World Thyroid Day

May 25

According to world statistics, thyroid diseases occur in almost 30% of the world's population. Among which the most common are diffuse goiter (mainly in regions with iodine deficiency), nodular formations, and currently there is an increase in autoimmune pathology of the thyroid gland.

The global nature and importance of this problem made it possible in 2009. experts from the European Thyroid Association propose to celebrate World Thyroid Day on May 25 . This initiative was supported by all other medical societies dealing with thyroid pathology: American, Latin American and Asian.

World Thyroid Day has five main goals :

increasing public awareness about problems associated with thyroid pathology and their medical and social significance;
raising awareness about the prevalence of thyroid diseases and methods for their early detection;
promotion of prevention and educational programs in the field of thyroid pathology;
promotion of modern methods of treating thyroid diseases;
increasing the availability of medical care in the field of thyroid diseases.

Currently, the Republic of Belarus has built a clear system of providing care to patients with thyroid pathology. According to the Decree of the Ministry of Health of the Republic of Belarus dated August 12, 2016 No. 96 “On approval of the Instructions on the procedure for medical examination,” the detection of thyroid pathology is carried out at an outpatient appointment by pediatricians and general practitioners. If there are dysfunctions of the thyroid gland, patients are referred to an endocrinologist who provides medical care in accordance with the order of the Ministry of Health of the Republic of Belarus dated July 2, 2013 No. 764 “Clinical protocols for the diagnosis and treatment of the adult population with diseases of the endocrine system when providing medical care on an outpatient basis.” In 2017, it is planned to rework clinical protocols in order to optimize diagnostic and therapeutic approaches for diseases of the endocrine system, including thyroid pathology.

Since the beginning of 2000, the republic has been actively working to eliminate iodine deficiency using the most effective method of mass prevention - the use of iodized salt. Currently, the Republic of Belarus has established production and ensured the availability of iodized salt, which allows the population to receive a sufficient amount of iodine and, accordingly, prevent its deficiency.

The results of the implementation of the strategy for eliminating iodine deficiency in the Republic of Belarus allowed the International Committee for the Control of Iodine Deficiency Diseases and the Global Iodine Network to include Belarus in the list of countries that have achieved target levels of iodine nutrition . The measures taken to eliminate iodine deficiency led to a decrease in the primary incidence of nodular goiter (97.5% in 2000; 88.14% in 2016) and a more than 5-fold reduction in the primary incidence of endemic goiter (from 318.9% in 2000 to 59 .09% in 2016).

In the Republic of Belarus, over the past five years, there has been a clear decrease in the primary incidence rate and the total number of children with thyroid dysfunction due to the active implementation of the state program of mass iodine prophylaxis. In the structure of thyroid diseases in children, simple non-toxic goiter predominates. At the beginning of 2017, 13,636 patients under the age of 18 were observed with this diagnosis. One of the important criteria for the adequacy of iodine supply to the child population of the republic is the incidence rate of congenital hypothyroidism. Primary screening is performed in all obstetric institutions of the Republic of Belarus. The results of screening for primary congenital hypothyroidism indicate a level achieved that is adequate to the European average: in 2014, 1 case of hypothyroidism was detected in 4,216 newborns.

At the same time, over the past 15 years there has been an increase in autoimmune pathology of the thyroid gland. Thus, the number of patients with primary hypothyroidism increased 8 times (in 2000 - 11,078 people, in 2015 - 87,446 people), which is due not only to the accumulation of patients with this diagnosis, but also to the increased availability and accuracy of laboratory diagnostics. The primary incidence of primary hypothyroidism during this period increased 4.5 times (22.55% in 2000 and 94.94% in 2017).

One of the most common causes of hyperfunction of the thyroid gland is Graves' disease (diffuse toxic goiter), which requires careful monitoring and long-term differentiated treatment. The primary incidence of diffuse toxic goiter has almost doubled over 15 years: from 6.21 in 2000 to 11.0 in 2016.

In the Republic of Belarus in the last decade there has been an improvement in the diagnostic capabilities of thyroid pathology in both children and adults. Ultrasound examination of the thyroid gland is carried out in all regions of the republic, and hormonal examination of thyroid status is carried out at the inter-district level. At the regional level, fine-needle aspiration biopsy under ultrasound control and thyroid scintigraphy are performed. At the republican level, in the State Institution Republican Center for Medical Rehabilitation and Balneotherapy, according to indications, all necessary studies are performed in diagnostically difficult cases. Since 2015, the center has been piloting a telemedicine consultation system in the “Cytology” section.

Surgical treatment of thyroid pathology is carried out at the regional and republican level (Republican Center for Thyroid Tumors on the basis of the City Clinical Oncology Center in Minsk, Department of Endocrine Surgery of the State Institution Republican Scientific and Practical Center for Radiation Medicine and Human Ecology). Treatment with radioactive iodine is carried out in two institutions of the republic: the City Clinical Oncology Dispensary in Minsk, and the Gomel Regional Clinical Oncology Dispensary.

The main drugs for the treatment of thyroid diseases are potassium iodide preparations, synthetic analogues of levothyroxine (including domestically produced ones), and thyreostatic drugs. All necessary types of medicines are officially registered in the republic and are available in the pharmacy network.

Chief freelance endocrinologist

Ministry of Health A.P. Shepelkevich

Chief freelance children's endocrinologist

Ministry of Health A.V. Solntseva