sub-Saharan Africa (SSA). The review aims to (1) review the iodine status among populations in SSA until October 2018, and (2) identify populations at risk of excess or inadequate iodine intakes. A systematic search of relevant articles was carried out by a seven-member research team using PubMed, Science Direct and Scopus. A total of twenty-two articles was included for data extraction. Of the articles reviewed, the majority sought to determine the prevalence of iodine status of the study populations; others measured the impact of uncontrolled and unmonitored salt iodisation on iodine excess and tested the effectiveness of water iodisation. Although iodine status varied largely in study populations, ID and excessive iodine intake often coexisted within populations. The implementation of nutrition interventions and other strategies across SSA has resulted in the reduction of goitre prevalence. Even so, goitre prevalence remains high in many populations. Improvements in access to iodised salt and awareness of its importance are needed. The emerging problem of excess iodine intakes, however, should be taken into consideration by policy makers and programme implementers. As excessive iodine intakes may have adverse health effects greater than those induced by iodine deficient diets, more population-based studies are needed to investigate iodine intakes of the different population groups.

An Epidemiological Study of Risk Factors of Thyroid Nodule and Goiter in Chinese Women

Thyroid nodule (TN) and goiter are two common disorders of the thyroid. Despite their benign nature, both conditions can be associated with multiple pathologic conditions including thyroid cancer. In this study, we conducted a large-scale epidemiological study in Chinese women to identify the risk factors implicated in the occurrence of TN and goiter. We analyzed demographic data, lifestyle, medical history, body height, weight, waist circumference, body mass index (BMI), blood pressure, serum glucose and lipids. In addition, thyroid ultrasonography was performed for all subjects. Our results showed that age, menopause, waist circumference, BMI, hypertension, dyslipidemia, and hyperglycemia were associated with both TN and goiter. Furthermore, we found that the prevalence of TN was significantly affected by the medical management of hypertension. Our study suggests that postmenopausal Chinese women with advanced age, obesity, diabetes, and hypertension have an increased awareness of thyroid examination in the annual physical check. Conversely, patients with TN and goiter of the same population may have a higher incidence of age- and obesity-related metabolic disorders.

An epidemiological study of risk factors of thyroid nodule and goiter in Chinese women

Thyroid nodule (TN) and goiter are two common disorders of the thyroid. Despite their benign nature, both conditions are associated with multiple pathologic conditions including thyroiditis, endocrine dysregulation, and autoimmune disease. In this study we conducted a large-scale epidemiological study in Chinese women to identify risk factors implicated in the pathogenesis of TN and goiter. We analyzed demographic data, medical history, menstrual status, smoking, alcohol consumption, body height, weight, waist circumference, and body mass index (BMI). Thyroid ultrasonography was performed for all subjects. Our results showed that age, menstrual status, BMI, waist circumference, hypertension, dyslipidemia and hyperglycemia had a significant relationship with the prevalence of TN and goiter. There was also a significant association between parity, educational level, smoking, seafood consumption, salt consumption and TN. Waist-hip ratio, BMI, and triglyceride had a significant association with both TN and goiter, and total cholesterol only correlated with TN. Medical management of hypertension significantly affected TN prevalence. Our study also demonstrated age to be a strong predictor of TN and goiter, and obesity a predictor of the likelihood of developing goiter. Thus, our study suggests that the female Chinese population with advance age, menopause, obesity and metabolic syndrome be examined for TN and goiter, and those patients with confirmed TN and goiter be screened for age and obesity related disorders such as metabolic syndrome.