A 4-month unique executive on-the-job program with 25 centres in India aims to train and develop competencies in Primary Care Physicians to improve patient outcomes by enabling early diagnosis and evidence based treatment.
A first of its kind Pan-India Certificate Course in Management of Thyroid Disorders was launched by Public Health Foundation of India (PHFI) and Chellaram Diabetes Institute (CDI), Pune today. The national launch was simultaneously done in Pune and Guwahati by respective regional faculties along with members from PHFI. The course is a unique 4 months executive on the job program that aims to build capacity amongst primary care physicians to address management, counselling, referral and prevention of Thyroid Disorders. The programme is supported by an unrestricted educational grant from GSK India.
Thyroid diseases are among the commonest endocrine disorders worldwide. In India it has been estimated that about 42 million people suffer from thyroid disorders, majorly because the entire population, and not just the Himalayan belt, is prone to iodine deficiency disorders (IDD) due to deficiency of iodine in the soil of the subcontinent. The overall prevalence of IDD is above 10% in India. IDD in pregnancy can lead to spontaneous abortions and stillbirths. It can have profound effects on the growing fetus and lead to congenital goiter and cretinism in the newborn. However, the effects can be observed during childhood when it can affect the growth and development of children, as also during adulthood when it can affect the productivity.
Hypothyroidism and Autoimmune thyroiditis are common disorders in India, and over the years its incidences seem to be on the rise. A cross-sectional, multi-center study in eight major cities of India noted the prevalence of hypothyroidism of 10.95% among the adult population. It was thrice as common in females as compared to males. Hyperthyroidism, though not as common as hypothyroidism, is still quite prevalent. In the above-mentioned eight-city study, the prevalence of subclinical hyperthyroidism was 1.27% and thyrotoxicosis was 0.72% among the adult population.
In the case of Autoimmune thyroiditis population studies have suggested that about 16.7% of adult subjects have anti-thyroid peroxidase (TPO) antibodies and about 12.1% have anti-thyroglobulin (TG) antibodies. In the same study, when subjects with abnormal thyroid function were excluded, the prevalence of anti-TPO and anti-TG antibodies was 9.5% and 8.5% respectively.
Thyroid cancer data available from the cancer registries reveals a prevalence of 0.1%–0.2%. The age-adjusted incidence rates of thyroid cancer per 100,000 are about 1 for males and 1.8 for females as per the Mumbai Cancer Registry, which covered a population of 9.81 million subjects.
Similarly a study by Guwahati Medical College (pls see reference study link below) was conducted in a Community Development Block area, a valley between the offshoots of the Chilarai Hills, situated at a distance of 45 Km from Guwahati city. Eight villages were selected in the block for the study and family members of every 4th family of each village was interviewed and clinically examined for Thyroid disorder/ goiter. Total numbers of individuals examined were 1424. Overall goiter prevalence (TGR=Total goiter rate) was 33.84% of which visible goiter rate was 5.82% (WHO 1979 and PAHO 1984 classification). Age prevalence of the goiter was highest in 14- 19 years with female aggregation more. Single case each of Cretinism, Hypothyroidism and Hyperthyroidism showing correlation with the results of circulatory thyroid hormone was detected in the target population. 97.3% of the head of the families were not aware of salt iodisation. Majority (91.49%) of the head of the families did not consider thyroid/ goiter as a health problem. Mean urinary iodine excretion level was 48.03 microgram/g of Creatinine in the sampled population. Average water iodine level in the study area was 0.745 microgram/L of drinking water. Mean iodine content of soil in the study area was 1 ppm. Assessment of current iodine nutrition status of the population is essential to know the effective implementation of salt iodisation in the locality.
Officially launching the first cycle of the course in Pune, Dr AG Unnikrishnan, CEO of Chellaram Diabetes Institute, said, “There is a high burden of thyroid diseases in India, which is under-addressed both within the population level and also the medical fraternity level too. Thyroid diseases are different from other diseases in terms of their diagnosis and medical treatment. Early diagnosis and treatment is the cornerstone of management of thyroid disorders, hence there is an urgent need to build capacity in this area as Thyroid has become a serious health threat with exploding population. The Chellaram Diabetes Institute, a state-of-the-art hospital in Pune that aims to make an impact on diabetes and related diseases in India as well as globally – is proud to be associated with PHFI for leading a pan-India course that will ultimately benefit patients with thyroid diseases in India. In Pune centre itself we have 32 doctors enrolled, and I hope that the successful doctors from this course take the responsibility and duty to secure a healthy future for generations ahead.”
Launching the first cycle of the course in Guwahati, Dr Manash P Baruah, Director Excel Centre Guwahati and PHFI CCMTD National Expert, Assam said, “There is a high burden of thyroid disorder in the North Eastern parts, primarily due to the prevalence of iodine deficiency and goitre disorders in the Himalayan regions. Frequent flooding and change of river course attributed to the major causes of iodine depletion in the soil making North East a bed-ground for Thyroid disorders. To manage, treat and to prevent the complications of thyroid diseases we need a trained set of doctors who are equipped with the latest advancements, and follow the cutting-edge international and national guidelines. This course by PHFI is a timely and well-designed compendium that will help tackle the challenges of disease detection, management, and further familiarizing doctors with advancements in the subject. I hope that the successful doctors from this course take the responsibility and duty to secure a healthy future for generations ahead.”
In his address Dr Sandeep Bhalla, Programme Director PHFI said, “Recently various studies have indicated that thyroid disease should be considered during routine evaluation of the subcontinents susceptible group and should be followed by appropriate detection and treatment. The findings support the usefulness of training, screening and management for early detection that will benefit in preventing adverse health outcomes in the population such as Osteoporosis, Cardiovascular diseases and Hyperlipidemia. At PHFI it is our endeavour to help strengthen education, training, and research in the area of Public Health. The launch of the 1st Cycle of CCMTD is a step further to tackle the rising prevalence thyroid disorders, aiming to strengthen the capacity of doctors to deal with the enormous challenges it poses, with the ultimate aim of improving the health outcomes of people.”
The Certificate Course in Management of Thyroid Disorder is an on-job training program with study modules spanning over four consecutive months, with once a month contact session. These sessions will be conducted at 25 Regional Centres (covering 13 states, 2 Union territories and 22 cities) across India. The course has been designed by a panel of 15 National Experts, will be delivered by 25 Regional Faculty across India. The program has been conceptualized to train Primary Care Physicians (PCP) across the with its main objective is to enhance knowledge, skills and core competencies of primary care physicians to address case management, counselling, referral & prevention of thyroid disorders in patients. This will enable early diagnosis and prompt referrals of patients and establish a referral linkage pattern. The course utilizes a variety of teaching/learning techniques. Training in management of thyroid disorders will be complemented by providing the participants with various distinct case studies and challenging assignments. The course will be interactive with the inclusion of hands-on activities for the participants. Videos to highlight certain points will be a distinctive feature of the course. It will be offered on a modular basis with judicious mix of case-studies, group discussion and direct teaching by eminent experts, with inbuilt flexibility to accommodate participant’s requirements.
For Course details and Media Contact:
- Dr. Shailesh Deshpande, CDI Pune: Mob: +91-9890394334
- Dr Manash Baruah, Director Excel Centre Guwahati: Mob: 919435018344
- Ms Shradha T Dhingra: Lalani Quantum, Pune-Bangalore Highway, Bavdhan Budruk, Pune 411021; Tel: 020 66839 777 (Ext 765); Email: [email protected] | Website: www.cdi.org.in | www.diabeteshealth.co.in
- Mr Rajiv Chhibber, PHFI, New Delhi. (Mob: +919810426698)