Patterns of surgically treated thyroid disease in Lusaka, Zambia

Abstract

Background: Thyroid gland disease is a common disorder of the endocrine system worldwide.This disease varies according to the environment. The aim of this study is to determine demographic and histopathologic patterns of thyroid disease at the University Teaching Hospital, Lusaka, Zambia.
Methods: This was a retrospective review of patients records (n=239) over a ten year period (2001-2010) at the University teaching Hospital, Lusaka, Zambia. Rate of thyroidectomies, demographic characteristics (age and gender), histologic types and regions where patient came from (for clustering) were analysed.
Results: A total of 3475 general surgical operations were done in a 10-year period. Of these 252(7.25%) were for thyroid surgery. 239 thyroid specimen results were found. They were from 212 females and 27 males with female: male ratio of 7.8:1. There were172 cases (71.96%) of colloid goitre (the most common thyroid disease) followed by 33 cases of thyroid neoplasms (n=33, 13.8%). Benign tumour i.e., adenoma were seen in eight (3.3%) cases and thyroid carcinoma in 26 (10.8%) cases. Thyroiditis constituted three (1.2%) of the cases Thyroid cyst accounted 19(8.1%) and Toxic goitre nine(3.8%) cases.Age range for colloid goitre was 19-89, malignancy 19-69, thyroid adenoma 19-69 and toxic goitre 20- 69 Colloid goitre had a peak at age group 31-49years. Follicular carcinoma was the commonest malignant thyroid tumour (15 cases).Peak age for thyroid malignancy 30-59. Most patients were from Lusaka (n=103) followed by Eastern province (29 patients).
Conclusion: This study showed that thyroid surgery constituted a significant proportion of major surgical operations. Colloid goiter (a preventable disease), was the commonest thyroid disease in this study. Thus, public health measures such as iodination of salt and health education could play a role reducing the occurrence of this disease and of related surgery. Females mostly affected. A thyroid carcinoma pattern differs from other parts of world. Follicular carcinoma is common in sub-Saharan Africa. In the Western world papillary carcinoma is more common. A further prospective study is expected to bring more statistical data.