After my last post on Congenital Hypothyroidism in India, a disease that can be managed if detected at birth, I got the opportunity to interview Dr. Prasanna, Endocrinologist, in Bangalore. He has been practicing for many years and has closely seen cases of congenital hypothyroidism.
I talked to him to get a better understanding of the prevailing situation in India. This is the information he gave me:
Congenital Hypothyroidism is a disease in newborn children whereby their body does not produce adequate thyroid hormones. If not detected at birth, it can lead to severe consequences in a child. If detected, the baby can be treated and can lead a normal life. Do read my first post on ACT— Act against congenital hypothyroidism for more information. In India, the neonatal test that tests for congenital hypothyroidism is not mandatory. Some premier private hospitals do offer it but most of the government hospitals do not offer the test as it is not made mandatory by the government. The test is a simple pin-prick test to withdraw blood. This blood is then tested for TSH levels just like a thyroid test is done for adults. The test cost varies from Rs. 10 – Rs. 20 in govt. hospitals to Rs. 100 – Rs. 300 in large, private hospitals.
The test can be easily conducted even in places like rural areas or far-flung areas that have no access to any medical facilities or a doctor. One of the easiest methods to do this test is to take a few drops of cord blood after the birth of the baby onto a filter paper. This filter paper can then be posted to the nearest government hospital for the test. The blood taken in this way stays good enough to test even 4 days after it has been originally taken. This method is one of the simplest ways to make it available to all villages.
Normally the test must be conducted after birth within 48-72 hours. According to a rough estimate, the delay in detection of congenital hypothyroidism may permanently impair mental faculties. Almost 50% of brain’s faculties are lost if the disease is not detected in the first 6 months of the child’s life. This deficit is irretrievable.
Some of the common reasons for congenital hypothyroidism is the absence of thyroid or sluggish thyroid in children. Deficiency of iodine in mother may also lead to this disease in the newborn. Congenital hypothyroidism if untreated may cause mental retardation and stunted physical growth.
If detected in time, congenital hypothyroidism is easily managed with medication. The medication must be taken lifelong at dosages that are decided by the doctors by repetitive testing. But the child will grow up to be normal both physically and mentally. The cost of the medication is just Re. 0.75 to Re. 1 per day. Regular TSH tests will need to be conducted over the life time of the patient.
Many gynaecologists are also not aware of this test and do not actively recommend it to the parents. As this disease is not well known, even educated parents in larger cities are unaware. The only way in which this can be brought under control is by creating awareness among doctors and parents and also in making the facilities readily available to all. Standardizing the cost of the test may help as well.
I hope that the Government wakes up and helps curtail the largest cause of mental retardation among children. One simple test can help all. It is not even expensive. If any of your friends are expecting do let them know about this.