Assessment of chalenges in normalization of thyroid Functiontestsamongthyrotoxic patients ontreatment Attending chronic followupclinic at jmc, jimma, Southwestern ethiopia

Abstract

Background: Thyrotoxicosis is a clinical state that results from inappropriately high thyroid hormone action in tissues. Although it is one of the common endocrine disorders, there is scarcity of data on the management of thyrotoxicosis in Africa, particularly in Ethiopia. In Ethiopia, the prevalence of thyroid disease is reported to be 1.2%. Longer duration that takes for resolution of symptoms and normalization of TFT has been a major challenge in areas like Ethiopia where first line Antithyroiddrugs are scarce. Other factors, like high initial FT4 before initiation of treatment, longer duration of symptoms before diagnosis of thyrotoxicosis and high prevalence of Toxic Multinodular goiter also contribute for the prolonged symptom resolution and normalization of TFT. Objective: The objective of this study was to assess factors associated with normalization of TFTs and determinants of treatment outcomes among patients with thyrotoxicosis on antithyroid drugs attending follow up clinic in JMC, Jimma Ethiopia. Methods: A Hospital –based retrospective cohort study was conducted on medical records of 176 patients with the diagnosis of thyrotoxicosis who were attending chronic Follow up clinic of JMC between June 2016 and November 2021. The collected data was cleaned, enteredinto, and analyzed using SPSS statistical software version 26. Appropriate statistical analysis was performed and p value less than 0.05 and confidence interval of 95% was used to declare statistically significant. Results:Data from a total of 176 were eventually analyzed. The mean age if the patients was 41.24 (+ 12.003) years with female majority (92.6%).The most common etiology was TMNG (90.9%).All of the patients included in this study were taking Prophylthiouracil (PTU).Nearly 80.7% of patients had symptom resolution within a mean period of 5.31(+ 2.18).Thirty- seven(21.02%) ,45(25.56%) and 43(24.43%) patients achieved normalization of TSH ,FT4 and FT3 respectively.The mean time to normalization of TSH,FT4 and FT3 was 13.81(+ 7.415), 9.85 (+ 7.28) and 10.51(+ 7.86) respectively. Conclusion:Though PTU is not the preferredAntithyroid agent for the treatment of thyrotoxicosis, in our study all patients used PTU for the management of hyperthyroidism.All TFTs were normalized in only one –fourth of patients .Even if majority 142(80.7%) of patients achieved resolution of symptoms , it took longer period of time than expected.