The New Nation - Internet Edition

Md. Omer Farupue Dewan

Thyroid gland is situated at the front of neck and release important hormone thyroxin, which uses body to increase body metabolism and physical and mental development in case of infant.

Around the world, the most common cause of congenital hypothyroidism is iodine efficiency, but in most of the developed world and areas of adequate environmental iodine, cases are due to a combination of known and unknown causes. Most commonly there is a defect of development of the thyroid gland itself, resulting in the absent (athyreosis) or underdeveloped (hypo plastic) gland.

Congenital Hypothyroidism (CH) is a serious condition of newborn babies, which leads to permanent mental and physical retardation if not identified within first few weeks of life.

Unfortunately clinical symptoms are often late and nothing can be done at that point to save those children from permanent mental and physical handicap ness.

To identify the babies in early stage screening of babies in first few days of life is the only choice and is an established procedure for long in almost all the developed countries.

Even in developing countries like Thailand, Vietnam and Philippines this screening programme is now a national programme of their own and some of those countries have achieved a target of 90% to screen their newborns to identify congenital hypothyroidism.

Bangladesh is an iodine deficient area and thyroid related diseases are common in our country. The latest national survey shows that about 17% of the population is suffering from thyroid disorder.

Incidence of congenital hypothyroidism in Bangladesh is not yet known. However, it has been found that incidence of CH is higher in iodine deficient areas.

Preliminary study shows an incidence of 1:2300, which is also much higher than world incidence (1:4000). Probably deficiency of thyroid hormone plays an important role in our higher infant mortality rate.

The present birth rate of the country is 1.8% and with that birth rate some 24 million babies are born each year. With a suspected incidence rate of 1: 1000 some 2400 babies are born with CH and going added to our population each year.

These large numbers of babies are not only becoming burden for the family or society but also causing a great loss in our national economy.

BAEC (Bangladesh Atomic Energy Commission) is working for the last 5 years to develop the technology of newborn screening in collaboration with International Atomic Energy Agency (IAEA).

It is the right of newborn to be screened from congenital diseases and WHO has accepted this in its chatter of 1968.

Now it is working in national level to know the exact situation of congenital hypothyroidism in the country. Nuclear medicine technique is quite effective for newborn screening.

But 100% of the babies born in the country could not be shortage of manpower. The Ministry of Health (MOH) has to take over this programme to cover, our total birth neontes in the whole country as universal immunisation.

BAEC has taken an initiative

* To identify babies born with congenital hypothyroidism.

* To collect a meaningful data for professionals and policy makers.

* To achieve the above objectives a newborn screening centre will be established in the Institute of Nuclear Medicine & Ultrasound (INMU), Dhaka that will serve the nation by identifying babies born with congenital hypothyroidism and other inborn error of metabolism.

* To save our children from mental and physical retardation due to congenital hypothyroidism.

* To evaluate the situation of congenital hypothyroidism in Bangladesh.

* To achieve a national mandate for newborn screening so that ministry of health took this project as national programme as universal immunisation of children.

Nearly 100,000 of thyroid patients are getting services from nuclear medicine centres every year. BEAC has set a target upon the matter.

A total number of 200,000 newborns will be screened in a period of 4 years in Dhaka city and adjacent to Centre for Nuclear Medicine & Ultrasound at Dinajpur, Rangpur, Bogra, Rajshahi, Khulna, Faridpur, Barisal, Chittagong, Comilla, Sylhet and Mymensingh and some remote areas.

The initiative will be implemented with a base at Institute on Nuclear Medicine & Ultrasound (lNMU), Dhaka involving other 11 Centres for Nuclear Medicine & Ultrasound (CNMU) of BAEC located in different parts of the country.

After working on it a demographic picture on congenital hypothyroidism in our country will come out as an output of the initiative as will as a large number of our children will be identified who born with CH and will be saved from mental and physical retardation who will get an opportunity to live a healthy lives and will thus contribute to our national economy.

To combat against CH, massive public awareness is the most important component.

Actually, most of our even literate people do not know about the harm ness of CH. It is now happening because of our ignorance. Even we do not know that this commodity remains within our race. But nobody wants his/her child CH problematic.

Therefore, our 'child can be born at any Hospital even at any place we would scream him/her within the 'time for his/her better future. MOH (Ministry of Health) has to take over this programme to cover the whole country.

BAEC can give technical knowledge, laboratory support and training facility to MOH. Ministry of Information particularly Press Information Department can take massive publicity through media for public awareness

-PID Article