Patterns and outcome of surgical management of goitres at Bugando Medical Centre in northwestern Tanzania

Abstract

Despite the well established endemicity of goitres little work has been done on the management of goiters in Tanzania. A cross-sectional study was conducted at Bugando Medical Centre (BMC) in Mwanza, Tanzania to determine the pattern and outcome of surgical management of goitres. Data was collected using a pre-tested, coded questionnaire. A total of 152 patients were studied of which 140 (92.1%) were females and males were 12 (7.9%) (F: M = 11.7: 1). Their ages ranged from 18 to 72 years (mean =38.4 12.5 years). The mean duration of illness was 9.2 years. The thyroid gland size at admission was grade III in 63.8% of patients. Multinodular goitres were reported in 51.3% of patients. The majority of patients (92.1%) presented with euthyroid goitres and the remaining (7.9%) patients had toxic goitres. Pressure symptoms and cosmetic disfigurement were the common indications for thyroidectomy in 47.4% and 23.7%, respectively. Near total thyroidectomy and total thyroidectomy were the surgical procedures performed for benign and malignant goitres in 47.3% and 8.1% of patients, respectively. Simple multinodular goitres were the most common histopathological pattern accounting for 67.2% of cases. Twelve (7.9%) patients had a histologically proven thyroid malignancy, of which follicular and papillary carcinoma were reported in 41.7% and 33.3% of cases, respectively. Post-operative complications rate was 7.9%. The mean length of hospital stay was 14.4 days (range 3 to 34 days). Five patients died giving a mortality rate of 3.4%. In conclusion, this study has shown that the pattern of surgical goitres seen at Bugando Medical Centre is similar to what is reported from other parts of the world. However, the majority of patients present for surgery very late with huge goitres predisposing them to increased risk of post-operative complications, prolonged length of hospital stay and cost of medical care. It is therefore recommended that health education should be given to the community about the cause, prevention and treatment options so that patients could seek early medical attention. __________________________________________________________________________________________

Histopathologic Pattern of Thyroid Disease in 1351 Thyroidectomy Patients

“…Benign (nonneoplastic) thyroid diseases constituted the majority of patients ranging from 69-87% of patients (Table 2). These findings as well as thyroid disease patterns were generally in concordance with that reported in countries where iodine deficiency is endemic [6][7][8][9] (Table 3).…”

Prevalence of thyroid cancer among thyroid swelling in Jimma University Medical Center, South West Ethiopia: A five-year retrospective study

“…Thus, even though Jimma has a higher incidence of (100) abroad like in Mangalore, India (Goitre, 2012) and Switzerland (Franssila et al, 1981). The second most common type of malignancy was follicular carcinoma with 31.4% (28/89) of cases and this seems to be consistent with the study done in Gondar (Bekele and Osman, 2006) and Tanzania (Chalya et al, 2011). In this study, the incidence of anaplastic carcinoma was 17 (19.11%) of the cases which was found to be higher than studies done in Gondar and India (Goitre, 2012).…”

Characteristics of Burn Injury and Factors in Relation to Infection among Pediatric Patients

“…39 This may be related to the raise of physical mobility and social independence in our country of older children especially girls for preparing foods and other works related cooking and lighting fires. Also this difference is highly statistical significant p<0.001.…”

“…This finding nearly in accordance with the previous studies which revealed that most of burn injuries were at home. 39,40 This is because of in our society children spend more of their times at home rather than other places. …”