Sains Ma1aysiana 25(2): 51-58 (1996)                                                                                           Sains Hayat/

                                                                                                                                                                Life Sciences

 

Prevalens Goiter dan Performans Mental di Kalangan

Orang Asli di Sinderut, Pahang

(Goitre prevalence and mental performance amongst the

Aborigines in Sinderut, Pahang)

 

 

Zaleha M. I., Osman A., Iskandar Z. A., Zainuddin B.

Mohd. Ali M. & Khalid B. A. K.

Jabatan Kesihatan Masyarakat Fakulti Perubatan

Universiti Kebangsaan Malaysia

43600 UKM Bangi Selangor D.E. Malaysia

 

 

ABSTRAK

 

Prevalens goiter dan performans mental telah ditentukan di kalangan penduduk Orang Asli di Sinderut; suatu kawasan pedalaman di Pahang. Seramai 196 subjek telah dipilih untuk kajian dengan julat umur dari 4 hingga 60 tahun. Status goiter telah ditentukan oleh pakar endokrinkologi menggunakan pengkelasan yang dicadangkan oleh Pertubuhan Kesihatan Sedunia; manakala performans mental diukur menggunakan ujian Raven (Oxford Psychologists Press). Pengambilan spesimen darah juga dilakukan untuk ditentukan paras tiroksin (T4) dan hormon perangsang tiroid (TSH). Didapati prevalens goiter adalah 26.5% (521196); dengan prevalens goiter nyata 42.3% (22152). Min isipadu goiter keseluruhan adalah 21.4 ± 19.1 ml (julat : 3.0 - 90.8 ml), sementara prevalens performans mental bagi nilai persentil lebih daripada 5.0 adalah 26.5% (julat : 5.0 - 50.0). Min paras tiroksin adalah 75.4 ± 19.3 nmol/L (julat : 19.9 - 138.1 nmol/L) manakala min paras hormon perangsang tiroid adalah 4.9 ± 3.2 mU/L (julat : 0.4 18.9 mU/L). Tidak terdapat korelasi yang signifikans di antara paras hormon dan skor performans mental (Korelasi Pearson; T4 : r=-0.002, p=0.9736; TSH : r=0.10, p=0.1843), serta isipadu goiter dan skor performans mental (Korelasi Pearson;   r=-0.02, p=0.8395). Prevalens goiter 20% menunjukkan kawasan ini mengalami endemia yang sederhana. Performans mental pula menunjukkan tahap pemikiran yang rendah di kalangan penduduk Orang Asli terutamanya di kawasan pedalaman.

 

 

ABSTRACT

 

Goitre prevalence and mental performance were determined amongst the Aborigines in Sinderut, a remote rural area in Pahang. A total of 196 subjects aged 4 to 60 years old were selected for study. Goitre status was determined by an experienced endocrinologist using classification suggested by World Health Organization; while mental performance was measured using Raven's test (Oxford Psychologists Press). Blood specimen was also taken for thyroxine (T4) and thyroid stimulating hormone (TSH) measurement. It was found that goitre prevalence was 26.5% (52/196); with visible goitre prevalence of 42.3% (22152). The overall mean of goitre volume was 21.4 ± 19.1 ml (range: 3.0 - 90.8 ml), while the prevalence of mental performance for the percentile value of more than 5.0 was 26.5% (range: 5.0 - 50.0). Mean thyroxine levels was 75.4 ± 19.3 nmol/L (range: 19.9 - 138.1 nmol/ L) while mean levels of thyroid stimulating hormone was 4.9 ± 3.2 mU/L (range: 0.4 - 18.9 mU/L). There was no significant correlation between hormone levels and mental performance score (Pearson Correlation; T4 : r=-0.002, p=0.9736; TSH : r=0.10, p=0.1843). goitre volume and mental performance score (Pearson Correlation; r=-0.02, p=0.8395). Goitre prevalence of more than 20% in this area indicates a moderate endemia, while mental performance showed a low thinking level in the Aborigines particularly those who lived in remote areas.

 

RUJUKAN/REFERENCES

 

Chen, P.C. 1981. Endemic goitre: a preventable and yet highly prevalent disease in Sarawak. Med J. Malaysia 43(2): 67-69.

Chen, P.C. & Yap, S.B. 1988. The prevalence of endemic goitre among Penans of the Baram. Med J. Malaysia 43(2): 159-161.

Gutekunst, R, Fierro-Benitez, R., Teichert, H.M. & Standbury, J.B. 1991. The effect of iodinated oil and salt on thyroid volume determined by ultrasonography in two villages in Equador. Tenth International Thyroid Congress. The Haque.

Hegedus,. L., Perrild, H., Poulsen, J.R., Andersen, B. Holm, Schnorr, P., Jensen, G., & Hansen, J.M. 1983. The determination volume by ultrasound and its relationship to body weight, age and sex in normal subjects, J Clin Endocrinol Metab. 56: 260.

Maberly, G.F. 1975. The significance of endemic goitre in Sarawak, Borneo. Bachelor of Science (Med) thesis, University of New South Wales.

Maberly, G.F., Boyages, S.C., LI, M., Eastman, c.J., Morris. J., Jupp, J.J., Collins, J.K., Qian, Q.D., Zhang, P., Qu, C. & Liu, D. 1986. Intellectual deficit persists in an iodine deficient population in China given iodized salt and oil prophylaxis. Dlm. Recent progress in thyroidology. Vichayanrat, A, Eastman, C.J., Nitiyanant, W. & Nagataki, S. eds. Proceeding of the third Asia and Oceania Thyroid Association meeting, Bangkok.

Maberly, G.F., Waite K.V., Eastman, C.J. & Coreoran, J.M. 1982. The role of cassava in endemic goitre in Sarawak, Malaysia. Abstract of the 2nd Asia and Oceania thyroid congress, Tokyo.

Morreale de Escobar, G. & Escobar-del Ray, F. 1980. Dlm. Neonatal Screening, Ed Burrow GN. New York: Raven Press.

Osman, A 1992. Hubungan malpemakanan dan keluarbiasaan endokrin di kalangan orang Asli dan orang Melayu di Malaysia. Tesis Ijazah Doktor Falsafah, yang dikemukakan kepada Universiti Kebangsaan Malaysia.

Osman, A, Khalid, B.AK., Tan, T.T., Wu, L.L & Ng, M.L. 1992. Protein energy        malnutrition,thyroid hormones and goitre among Malaysian Aborigines and Malays. Asia Pacific J Clin Nutr. 1:13-20.

Osman, A. & Zaleha, M.I. 1994. Beguk: kesannya pada manusia. Majalah IBU Julai: 46-47.

Osman, A, Zaleha, M.I., Khalid, B.AK. & Letchumen, R 1993. The prevalence of goitre in remote inland versus coastal areas. Proceeding of the 7th Congress of the Asean Federation of Endocrine Societies.

Polunin, I.V. 1971. Goitre control: West and East Malaysia. Internal WHO report, Malaysia.

 

 

previous