Study of Endemic goiter of Children in Eastern Sudan Using Ultrasonographyand ELISA

Abstract

The diagnosis of goiter used to be based on palpation, but now it is based on volume

measurement using ultrasonography. Volume measurement of the thyroid gland is especially

easy to obtain because the gland has a different echogenicity compared with adjacent soft tissues.

The aim of this study was to evaluate epidemic endemic goiter and to estimate the measurement

of normal thyroid gland dimensions and thyroid hormones level in school-aged children Using

Ultrasonography and ELISA in Eastern Sudan.This is distinctive study was condacted in Eastern

Sudan (Kassala , El Gadaref and Red Sea State) included 300 subjects , 102 (40%) male and 198

(60% ) female , divided in five age groups (6-8 , 9-11 , 12-14 , 15-17 , 18 yrs), in the period from

May 2016 to January 2019,the thyroids volume was measured using ultrasound machine(Mindry

DP2200 , Linear transducer 7-10Mhz) and the thyroid hormones level measured was done for all

children using ELISA machine (TOSO machine ). The ethics and research committee approved

the study and consents were obtained from all volunteers prior to the examination, The Subjects

with clinical evidence of thyroid disease were excluded. Furthermore, any student above 18

years, were excluded from the study.The results of this study revealed that 60 children (20%)

with goiter and 240 children (80%)normal , goiter is most prevalence in El Gadaref state (42%)

then Red Sea state (33%) and last one Kassala state (25%) , the most normal age group in this

study (9-11 yrs), 82 ( 27.3%) children and most affected age with goiter also (9-11 yrs), 34

(11.3%) students , and the goiter founded in female 38(12.6%) students more than male 24 (8%)

students . The mean of thyroid volume for normal subject and subject of goiter, (5.3 ± 0.91, 6.2 ±

0.7 mL) respectively, and TSH, T3, T4 (1.76±0.79, 1.3±0.64 UIu/nL), (3.5±0.24, 3.8±0.74

Pg/Nl), (1.2± 0.18, 1.5±0.33 ng/DI level respectively). The study showed there is there is the

significant association between the thyroid volume and the subject age (R² = 0.63 ) , thyroid

hormone level decease with age in normal children and goiter children , The mean thyroid

volume is greater in male (5cm3 ) than female (4.9 cm3 ), in normal subjects the mean of thyroid

volume of the right lobe (2.5) was greater than the left lobe (2.2) ,the thyroid hormone level

decease with age in normal children and goiter children.

This study concluded that goiter is most prevalence in El Gadaref state, more than in Red Sea

state and Kassala State, the volume of the right lobe of the glandwas greater than the left in both

sexes. The mean thyroidvolume in the males is greater than that in the females,alocal reference

of thyroid volume was established, and furtherstudies are required to establish national

references thyroidvolume and distribution of goiter in Sudan.