Abstract
Background: Disease of the thyroid in Sub-Saharan Africa mainly present as multinodular goiter (MNG). Our aim was to standardize indications for total thyroidectomy (TT) after our experience in the major non-governmental hospital of North Uganda. Methods: We included patients submitted to thyroid surgery during 5 camps held by a team of Italian ENT surgeons from April 2012 to December 2015 at Saint Mary’s hospital Lacor, Uganda, for single lobe macronodules or MNGs. From an initial pool of 218, we selected 142 (65.14%) patients: 137 (96.48%) were submitted to thyroidectomy. Results: We performed 84 lobectomies (61.3%), 13 loboisthmusectomies (9.49%), 25 sub-total thyroidectomies (18.25%), and 15 TTs (10.95%). We observed 5 postoperative complications and 1 intraoperative death. TTs increased in number compared with partial thyroidectomies (p=0.02) and STTs (p<0.0001). Conclusions: Partial and sub-total thyroidectomies were the primary procedures, however TT was confirmed to be feasibile for treating MNG in a rural area.
Highlights
Thyroid disorders are commonly encountered in Africa and often arise from environmental and nutritional factors [1], representing a severe public health problem in several countries of the sub-Saharan area, such as Uganda
In a low- and middle-income country (LMIC) the selection of the type of thyroid surgery needs to be based on several factors and may not always follow the same indications as for developed countries [6]
Because the study focused on thyroid surgery, the 5 procedures that were not thyroidectomies were excluded from the analysis
Summary
Thyroid disorders are commonly encountered in Africa and often arise from environmental and nutritional factors [1], representing a severe public health problem in several countries of the sub-Saharan area, such as Uganda. In these geographic regions, the lack of iodine in the food and drink is the primary cause of thyroid gland disease, in which goiters represent the most common manifestations [2]. Our aim was to standardize indications for total thyroidectomy (TT) after our experience in the major non-governmental hospital of North Uganda
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