The largest endocrine gland in the human body is believed to be the thyroid gland, which is located in the front of the neck. It creates and releases thyroid hormones, significantly impacting protein synthesis and basal metabolic rate (BMR). Additionally, these hormones are crucial for maintaining adults' healthy physiological functioning as well as children's and teenagers' developing neurocognitive abilities.[1-3]

Thyroid problems include thyroid gland hypertrophy and thyroid hormone over- or under-secretion. Thyroid disorders can be either primary (having a direct connection to the gland) or secondary (thyroid dysfunction due to other factors). These infections have been reported in more than 110 countries, putting 1.6 billion people at risk.[4,5].Thyroid dysfunction is one of the most common medical conditions in the globe. If thyroid disorders are not treated, they may negatively affect a patient's quality of life. The condition's nature significantly impacts the clinical signs and symptoms of a thyroid issue, which can influence numerous physiological systems. Furthermore, because the bulk of the symptoms is not specific, thyroid disorders can be easily neglected or confused with other medical conditions.[6,7]

Being one of the most under-diagnosed and neglected medical problems, thyroid diseases, the lack of general information among patients may be of significant concern. The problem can be understood by many people who have thyroid dysfunction but are unaware of it. Most patients will likely go undiagnosed if the thyroid gland and the patient's symptoms are not understood.[8-10]

In Punjab, there aren't many studies that look at people's general knowledge about thyroid issues. As a result, this study aims to determine how knowledgeable the people of Punjab are about the signs, danger signs, and safety precautions related to thyroid issues.

Objectives of the Study

To evaluate the awareness regarding Thyroid Disorders, their symptoms, risk factors, and preventive measures among the General Population of Punjab.

• Research Approach -Descriptive

• Research Design- Cross-sectional survey design

• Study area:  Whole state of Punjab

• Study duration- between March 2022 and April 2022

• Study population: All adults above 18 years old who stayed in Punjab 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, their symptoms, risk factors, and preventive measures were 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- 

1. Demographic data survey instrument: The demographic form elicited information on participants' backgrounds: age, gender, marital status, religion, employment, education, and many more.

2. Questionnaire: The questionnaire contains 30 structured questions regarding Awareness of Thyroid Disorders, their symptoms, risk factors, and preventive measures having three options, i.e., Yes, No & Don't Know. The participants have to choose the right one. One mark was given for each correct answer and zeroed for the incorrect answer. The maximum score was 30, and the 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 email and social media platforms like WhatsApp groups, Facebook, Instagram, and LinkedIn in both rural and urban areas of Punjab till the 400 responses were collected. Responses were then recorded in a Google Excel spreadsheet.

• Data analysis was collected and entered in a Microsoft Excel spreadsheet, cleaned for errors, and analyzed with Epi Info V7 Software with an appropriate statistical test for frequencies and percentages. 

• Ethical Considerations- Participants' confidentiality and anonymity were maintained. 

The present study was a cross-sectional descriptive study to evaluate the awareness of Thyroid Disorders, their symptoms, risk factors, and preventive measures among the general population of Punjab.

A total of 400 respondents participated in the study, with 237 (59.25%) coming from rural areas and 163 (40.75%) from urban areas. The majority's participants included 387 (96.75 percent) Hindus, 269 (67.25 percent) males, 173 (43.25 percent) people in their 18 to 30s, 155 (38.75 percent) graduates, 266 (66.5 percent) working people, 238 (59.5 percent) married people.

Table-1: Socio-demographic characteristics of study participants

Table-2: Awareness about Thyroid Disorders, its symptoms, risk factors and preventive measures among participants

Table 3: Awareness about Thyroid Disorders among study participants

In the present study 76 (19.0%) study participants had very good (32-40 marks) awareness about Thyroid Disorders, 169 (42.25%) had good (24-31 marks), 132 (33.0%) had fair (16-23 marks) and 23(5.75%) had poor (<16 marks) awareness about Thyroid Disorders. 

The lack of general patient understanding may be of great concern as thyroid disorders are one of the most underdiagnosed and ignored medical conditions. Many people with thyroid disease who are ignorant of their condition can benefit from awareness.1,9.This cross-sectional community-based study was conducted to evaluate the awareness of the thyroid gland, its function, its disorders, and the risk factors affecting thyroid disorders among the general population of Punjab. In the present study 76 (19.0%) study participants had very good (32-40 marks) awareness about Thyroid Disorders, 169 (42.25%) had good (24-31 marks), 132 (33.0%) had fair (16-23 marks) and 23(5.75%) had poor (<16 marks) awareness about Thyroid Disorders 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.Patients would be more drug-compliant, follow up more frequently, and provide the correct information to their family and friends if they were more informed about their thyroid disease.

Limitations

The sample size and duration of the study are restricted to 400 respondents and two 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; hence, these findings cannot be generalized all over India.

The survey results showed that the general public's understanding of the thyroid gland, its functions, risk factors, causes of thyroid disease, clinical symptoms, and prevention of thyroid disorders were either insufficient or unsatisfactory. The current study supports public education initiatives and awareness efforts on thyroid problems. The health authorities should arrange more effective health education events to increase the general public's and their caregivers' understanding of the numerous features of thyroid problems and the need for early detection and sufficient control.

The authors declare that they have no conflict of interest

No funding sources

The study was approved by the Dayanand Medical College, and Hospital.

1. Alyahya, A., Alnaim, A., Albahr, A. W., et al. "Knowledge of Thyroid Disease Manifestations and Risk Factors among Residents of the Eastern Province, Saudi Arabia." Cureus, 13.1 (2021): e13035. https://doi.org/10.7759/cureus.13035.

2. 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, 3 (2019): 44-51. https://doi.org/10.24911/IJMDC.2019.3.2.3.

3. Abdulrahman, Ibrahim A. M. "Survey of Awareness of Thyroid Disorders among the Riyadh Population, Central Region of Saudi Arabia." Egyptian Journal of Hospital Medicine, 72 (2018): 4039-4044. https://doi.org/10.12816/0048457.

4. Alam Khan, V., Khan, M. A., and Akhtar, S. "Thyroid Disorders, Etiology and Prevalence." Journal of Medical Sciences, 2 (2002): 89-94. https://doi.org/10.3923/jmsci.2002.89.94.

5. Vanderpump, M. P. "Epidemiology of Thyroid Dysfunction – Hypothyroidism and Hyperthyroidism." Thyroid International, Darmstadt, 2009. 

6. Vanderpump, M. P. "The Epidemiology of Thyroid Disease." British Medical Bulletin, 99 (2011): 39-51. https://doi.org/10.1093/bmb/ldr030.

7. World Health Organization. Assessment of the Iodine Deficiency Disorders and Monitoring Their Elimination. 2007. Accessed 31 Mar. 2021, https://apps.who.int/iris/bitstream/handle/10665/43781/9789241595827_eng.pdf. 

8. Zelmanovitz, F. "Screening for Thyroid Disease." Annals of Internal Medicine, 130 (1999): 161. https://doi.org/10.7326/0003-4819-130-2-199901190-00015.

9. Rai, S., Sirohi, S., Khatri, A. K., Dixit, S., and Saroshe, S. "Assessment of Knowledge and Awareness Regarding Thyroid Disorders among Women of a Cosmopolitan City of Central India." National Journal of Community Medicine, 7 (2016): 219-222

10. Canaris, G. J., Tape, T. G., and Wigton, R. S. "Thyroid Disease Awareness is Associated with High Rates of Identifying Subjects with Previously Undiagnosed Thyroid Dysfunction." BMC Public Health, 13 (2013): 351. https://doi.org/10.1186/1471-2458-13-351.

11. Almuzaini, Assem Saleh Ali, et al. "Assessment of Knowledge and Awareness Regarding Thyroid Disorders among Saudi People." International Journal of Medicine in Developing Countries, 3.12 (2019): 1070–1076.https://doi.org/10.24911/IJMDC.2019.3.12.12.