Resurgence of goitre – Fresh cases of goitre in Nigeria raise questions

“It was my mother that suddenly observed my bulging eyes and took me to the hospital. After some checks they found signs of goitre. It was actually very small at the time, such that  I never noticed it myself.  I am now placed on medication for eight months, and then I will undergo surgery to […]

“It was my mother that suddenly observed my bulging eyes and took me to the hospital. After some checks they found signs of goitre. It was actually very small at the time, such that  I never noticed it myself.  I am now placed on medication for eight months, and then I will undergo surgery to remove it,” she said.

Amina  added that since she started taking the medication, her eyes had gradually returned to its previous state  and her hair had stopped falling off.

As for  42-year -old  Hajiya Zahara’u Mukhtar, she developed goitre 19 years ago, but she had surgery to remove it only two months ago. Recalling how it started, she said, “I became so thin that my husband and my mother were worried, though I was not worried  because I was not feeling  ill. It was after I gave birth in 1992 and saw the pictures of the naming ceremony that I observed a slight bulge in my neck, but I still didn’t think much of it. But it kept growing, so I went to the hospital in 1995, and I was scheduled for surgery, but I was afraid and refused.”

According to her, though pressed by family members to undergo the surgery over the years, she refused despite the fact that the goitre was growing.  Zahara’u said she started feeling suffocated when she was sleeping. She would perspire profusely, even when other people were feeling cold. She felt pains in her body and her monthly period stopped. When she contacted the doctor, she was told that those were the effects of  goitre.

She also said many people in her family had goitre.  Her late sister had  it, her sister, aunt and 14-year-old niece.

“I am so glad now that I had the surgery, I feel relieved,” she concluded.

Goitre is an enlargement of the thyroid gland, according to Clevelandclinic.com. The thyroid gland is a small gland located in the neck, below your Adam’s apple. The thyroid can be enlarged due to generalized enlargement of the thyroid or nodules (tissue growths) within the thyroid. The thyroid gland produces the hormones thyroxine (also called T4) and a small amount of triiodothyronine (also called T3). Most of the T4 is converted to T3 outside of the thyroid. These thyroid hormones influence such bodily functions as a person’s body temperature, mood and excitability, pulse rate, digestive functions, and other processes necessary for life. It is important to understand that goitre is not cancer and that most goitres are, in fact, benign.

Cases of goitre are often attributed to iodine deficiency, especially in salt but the  National Agency for Food and Drug Administration and Control (NAFDAC) has said that the “issue of goitre problem is not peculiar to the north. It is a national problem and even at that, we have four endemic areas, Benue, Nassarawa, Ebonyi  and Taraba. We have mapped out strategies to deal with the problem in these areas because Nigeria has attained about 98 percent universal salt iodization and the remaining two percent is as a result of the endemic areas. But National Food Drug Administration and Control (NAFDAC), in collaboration with UNICEF, has been working assiduously to reverse the trend so  we could achieve 100 percent universal salt iodization.”

Speaking with Sunday Trust in Abuja, the director-general of the agency, Dr Paul Orhii, said “We have done this through market sensitization campaign. It will be recalled that two years ago we ran intensive campaigns in the electronic and print media, and workshops were organized. As a matter of fact, about four years ago, NAFDAC’s strategies were celebrated in Beijing where Nigeria was singled out and honoured for the efforts we made towards promoting universal salt iodization programme in Nigeria.”

Goitre cases in Kano

Dr Yakubu Ahmed Ashuku is the Head of Surgical Department at Aminu Kano Teaching Hospital, Kano (AKTH).  He spoke to our reporter on the frequency of goitre cases recorded by his department. He said in recent times, his department  recorded more cases of the ailment, though the AKTH is a tertiary center to where referrals from different places are made.

Dr Yakubu said, “recently, we recorded a relative increase in the number of goitre cases but most of our operations have been very successful ,with just a negligible mortality rate. In over 160 cases we handled recently, we recorded just very few, just one or two cases, and even at those, the deaths were not directly caused by the goitre or its treatment”.

He further said, the relatively high record of goitre might not be unconnected with the successes recorded in the treatments of the disease. According to him, “Maybe the increase in the cases has to do with the fact that patients are now surviving, the procedure of treatment is very safe, unlike previously when people were afraid that if they have a cut on the neck, there is a possibility that the patient would die”.

According to Dr Yakubu, in 2007, 34 patients were operated upon. In 2008, 30  patients and from January 2009 to date 35 patients had been operated upon, adding that some patients who were advised to undergo surgery could not afford it as the cost of the operation. It cost N25,000 and the cost of staying in the hospital was N20,000. Therefore, some of those patients stopped going to the hospital . Some were simply scared and refused to undergo the operation.

The surgeon further advised people to consume iodized salt. He said “ goitre is a disease that can be prevented because its causes are known. They have to do with iodine deficiencies and, sometimes, some chemical substances in food items called goitrogens found in some species of cabbages, may be responsible for the growth on goitre in human. But some of this  cabbages are are not common in our environment.  It can also result from the intake of drugs like anti-hypertensive drugs even though this is not a common cause”.

Yakubu further said, “there are also situations that goitre is developed as a result of heredity and it can also occur when there is increased demand in the activities of the tyroid gland, usually seen during pregnancy, lactation, during puberty”.

He, therefore, advised thus: “people should take iodized salt and that I know that NAFDAC and the government have been campaigning for that. By so doing, I think the incidence of goitre will be reduced though there are some goitres that are malignant and  have no direct bearing to the iodine content of salt.”