The Prevalence and Spectrum of Thyroid Diseases Among Children and Youth Seen at the Endocrine Clinic, Kenyatta National Hospital From 2008 to 2021

Abstract

Background: Thyroid diseases are responsible for common endocrinopathies in childhood. Early diagnosis is essential in the integration of an appropriate treatment approach and control of irreversible damage to the nervous system. However, the prevalence of thyroid diseases in the local setting has not been investigated. Thyroid diseases constitute common endocrine disorders that untreated can lead to preventable mental retardation, slowed growth and adverse outcomes that could result in death. Low level of awareness and limited knowledge of the identification of the condition results in late diagnosis, which increases the risk of adverse outcomes. Currently, the true burden of thyroid diseases among children is not well known in Kenya as there is a paucity of evidence on the magnitude of thyroid disease in children in our setting. The purpose of the study: The main objective of this study was to determine the prevalence of thyroid diseases in children and youth at Kenyatta National Hospital from 2008 to 2021. Methodology: This was a retrospective cross-sectional study carried out within 13 years. All paediatric and adolescent patients seen at Kenyatta National Hospital Endocrinology clinic between January 2008 to December 2021 were included in the study. Data collection was carried out using a data abstraction form from the patient’s file. Data collected was coded and analyzed using Statistical Package for Social Sciences (SPSS version 28) was used in data analysis. Descriptive statistics were used to describe the proportions and clinical characteristics of the sample population. Prevalence was calculated as a proportion of the entire sample population and represented as a percentage. Chi-square or Fischer's exact test was used to investigate factors associated with different types of thyroid diseases. Logistic regression was used to determine factors associated with hypothyroidism and goitre. Results: The findings established that out of 2238 patients attending the endocrinology clinic, 147 had thyroid disease representing a 6.56%, (95%CI: 5.6 – 7.7%) prevalence. Among those with thyroid disease, 82(55.8%) of the patients had hypothyroidism, 43(29.3%) had goitre, 14(9.5%) had hyperthyroidism while 8(5.4%) had suspected thyroid tumour. Among patients with thyroid disease,79(53.7%) of patients were female, the median age was 18 (4.5 – 28) months with almost half of the patients (44.9%) who were aged ≤2 years. In investigating clinical characteristics, the majority of the patients with thyroid disease presented with vomiting (84.4%), coughing (83.7%), palpitations (78.9%), weight loss (58.5%) excessive sweat (53.7%) and poor sleep (51.0%). The findings revealed that age, weight, symptom duration, vomiting, coughing and weight loss were significantly associated with types of thyroid disease.

Conclusion: The prevalence of thyroid disease shows an increasing trend of thyroid disease. The commonly identified clinical characteristics include vomiting, poor sleep, weight loss and excessive sweat. Thus, there need for early screening of thyroid disease in children to improve child developmental status. Further, increase health education on thyroid diseases in the general public to help parents understand the common symptoms of thyroid disease such as weight loss, coughing, excessive sweat and palpitations.