[Problems in the management of thyrotoxicosis in Black Africa: the Tongolese experience]. / Les difficultés de la prise en charge de la thyréotoxicose en Afrique noire.

In black Africa, and particularly in Togo, management of thyreotoxicosis is not simple. The intervention of several specialists and effective patient collaboration is needed. In a majority of cases, the patient's apprehensions, financial problems, and taboos prevent correct management. We report 30 cases of thyreotoxicosis in 82 patients with thyroid disease seen over a 5-year period in the Internal Medicine and Cardiology Department of the Lomé teaching hospitals. Graves' disease was the most frequent (83.33%), followed by multinodular goiter (10%) and toxic nodule (6.67%). Diagnosis was strictly clinical in 53.33% of the cases. The main complication was cardiothyreosis in 46.67% of the patients. Drug treatment was used. Short-term results (4 - 6 weeks) was favorable in 96.67% of the cases. A percentage (65.41%) were lost to follow-up after discharge. The main impairment encountered for the management of thyreotoxicosis was financial and economical difficulties not specific to the disease. Other problems included the lack of diagnostic and therapeutic means and insufficient cooperation between the surgeon, the cardiologist and the endocrinologist.