Thyroid disorders, which include conditions such as hypothyroidism, hyperthyroidism, and goiter, have become increasingly common worldwide, affecting millions of people. The thyroid gland plays a crucial role in regulating metabolism, and its dysfunction can lead to a wide range of health issues, from weight changes and fatigue to more severe complications like cardiovascular diseases and infertility. In India, particularly in rural and semi-urban regions, thyroid disorders are often underrecognized and inadequately managed due to limited access to healthcare and low public awareness. This is particularly concerning in iodine-deficient areas, where the risk of thyroid-related issues is higher.1-3

District Kullu in Himachal Pradesh represents a rural setting where traditional lifestyles coexist with modern occupational demands. The population here is engaged in various activities, ranging from labor-intensive agriculture to sedentary office jobs, both of which can impact thyroid health. Despite the potential burden of thyroid disorders, public awareness and understanding of these conditions remain limited in such regions. Early detection and proper management are essential to prevent complications, but these efforts rely heavily on the population's awareness and knowledge of thyroid health.

This study aims to assess the level of awareness and knowledge about thyroid disorders among the general population of District Kullu. By identifying gaps in understanding, this research seeks to inform public health strategies that can improve early diagnosis, prevention, and management of thyroid disorders in the region, ultimately enhancing the quality of life for those affected.

Research Approach

A descriptive, cross-sectional survey design was employed to assess the awareness and knowledge of thyroid disorders among the adult population of District Kullu, Himachal Pradesh.

Study Area

The study was conducted in District Kullu, a rural and semi-urban region located in Himachal Pradesh, India. The district is known for its diverse population, with a mix of traditional and modern lifestyles.

Study Duration

The survey was conducted over a five-month period, from January to May 2024.

Study Population

The target population for the study included adults aged 18 years and above who had been residents of District Kullu for a minimum of 12 months. This criterion ensured that the participants were familiar with the local healthcare system and community health practices.

Sample Size

A sample size of 400 participants was determined based on a 95% confidence level, an estimated awareness level of 50%, and a 5% margin of error. This sample size was deemed sufficient to provide a representative assessment of the general population’s awareness of thyroid disorders.

Study Tool

Data were collected using a structured questionnaire. The questionnaire consisted of two main sections:

1. Socio-Demographic Information: This section collected data on participants' age, gender, marital status, education level, employment status, and other relevant demographic details.

2. Knowledge and Awareness Questions: The questionnaire included 20 structured questions aimed at assessing participants' knowledge about thyroid disorders, including symptoms, causes, risk factors, prevention, and treatment options. Each correct answer was awarded one mark, with the maximum score being 20 and the minimum score being zero.

The questionnaire was pre-tested on a small sample of participants to ensure clarity and ease of understanding. Based on feedback, minor revisions were made to improve the wording of the questions.

Data Collection

Data were collected through an online survey, using platforms such as Google Forms. The questionnaire link was disseminated via email and social media channels, including WhatsApp groups, Facebook, and Instagram. The survey remained open until 400 complete responses were received. To ensure data reliability, participants were informed about the purpose of the study, and their consent was obtained before participation.

Data Analysis

The collected data were entered into a Microsoft Excel spreadsheet, cleaned for errors, and then analyzed using Epi Info V7 software. Descriptive statistics, including frequencies and percentages, were used to summarize the socio-demographic characteristics and the knowledge levels of the participants.

Ethical Considerations

The study adhered to ethical guidelines, ensuring confidentiality and anonymity of all participants. Participation was voluntary, and informed consent was obtained from all respondents. The study was conducted under the supervision of the relevant health authorities in District Kullu.

The study conducted among 400 participants from District Kullu, Himachal Pradesh, provides valuable insights into the socio-demographic characteristics and awareness levels regarding thyroid disorders among the general population. The results are presented in the following tables, along with detailed explanations.

Table 1: Socio-Demographic Characteristics of Study Participants (N=400)

The socio-demographic profile of the study participants shows a balanced representation across age groups, with the largest group (29.5%) aged between 18-30 years. The gender distribution is nearly equal, with 49.0% male and 51.0% female participants. Educational attainment is fairly high, with 33.5% being graduates and 24.5% holding postgraduate or higher degrees. Employment status indicates that almost half of the participants are employed, while 22.5% are students.

Table 2: Awareness of Thyroid Disorders (N=400)

The majority of participants (67.5%) have heard of thyroid disorders, indicating a moderate level of general awareness. However, knowledge of specific symptoms varies. While 60.2% recognize weight changes as a symptom, awareness of fatigue (55.8%) and mood changes (50.5%) is somewhat lower. Only 49.0% of participants are aware that neck swelling, a common sign of thyroid disorders, can be a symptom.

Table 3: Knowledge of Causes and Risk Factors for Thyroid Disorders (N=400)

Awareness of the causes and risk factors associated with thyroid disorders is moderate. The most recognized cause is iodine deficiency, known by 58.5% of participants. Awareness of other significant risk factors, such as autoimmune diseases (48.5%) and family history (42.5%), is lower. Less than half of the participants understand that stress (41.3%) and radiation exposure (35.5%) are also contributing factors.

Table 4: Knowledge Regarding Prevention of Thyroid Disorders (N=400)

Awareness of preventive measures for thyroid disorders is relatively low. Only 50.0% of participants know that regular health check-ups can aid in early detection and prevention. Slightly fewer participants recognize the importance of maintaining adequate iodine intake (48.8%) and reducing stress (45.8%). Knowledge about avoiding radiation exposure (44.0%) and the benefits of regular exercise (42.0%) is also limited.

Table 5: Knowledge Regarding Treatment and Management of Thyroid Disorders (N=400)

Knowledge regarding the treatment and management of thyroid disorders is also limited. While 45.0% of participants are aware that hormone replacement therapy is a common treatment, only 40.0% recognize the importance of consistent medication adherence. Awareness of the need for regular follow-up (38.3%) and the role of diet and lifestyle changes (37.0%) is even lower. Only 35.0% of participants know that surgery may be necessary in severe cases.

Table 6: Overall, Knowledge Score Categories for Thyroid Disorders (N=400)

The distribution of overall knowledge scores reveals that only 24.5% of participants demonstrate very good knowledge of thyroid disorders. A slightly larger portion (29.0%) has good knowledge, while 27.5% fall into the fair knowledge category. 

A significant 19.0% of participants have poor knowledge, indicating a need for targeted educational interventions to improve understanding of thyroid disorders across the population.

The study highlights that while a moderate level of general awareness about thyroid disorders exists among the population of District Kullu, significant gaps remain in knowledge regarding symptoms, causes, prevention, and treatment. This variability in understanding suggests the need for public health initiatives to focus on educating the population about the comprehensive aspects of thyroid disorders, including preventive measures and effective management strategies. By addressing these knowledge gaps, healthcare providers and policymakers can work towards reducing the burden of thyroid disorders in this region.

The findings of this cross-sectional study reveal both strengths and gaps in the public's awareness and knowledge of thyroid disorders in District Kullu, Himachal Pradesh. While a moderate level of general awareness exists, the study highlights significant knowledge deficits in crucial areas such as symptom recognition, risk factors, prevention, and treatment management.

One of the key findings is that while 67.5% of participants have heard of thyroid disorders, detailed knowledge about specific symptoms, causes, and treatment options is limited. For example, although 60.2% of participants recognized weight changes as a symptom, fewer were aware of other critical symptoms such as fatigue (55.8%) and mood changes (50.5%). This suggests that public health messaging around thyroid disorders has primarily focused on a narrow range of symptoms, potentially leaving individuals unaware of other important indicators that might prompt them to seek medical attention earlier.^4,5

The study also reveals a moderate level of understanding regarding the causes and risk factors for thyroid disorders. Although iodine deficiency is widely recognized as a cause, with 58.5% awareness among participants, knowledge of other significant risk factors such as autoimmune diseases (48.5%) and family history (42.5%) is lower. This is concerning, given the high prevalence of autoimmune thyroid conditions like Hashimoto's thyroiditis and Graves' disease. These findings highlight the need for comprehensive public health education that emphasizes a broader range of risk factors, particularly those that are modifiable, such as stress and lifestyle factors, which are often overlooked.^6,7

Preventive knowledge is another area of concern. Only half of the participants (50.0%) recognized the importance of regular health check-ups in preventing thyroid disorders, and even fewer were aware of the role of maintaining iodine intake (48.8%) and reducing stress (45.8%). These figures indicate a critical gap in public understanding of how to proactively manage thyroid health. Given the rural setting of Kullu, where access to healthcare may be limited, empowering the population with knowledge about prevention and early detection is essential. Public health campaigns should focus on practical strategies that individuals can incorporate into their daily lives, such as dietary adjustments, stress management techniques, and the importance of routine screenings.^8,9

The findings regarding treatment and management knowledge further underscore the need for targeted education. Less than half of the participants were aware that hormone replacement therapy is a common treatment for thyroid disorders, and only 40.0% understood the importance of consistent medication adherence. This is particularly concerning, as inconsistent treatment can lead to poor health outcomes, including exacerbation of symptoms and increased risk of complications. The low awareness of the need for regular follow-ups and the potential necessity of surgery in severe cases suggests that many individuals may not fully understand the long-term management of thyroid disorders. This gap in knowledge can lead to delays in seeking appropriate care, resulting in poorer health outcomes.^9,10

Overall, the study highlights a significant variability in knowledge levels across the population, with only 24.5% of participants demonstrating very good knowledge of thyroid disorders. This disparity underscores the need for targeted interventions that address these knowledge gaps, particularly in rural areas where healthcare access may be more limited. 

Community-based education programs, health camps, and collaborations with local healthcare providers could be effective strategies for improving public knowledge and promoting early diagnosis and effective management of thyroid disorders.

This study demonstrates that although there is a general awareness of thyroid disorders among the population of District Kullu, Himachal Pradesh, significant gaps persist in their understanding of symptoms, causes, prevention, and treatment. These knowledge deficiencies could impede early diagnosis and effective management, particularly in a rural context where healthcare resources are often scarce. To bridge these gaps, it is imperative to implement targeted public health strategies, including comprehensive educational campaigns and localized community initiatives. By empowering the population with a deeper understanding of thyroid health and encouraging proactive measures, these efforts have the potential to greatly enhance early detection, improve treatment adherence, and ultimately elevate the overall health and quality of life in the region.

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7. Sethi, B., Khandelwal, D., and Vyas, U. "A Cross-Sectional Survey to Assess Knowledge, Attitude, and Practices in Patients with Hypothyroidism in India." Thyroid Research and Practice, vol. 15, no. 1, 2018, pp. 15–22. doi: 10.4103/trp.trp_7_18.

8. Felicia, P., and Lakshmi, N. "Knowledge of Thyroid Disorders Among Women in a Rural Area, Chengalpattu District, Tamil Nadu: A Cross-Sectional Study." International Journal of Scientific Research, vol. 11, no. 6, 2022, pp. 371–375. doi:10.36106/ijsr.

9. Maheshwari, P., Mohan, R., and Shanmugarajan, T. S. "KAP Study on Thyroid Disorders (Hypothyroidism and Hyperthyroidism) in a Tertiary Care Hospital." Research Journal of Pharmacy and Technology, vol. 10, no. 1, 2017, pp. 41–43. doi:10.5958/0974-360X.2017.00009.1.

10. Namitha, D., Shilpahree, Y. D., and Nusrath, A. "Analysis of Knowledge and Awareness of Thyroid and Its Disorders Among Students of Rural South Karnataka." Scholars International Journal of Biochemistry, vol. 2, no. 5, 2019, pp. 149–152. doi:10.36348/sijb. 2019.v02i05.002.