Unexplained chronic liver disease in Ethiopia: a cross-sectional study.

Autor: Orlien SMS; Regional Centre for Imported and Tropical Diseases, Oslo University Hospital Ullevål, Oslo, Norway., Ismael NY; Department of Internal Medicine, Hiwot Fana Specialized University Hospital, Harar, Ethiopia.; Haramaya University College of Health and Medical Sciences, Harar, Ethiopia., Ahmed TA; Haramaya University College of Health and Medical Sciences, Harar, Ethiopia.; Department of Internal Medicine, Jugal Hospital, Harar, Ethiopia., Berhe N; Regional Centre for Imported and Tropical Diseases, Oslo University Hospital Ullevål, Oslo, Norway.; Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia., Lauritzen T; Department of Medical Biochemistry, Vestre Viken Hospital Trust, Drammen, Norway., Roald B; Department of Pathology, Oslo University Hospital Ullevål, Oslo, Norway.; Institute of Clinical Medicine, Faculty of Medicine, Oslo University, Oslo, Norway., Goldin RD; Centre for Pathology, Imperial College London, London, UK., Stene-Johansen K; Department of Molecular Biology, Norwegian Institute of Public Health, Oslo, Norway., Dyrhol-Riise AM; Institute of Clinical Medicine, Faculty of Medicine, Oslo University, Oslo, Norway.; Department of Infectious Diseases, Oslo University Hospital Ullevål, Oslo, Norway.; Department of Clinical Science, University of Bergen, Bergen, Norway., Gundersen SG; Research Unit, Sørlandet Hospital HF, Kristiansand, Norway.; Department of Global Development and Planning, University of Agder, Kristiansand, Norway., Morgan MY; UCL Institute for Liver & Digestive Health, Division of Medicine, University College London, Royal Free Campus, London, UK., Johannessen A; Regional Centre for Imported and Tropical Diseases, Oslo University Hospital Ullevål, Oslo, Norway. johannessen.asgeir@gmail.com.; Department of Infectious Diseases, Vestfold Hospital Trust, Tønsberg, Norway. johannessen.asgeir@gmail.com.
Jazyk: angličtina
Zdroj: BMC gastroenterology [BMC Gastroenterol] 2018 Feb 13; Vol. 18 (1), pp. 27. Date of Electronic Publication: 2018 Feb 13.
DOI: 10.1186/s12876-018-0755-5
Abstrakt: Background: Hepatitis B virus (HBV) infection is assumed to be the major cause of chronic liver disease (CLD) in sub-Saharan Africa. The contribution of other aetiological causes of CLD is less well documented and hence opportunities to modulate other potential risk factors are being lost. The aims of this study were to explore the aetiological spectrum of CLD in eastern Ethiopia and to identify plausible underlying risk factors for its development.
Methods: A cross-sectional study was undertaken between April 2015 and April 2016 in two public hospitals in Harar, eastern Ethiopia. The study population comprised of consenting adults with clinical and radiological evidence of chronic liver disease. The baseline evaluation included: (i) a semi-structured interview designed to obtain information about the ingestion of alcohol, herbal medicines and local recreational drugs such as khat (Catha edulis); (ii) clinical examination; (iii) extensive laboratory testing; and, (iv) abdominal ultrasonography.
Results: One-hundred-and-fifty patients with CLD (men 72.0%; median age 30 [interquartile range 25-40] years) were included. CLD was attributed to chronic HBV infection in 55 (36.7%) individuals; other aetiological agents were identified in a further 12 (8.0%). No aetiological factors were identified in the remaining 83 (55.3%) patients. The overall prevalence of daily khat use was 78.0%, while alcohol abuse, defined as > 20 g/day in women and > 30 g/day in men, was rare (2.0%). Histological features of toxic liver injury were observed in a subset of patients with unexplained liver injury who underwent liver biopsy.
Conclusion: The aetiology of CLD in eastern Ethiopia is largely unexplained. The widespread use of khat in the region, together with histopathological findings indicating toxic liver injury, suggests an association which warrants further investigation.
Databáze: MEDLINE
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