Articles

Prevalence and Pattern of Thyrocardiac Disease among Patients with Hyperthyroidism in Ethiopia: A Systematic Review and Meta-Analysis

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Background: Thyrocardiac disease encompasses the spectrum of cardiovascular abnormalities that arise as complications of hyperthyroidism. Despite being clinically significant and potentially life-threatening, its burden in Ethiopia remains poorly defined.

Objective: To determine the pooled prevalence and pattern of thyrocardiac disease among hyperthyroid patients in Ethiopia.

Methods: A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. Comprehensive searches were carried out in PubMed, Google Scholar, AJOL, Hinari, Europe PMC, Cochrane library, and institutional repositories. Observational studies reporting cardiac outcomes in adults with hyperthyroidism in Ethiopia were included. Analysis was done using STATA version 17. Prevalence data were pooled using a random-effects model, and heterogeneity was assessed using the Cochrane Q and I² statistic.

Results: Seven studies with a total of 1,160 participants were included in the review. Sinus tachycardia (39.32%; 95% CI: 23.34%–55.31%), Heart failure (21.65%; 95% CI: 13.84–29.46%), and Pulmonary hypertension (19.43%; 95% CI: 6.78–32.09%) were the commonest presentations, while Dilated cardiomyopathy (12.35%; 95% CI: 6.16–18.53%) and Atrial fibrillation (16.27%; 95% CI: 12.17–20.38%) were the least common. Toxic multinodular goiter was the most common cause of hyperthyroidism among these patients accounting for 64.8% (95% CI: 53.2–75.3%).

Conclusion: Thyrocardiac disease is a frequent complication among hyperthyroid patients in Ethiopia, with sinus tachycardia and heart failure being the most common presentations. These findings highlight the importance of integrating routine cardiac evaluation into the clinical management of hyperthyroidism.

Time to Normalization of Thyroid Function Tests and Associated Factors Among Thyrotoxic Patients at Saint Paul’s Hospital Millennium Medical College Endocrine Clinic, Addis Ababa, Ethiopia, 2024

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Background: Thyrotoxicosis is characterized by excessively high tissue thyroid hormone levels. Untreated or inadequately managed thyrotoxicosis can lead to various complications. Understanding factors influencing the time to achieve thyroid function normalization is essential for improving treatment outcomes and patient care.

Objectives: This study aimed to assess the median time to normalization of thyroid function tests and identify factors associated with delayed euthyroidism among thyrotoxic patients attending the Endocrine Clinic at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, in 2023.

Methods: A hospital-based retrospective cohort study was conducted involving 181 patients diagnosed with thyrotoxicosis who attended the adult Endocrine Clinic from April 2023 to January 2024. Data were collected using a structured questionnaire and entered into EpiData version 7.1, then exported to STATA version 15 for analysis. Descriptive statistics summarized continuous variables as mean ± SD or median with interquartile range, and categorical variables as frequencies and percentages. The association between independent variables and time to euthyroidism was analyzed using Cox proportional hazards regression, with the log-rank test employed to compare median times across groups. Adjusted hazard ratios (AHR) with 95% confidence intervals (CI) were reported to quantify the strength of associations.

Results: Approximately 61% of patients achieved euthyroidism, with a median time of 7 months (Interquartile Range: 3–13 months). Factors significantly associated with delayed normalization included use of Propylthiouracil (AHR = 0.33; 95% CI: 0.12–0.89), poor medication adherence (AHR = 0.24; 95% CI: 0.13–0.42), higher baseline pulse rate (AHR = 0.97; 95% CI: 0.95–0.99), and elevated baseline free thyroxin levels (AHR = 0.99; 95% CI: 0.98–0.995).

Conclusion: Although more than half of the patients attained euthyroidism, the process took longer than expected. High baseline FT4 levels, elevated pulse rate, non-adherence to medication, and the use of PTU as the anti-thyroid drug delayed the achievement of euthyroidism. Patients with thyrotoxicosis require attentive and continuous monitoring until thyroid function normalizes to prevent complications.