The role of medical and organizational measures in improving the quality of early detection and clinical examination of autoimmune thyroiditis among the population of the Republic of Belarus

Abstract

Objective. To evaluate the role of medical and organizational measures in improving the quality of early detection and medical examination of autoimmune thyroiditis in the population of the Republic of Belarus.Materials and methods. The data of population statistics and the State register of persons affected by the Chernobyl catastrophe and other accidents on cases of thyroid pathology, as well as outpatient records of patients were analyzed. Epidemiological, statistical and sociological methods were used.Results. It was noted that different clinical and laboratory variants of autoimmune thyroiditis (AIT) are encountered in clinical practice. Subclinical AIT with sonographic signs of the disease but without diagnostic concentrations of antibodies to thyroid peroxidase (AB/TPO) and disturbances of its function is registered in 14.1 (6.0-24.4) %. AIT with diagnostic concentrations of autoantibodies to AB/TPO, with preserved thyroid function or hypothyroidism occurs in 22.5 (13.534.0) % of the cohort subjects. The frequency of combining AIT with nodular neoplasms of the thyroid increased by the 4th stage of screening and reached 20.7 (11.2-33.4) %.The reasons for different approaches to diagnosis were analyzed and measures to improve organizational and medical measures for early detection and dispensary treatment of patients with AIT were proposed: groups of persons at high risk of AIT and primary hypothyroidism (PHT) were identified, an algorithm for early detection and dispensary treatment was developed, etc.Conclusion. When making a decision to improve the quality of medical care to the population of the Republic of Belarus on early detection and medical examination of patients with AIT, it is necessary to take into account the timeliness of thyroid status studies in the population, compliance with the terms of dynamic observation for persons at high risk of AIT and PHT development, peculiarities of clinical and laboratory variants of AIT course.