Treatment of the Elderly Goiter patients in Kagera Region Tanzania

Treatment of the Elderly Goiter patients in Kagera Region Tanzania

Cassava (Manihot esculenta Crantz), an edible crop that is renowned out of its growth advantages over other crops, carries cyanide which is potentially poisonous to humans. The threat is intensified by human habit of consuming raw cassava tubers whose toxicological status is not established. Among other severe effects, long-term consumption of cassava containing high levels of cyanogenic glycosides has been associated with development of hypothyroidism, goiter, and cretinism in areas with low iodine intake. In 2005, the world Health Organization reported that the total global goiter prevalence was 28.3% (Andersson et al., 2005). Furthermore, Global estimates indicated that about 30% of the world population was affected by Iodine deficiency disorders (WHO/UNICEF/ICCIDD, 2008). Endemic goiter reported to affects millions of people in low-income countries mainly due to deficiency of iodine in food sources and factors that affect the bioavailability of iodine sources (Abuye et al., 2008; Ashraf et al., 2010). The reason why poverty increased the prevalence of goiter in low income countries, is the huge consumption of cassava by the poor people in their daily meals. Fore stance, Tanzania, has been reported as one of the largest cassava producers in Africa and cassava has been considered as a famine reserve crop. Cases and indicators of cyanide poisoning due to cassava consumption are evident in Tanzania, particularly in Kagera and Morogoro regions (CB Mushumbusi et al- 2018).

Tanzania has previously suffered from moderate to severe iodine deficiency. For the past twelve years after the initiation of universal salt iodation program as an intervention strategy, there is a marked improvement in iodine nutrition in Tanzania (VD Assey et al 2009). However, the incidence of elderly goiter in areas with sufficient iodine intake has been documented in different areas of the world (Medeiros-Neto G et al 2016). In countries with previous deficiency that was corrected by universal salt iodination, elderly subjects have been reported to have an incidence of, approximately, 10% of nodular and multinodular goiter, attributed to lack of nutritional iodine in early adult life (Medeiros-Neto G et al 2016). When goiter becomes hemorrhagic, it may cause acute pain and swelling, mimicking painful subacute thyroiditis or neoplasia. The goiter may also compress adjacent structure such as the trachea, esophagus and recurrent laryngeal nerves. Among the challenges in combating the goiter cases in Tanzania is that, the majority of patients present for surgery very late with huge goiters predisposing them to increased risk of long term disabilities, post-operative complications, prolong length of hospital stay and cost of medical care. This situation is further aggravated by the poor communities especially in remote districts areas and cost-sharing healthcare system in Tanzania.

TAHO’S COMMUNITY SUPPORT

In acknowledging the Tanzanian government efforts in the struggle for eliminating the iodine deficiency disorders and their long-term disabilities among the communities, The Awaited One Hand Organization (TAH0) is critically intended to help low social economic status families which cannot afford the hospital billing while suffering from emergency or long term illness. As our duty, we explored the variety of communities in Kagera districts and found out that, there are numerous poor elderly individuals suffering from goiter and most of them can’t afford the hospital surgical treatments bills. Most of these cases has been treated locally at home leading to further complications and risk the general body health. Other individuals are in- doors for several years due to social discrimination. Our organization through your support will consider helping the individuals whose cases did not advance to malignancy for surgical treatments in the selected hospital within the region. However, in doing so, we will kindly help the transportation and accommodation bills for referral cases. For a period of six month, the organization has cited a total of 52 cases in need for hospital treatments from six remote districts communities (Karagwe, Kyerwa , misenyi, kyaka, biharamulo and muleba) which we were able to reach them. The following few photo cases has been taken from consented individuals requested for help in our organization during the field visits to village sites.

  ANTICIPATED IMPACTS

Poor health is one among the contributing factors to family poverty. Poverty has been described as an economic state that does not allow for the provision of basic family and child’s needs such as adequate food, clothing and housing. In worst cases the burden of illness may mean that families sell their property, take their children out of school to earn a living or even start begging. Poor elderly health will further increase the children’s risk for chronic health problems, school failure, gangs, drugs, violence, struggling families and early childhood pregnancy. Furthermore, female kids who are missing out on education has long term implications for a woman opportunity later in life and for her own health. Therefore, by supporting the elderly individuals in need of treatments, the organization is focused on improving their general health that will enhance their ability to work and raise the elderly person out of poverty. By doing so, we intend to improve their household economic status and minimizing the multiple risk hindering their children wellbeing and future developmental status.