Research Article Thyroid Disorders in Central Ghana: The Influence of 20 Years of Iodization Osei Sarfo-Kantanka, 1 Ishmael Kyei, 1 Fred Stephen Sarfo, 1,2 and Eunice Oparebea Ansah 1 1 Komfo Anokye Teaching Hospital, Kumasi, Ghana 2 Kwame Nkrumah University of Science & Technology, Kumasi, Ghana Correspondence should be addressed to Osei Sarfo-Kantanka; osarfokantanka21@gmail.com Received 22 March 2017; Revised 16 May 2017; Accepted 28 May 2017; Published 4 July 2017 Academic Editor: Massimo Tonacchera Copyright © 2017 Osei Sarfo-Kantanka et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Ghana began mandatory iodization of salt in 1996. Tis study compares the prevalence of thyroid disorders before and afer the introduction of iodization. Methods. Tis is a retrospective study of thyroid cases from the middle belt of Ghana between 1982 and 2014. To demonstrate a link between iodization and hyperthyroidism and autoimmunity, we compared the prevalence of hyperthyroidism and autoimmune thyroid disorders before and afer the iodization programme. Results. A total of 10,484 (7548 females, 2936 males) cases were recorded. Te rate of thyroid cases seen was 343/100,000. Nontoxic nodular goiters (25.7%) and toxic nodular goiters (22.5%) represented the second commonest thyroid disorders recorded. Te prevalence of hyperthyroid disorders seen afer 1996 was signifcantly higher than the prevalence seen before the iodization (40.0 versus 21.1%,  < 0.001). Te prevalence of autoimmune disorders recorded afer iodization was signifcantly higher than that before the iodization programme started (22.3% versus 9.6%,  < 0.001). Conclusions. Tis study has revealed a signifcant increase in thyroid admissions in Central Ghana over the decades. A connection between iodine fortifcation and iodine-induced hyperthyroidism and between iodine fortifcation and autoimmune thyroiditis has been shown in this study. 1. Introduction Tyroid disorders represent an important public health problem worldwide ranking second to diabetes as the com- monest endocrinological disorder seen in adult medical practice and presenting a myriad of devastating consequences if not treated early [1, 2]. Te epidemiology and clinical features of thyroid disease are determined by the supply of iodine, an essential element in the synthesis of thyroid hormones [3–5]. Additionally, the presence of both excess and defcient iodine levels can pose adverse health efects [6]. Chronic iodine defciency results in goiter formation and, if severe, hypothyroidism [7–9]. Tis can result in severe implications including cretinism, intellectual impairments, increased pregnancy loss, and infant mortality [9–11]. Sub- Saharan Africa has for a long-time been classifed as an area of moderate to severe iodine defciency [12–17]. Tyroid disorders on the continent represent over 25% of the global burden of the disease [18]. Te drive by the World Health Organisation and the United Nation International Children Emergency Fund towards the elimination of iodine defciency disorders through universal iodization of salt and other food products has so far achieved mixed results, particularly on the African continent [14, 19–21]. Whereas persistent wars and famine coupled with difculties in implementation and regulation of iodine nutrition have eroded some of the gains made towards sufcient iodine intake on parts of the continent [22–24], excessive intake of iodine has been recorded in other areas of the continent [25, 26]. World Health Organisation reports show that adequate or excessive iodine intake borne out of the universal iodization programme has been observed in over 30 countries, some of them on the African continent [27– 30]. Aghini-Lombardi et al. in Italy [31, 32], comparing the prevalence of various thyroid disorders in an initial region of severe iodine defciency before and afer the introduction of iodated salt in 1995 in Italy, revealed a reduction in the prevalence of nodular goiter from 46% to 25%, whereas Hindawi Journal of yroid Research Volume 2017, Article ID 7843972, 8 pages https://doi.org/10.1155/2017/7843972