Thyroid disorders in Africa: Where do we stand?

Abstract

Thyroid disorders occur in Africa. These disorders present in various ways over many years with presentation associated with iodine  status and influences of the environment. This article examined disorders of the thyroid gland in Africa, the epidemiology, progress in iodine nutrition, diagnosis and management of these disorders. We search available literatures using Pubmed, Medline and Googles  scholar search engine. The search term was 'Africa' used in various combinations with thyroid gland, iodine deficiency disorders, goitre, hyperthyroidism, hypothyroidism, autoimmune thyroid disorders and thyroid cancers. We reviewed available articles on thyroid  disorders in Africa continent published until 2017. From the published works reviewed during this period, the commonest thyroid  disorder in Africa was iodine deficiency disorders (IDD). This was found to be prevalent in the areas with inadequate iodine intake. Autoimmune thyroid disorders are rare in iodine deficiency but become prevalent with transition to iodine sufficiency. Tremendous improvement has been achieved in iodine nutrition through salt iodination in the African continent. In the African continent, there are no thyroid registry. This has made determination of scope and burden of thyroid disorder in Africa difficult. The challenges of making proper diagnosis is still bane of diagnosis of thyroid disorders in the African continent. There is a strong link between regional iodine status and thyroid disorders in Africa. Most countries in Africa are 80 – 90% iodine sufficient. The use of nuclear modality to diagnose and treat thyroid disorders is highly underutilized. Treatment modalities remain pharmacotherapy and surgical intervention.

Key words: Thyroid, Iodine deficiency, Africa, hyperthyroidism, hypothyroidism, thyroid malignancy.