Background: Endocrine diseases involving the thyroid are widespread. These illnesses are frequently not properly diagnosed. In general, patients may go undiagnosed due to a lack of awareness and comprehension of thyroid problem effects. This study intends to determine the general public's degree of knowledge of thyroid disease signs, risk factors, and preventive measures. Material & Methods: This cross-sectional survey of residents of the state of Himachal Pradesh was carried out between June 2021 and August 2021 using Google forms. Until 400 replies were gathered, the questionnaire was distributed among state citizens in both rural and urban areas via email and social media sites such Whatsapp groups, Facebook, Instagram, and Linkedin. We collected data on their socio-demographic traits and awareness about Tuberculosis. Epi info v7 software was used to evaluate the data using the necessary statistical tests. Results: A total of 400 respondents took part in the study, of whom 165 (41.25%) were from urban areas and 235 (58.75%) were from rural areas. 262 (65.5%) of the participants in the majority were male, 174 (43.5%) were between the ages of 18 and 30, 159 (39.75%) had a graduate degree, 259 (64.75%) were in the workforce, 248 (62%) were married, and 384 (96.0%) were Hindu. In the present study 36 (9.0%) study participants had very good (24-30 marks) awareness regarding Thyroid Disorders , 122 (30.5%) had good (18-23 marks), 147 (36.75%) had fair (12-17 marks) and 23(5.75%) had poor (<12 marks) awareness regarding Thyroid Disorders. Conclusion: According to survey findings, the general public had either insufficient or not satisfactory knowledge about the thyroid gland, its functioning, risk factors, causes of thyroid illness, clinical symptoms and prevention of thyroid problems. The present study warrants the educational program and awareness campaigns on thyroid disorders for the general population.
The thyroid gland, which is situated in the front of the neck, is thought to be the largest endocrine gland in the human body. It produces and secretes thyroid hormones, which have a significant impact on protein synthesis and the basal metabolic rate (BMR). Additionally, these hormones play a crucial role in sustaining adults' proper physiological functioning as well as the neurocognitive development of children and adolescents.[1-3]
The over- or under-secretion of thyroid hormones as well as thyroid gland hypertrophy are illnesses known as thyroid disorders. Disorders of the thyroid gland can either be primary (directly linked to the gland itself) or secondary (thyroid dysfunction due to other factors). With 1.6 billion people at risk, these illnesses have been recorded in more than 110 countries.[4,5]
One of the most prevalent medical diseases in the world is thyroid disorder. Thyroid conditions can cause consequences that may lower a patient's quality of life if they are not handled. The clinical signs and symptoms of a thyroid problem can affect several physiological systems and largely rely on the disorder's nature. Furthermore, thyroid issues can be easily overlooked or mistaken for other medical conditions because the majority of the symptoms are not specific.[6,7]
The lack of general knowledge among patients may be of great concern because thyroid diseases are one of the most under-diagnosed and neglected medical conditions. Many persons who have thyroid dysfunction who are unaware of their condition can benefit by knowledge of the condition. Patients would typically go undetected if their symptoms and the thyroid gland are not understood.[8-10]
There aren't many researches in Himachal Pradesh that examine people's general understanding about thyroid problems. Therefore, the purpose of this study is to ascertain how well-informed the general population of Himachal Pradesh is regarding the symptoms, risk factors, and preventive measures associated with thyroid problems.
Objectives of the Study
To evaluate the awareness regarding Thyroid Disorders, its symptoms, risk factors and preventive measures among General Population of Himachal Pradesh.
Research Approach -Descriptive
Research Design- Cross-sectional survey design
Study area: Hilly state of Himachal Pradesh
Study duration- between June 2021 to August 2021
Study population: All adults above 18 years of age who were staying in the Himachal Pradesh for 12 months or more.
Sample size- 400 Adults assuming 50% have adequate knowledge regarding Thyroid Disorders, 5% absolute error, 95% confidence level, and 5% non response rate.
Sampling Technique- convenience & snowball Sampling technique
Study tool: A google form questionnaire consisting of questions regarding socio-demography, Awareness regarding Thyroid Disorders, its symptoms, risk factors and preventive measures was created. The questionnaire was initially pre-tested on a small number of people to identify any difficulty in understanding by the respondents.
Description of Tool-
Demographic data survey instrument: The demographic form elicited information on participants’ background: age, gender, marital status, religion, employment, education and many more.
Questionnaire: The questionnaire contains 30 structured questions regarding Awareness about Thyroid Disorders, its symptoms, risk factors and preventive measures having three options i.e. Yes, No & Don’t Know. The participants have to choose right one. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 30 and minimum score was zero. Scoring was done on the basis of marks as >80%(24-30)=very good,60-79%(18-23) =Good,41-59% ( 12-17)=Fair,<40% (< 12)=poor
Validity of tool - by the experts in this field
Inclusive Criteria- who were willing to participate in the study.
Exclusion Criteria: who were not willing to participate in the study
Data collection- Data was collected under the guidance of supervisors. The google form questionnaire was circulated via online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin in both rural and urban area of Himachal Pradesh till the 400 responses were collected. Responses were then recorded in a Google Excel spreadsheet.
Data analysis- Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage.
Ethical Considerations- Participants confidentiality and anonymity was maintained.
The present study was cross sectional descriptive study carried out to evaluate the awareness about Thyroid Disorders, its symptoms, risk factors and preventive measures among the general population of Himachal Pradesh.
A total of 400 respondents including 165(41.25%) were from urban area and 235(58.75%) were from rural area were participated in the study. Among the participants of the majority 262(65.5%) were males, 174(43.5%) were between 18-30 years, 159(39.75%) were Graduate, 259 (64.75%) were employee, 248(62.0%) were married and 384 (96.0%) were Hindu.
Table-1: Socio-demographic characteristics of study participants
Socio-demographic Variables | Frequency | Percent | |
Area | Urban | 165 | 41.25 |
Rural | 235 | 58.75 | |
Gender | Males | 262 | 65.5 |
Females | 138 | 34.5 | |
Age | 18-30 | 174 | 43.5 |
31-40 | 122 | 30.5 | |
41-50 | 52 | 13 | |
51-60 | 38 | 9.5 | |
61-70 | 14 | 3.5 | |
Education | Graduate | 159 | 39.75 |
Intermediate | 111 | 27.75 | |
Matriculate | 58 | 14.5 | |
Middle | 32 | 8 | |
Post Graduate | 40 | 10 | |
Occupation | Employed | 259 | 64.75 |
Unemployed | 141 | 35.25 | |
Marital status | Married | 248 | 62 |
Unmarried/ Divorce | 152 | 38 | |
Religion | Hindu | 384 | 96 |
Muslim | 5 | 1.25 | |
Sikh | 4 | 1 | |
Others | 7 | 1.75 | |
Total | 400 | 100 |
Table-2: Awareness about Thyroid Disorders, its symptoms, risk factors and preventive measures among participants
S.No. | Awareness about Thyroid Disorder | Correct Response | Percent |
| Knowledge about the thyroid gland, its functions, Risk factor & causes of thyroid disease | ||
The thyroid gland is an endocrine gland | 287 | 71.75 | |
Thyroid dysfunction affects brain development | 262 | 65.5 | |
Thyroid dysfunction affects the blood cholesterol level | 42 | 10.5 | |
Thyroid dysfunction results in cardiac diseases | 78 | 19.5 | |
Exercise and Sports affect thyroid dysfunction | 125 | 31.25 | |
Thyroid dysfunction is genetic | 79 | 19.75 | |
Smoking is a risk factor for thyroid diseases | 186 | 46.5 | |
Radiation exposure is a risk factor for thyroid diseases | 202 | 50.5 | |
Insufficient or excess iodine intake is a risk factor for thyroid diseases | 265 | 66.25 | |
Females are more at risk of having thyroid diseases | 287 | 71.75 | |
Pregnancy and the postpartum period are risk factors for thyroid diseases | 215 | 53.75 | |
Medication like Amiodarone is a risk factor for thyroid diseases | 84 | 21 | |
Lithium intake is a risk factor for thyroid diseases | 108 | 27 | |
| Knowledge about the clinical picture of thyroid disorders | ||
The sudden increase in weight is a symptom of hypothyroidism | 286 | 71.5 | |
Fatigability and sleepiness are manifestations of hypothyroidism | 255 | 63.75 | |
Skin and hair dryness are symptoms of hypothyroidism | 116 | 29 | |
Feeling cold in hot weather is a symptom of hypothyroidism | 141 | 35.25 | |
Loss of weight despite good appetite is a symptom of hyperthyroidism | 190 | 47.5 | |
Insomnia and lack of sleep are symptoms of hyperthyroidism Respondents | 187 | 46.75 | |
Increased heart rate is a symptom of hyperthyroidism | 207 | 51.75 | |
Inability to stand hot weather and wearing light clothes in cold weather are symptoms of hyperthyroidism | 134 | 33.5 | |
Oligomenorrhea and amenorrhea are symptoms of hyperthyroidism | 158 | 39.5 | |
Neck lump can be a sign of thyroid diseases | 216 | 54 | |
Fatigue can be a symptom of thyroid diseases | 169 | 42.25 | |
Diarrhea, constipation, or stomachache can be symptoms of thyroid diseases | 107 | 26.75 | |
Skin and nail changes or hair loss can be signs of thyroid diseases | 84 | 21 | |
Bulging eyes can be a sign of thyroid diseases | 109 | 27.25 | |
| Knowledge about the prevention of thyroid disorders | ||
Away from Soya and Goitrogenic foods is one of the preventive way from thyroid diseases | 187 | 46.75 | |
Early thyroid function tests can prevent the complication of thyroid disease | 206 | 51.5 | |
Well-balanced diet is essential to prevent thyroid diseases | 196 | 49 |
Table 3: Awareness regarding Thyroid Disorders among study participants
Category (Marks) | Awareness regarding Thyroid Disorders ( n=400) | Percent |
V. Good (24-30) | 36 | 9 |
Good (18-23) | 122 | 30.5 |
Fair(12-17) | 147 | 36.75 |
Poor(<12) | 95 | 23.75 |
Total | 400 | 100 |
In the present study 36 (9.0%) study participants had very good (24-30 marks) awareness regarding Thyroid Disorders , 122 (30.5%) had good (18-23 marks), 147 (36.75%) had fair (12-17 marks) and 23(5.75%) had poor (<12 marks) awareness regarding Thyroid Disorders.
Thyroid disorders are one of the most underdiagnosed and neglected medical problems, and the lack of general patient knowledge may be of considerable concern. Awareness can benefit many individuals who have thyroid disease and are unaware of their problem .[1,9]
This cross-sectional community-based study was conducted to evaluate the awareness of the thyroid gland, its function, its disorders, risk factors affecting thyroid disorders among the general population of Himachal Pradesh. In the current study, 36 (9.0%) study participants had very good awareness of thyroid disorders (24-30 marks), 122 (30.5%) had good awareness (18-23 marks), 147 (36.75%) had fair awareness (12-17 marks), and 23 (5.5%) had low awareness (12 marks).
Similarly in the study done by Abdulwahab Alyahya et al1, the overall mean knowledge score regarding thyroid disease manifestations and its risk factors was 8.67 (SD 3.69) with 44.7%, 41.2%, and 14.2% were classified into low, average, and high knowledge, respectively. Another study by Assem Saleh Ali Almuzain et al11 showed that 57.32% of respondents had good knowledge, whereas 42.68% had poor knowledge of thyroid disorder diseases.
Increased awareness and knowledge of their thyroid condition would enable patients to become more drug-compliant, follow-up on a regular basis, and distribute the right information to their family and friends.
LIMITATIONS
The sample size and duration of the study are restricted to 400 respondents and 3 months in time; thus, the scope and extent of the conducted research might be minimized. This survey was conducted only in one state of India, and hence, these findings cannot be generalized all over India.
According to survey findings, the general public had either insufficient or not satisfactory knowledge about the thyroid gland, its functioning, risk factors, causes of thyroid illness, clinical symptoms and prevention of thyroid problems. The present study warrants the educational program and awareness campaigns on thyroid disorders for the general population. The health authorities should hold more successful health education methods to improve the public and their caregivers' awareness of the various aspects of thyroid disorders and the value of their early detection and adequate control.
Conflict of Interest: The authors declare that they have no conflict of interest
Funding: No funding sources
Ethical approval: The study was approved by the IGMC Shimla, Himachal Pradesh, India.
Alyahya A, AlNaim A, AlBahr AW, Almansour F, Elshebiny A. Knowledge of Thyroid Disease Manifestations and Risk Factors Among Residents of the Eastern Province, Saudi Arabia. Cureus. 2021 Jan 31;13(1).
Khalifa A, Alotaibi A, Albahlal A, et al.: General public awareness about symptoms and risk factors of cardiovascular diseases in Riyadh city, Saudi Arabia. IJMDC. 2019, 3:44-51.
Almousa AI, Alotaibi AM. Survey of awareness of thyroid disorders among the Riyadh population, Central Region of Saudi Arabia. The Egyptian Journal of Hospital Medicine. 2018 Jul 1;72(2):4039-44.
Alam Khan V, Khan MA, Akhtar S. Thyroid disorders, etiology and prevalence. J Med Sci. 2002 Mar;2(2):89-94.
Vanderpump MP: Epidemiology of Thyroid Dysfunction - Hypothyroidism and Hyperthyroidism . Thyroid International, Darmstadt; 2009.
Vanderpump MP: The epidemiology of thyroid disease . Br Med Bull. Sep 2011, 99:39-51.
Assessment of the iodine deficiency disorders and monitoring their elimination. (2007). Accessed: March 31, 2021: https://apps.who.int/iris/bitstream/handle/10665/43781/9789241595827_eng.pdf
Zelmanovitz F: Screening for thyroid disease. Ann Intern Med. 1999, 130:161.
Rai S, Sirohi S, Khatri AK, Dixit SD, Saroshe S. Assessment of knowledge and awareness regarding thyroid disorders among women of a cosmopolitan city of central India. National Journal of Community Medicine. 2016 Mar 31;7(03):219-22.
Canaris GJ, Tape TG, Wigton RS. Thyroid disease awareness is associated with high rates of identifying subjects with previously undiagnosed thyroid dysfunction. BMC Public Health. 2013 Dec;13(1):1-7.
Almuzaini A, Alshareef B, Alghamdi S, Munshy AA, Aljarallah AK, Salman SA, Alroqi KS, Alkhaldi RD. Assessment of knowledge and awareness regarding thyroi d disorders among Saudi people. IJDMC. 2019;3:1070-6.