Cargando…

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

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Orlien, Stian Magnus Staurung, Ismael, Nejib Yusuf, Ahmed, Tekabe Abdosh, Berhe, Nega, Lauritzen, Trine, Roald, Borghild, Goldin, Robert David, Stene-Johansen, Kathrine, Dyrhol-Riise, Anne Margarita, Gundersen, Svein Gunnar, Morgan, Marsha Yvonne, Johannessen, Asgeir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812015/
https://www.ncbi.nlm.nih.gov/pubmed/29439653
http://dx.doi.org/10.1186/s12876-018-0755-5
_version_ 1783299960346771456
author Orlien, Stian Magnus Staurung
Ismael, Nejib Yusuf
Ahmed, Tekabe Abdosh
Berhe, Nega
Lauritzen, Trine
Roald, Borghild
Goldin, Robert David
Stene-Johansen, Kathrine
Dyrhol-Riise, Anne Margarita
Gundersen, Svein Gunnar
Morgan, Marsha Yvonne
Johannessen, Asgeir
author_facet Orlien, Stian Magnus Staurung
Ismael, Nejib Yusuf
Ahmed, Tekabe Abdosh
Berhe, Nega
Lauritzen, Trine
Roald, Borghild
Goldin, Robert David
Stene-Johansen, Kathrine
Dyrhol-Riise, Anne Margarita
Gundersen, Svein Gunnar
Morgan, Marsha Yvonne
Johannessen, Asgeir
author_sort Orlien, Stian Magnus Staurung
collection PubMed
description 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.
format Online
Article
Text
id pubmed-5812015
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-58120152018-02-15 Unexplained chronic liver disease in Ethiopia: a cross-sectional study Orlien, Stian Magnus Staurung Ismael, Nejib Yusuf Ahmed, Tekabe Abdosh Berhe, Nega Lauritzen, Trine Roald, Borghild Goldin, Robert David Stene-Johansen, Kathrine Dyrhol-Riise, Anne Margarita Gundersen, Svein Gunnar Morgan, Marsha Yvonne Johannessen, Asgeir BMC Gastroenterol Research Article 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. BioMed Central 2018-02-13 /pmc/articles/PMC5812015/ /pubmed/29439653 http://dx.doi.org/10.1186/s12876-018-0755-5 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Orlien, Stian Magnus Staurung
Ismael, Nejib Yusuf
Ahmed, Tekabe Abdosh
Berhe, Nega
Lauritzen, Trine
Roald, Borghild
Goldin, Robert David
Stene-Johansen, Kathrine
Dyrhol-Riise, Anne Margarita
Gundersen, Svein Gunnar
Morgan, Marsha Yvonne
Johannessen, Asgeir
Unexplained chronic liver disease in Ethiopia: a cross-sectional study
title Unexplained chronic liver disease in Ethiopia: a cross-sectional study
title_full Unexplained chronic liver disease in Ethiopia: a cross-sectional study
title_fullStr Unexplained chronic liver disease in Ethiopia: a cross-sectional study
title_full_unstemmed Unexplained chronic liver disease in Ethiopia: a cross-sectional study
title_short Unexplained chronic liver disease in Ethiopia: a cross-sectional study
title_sort unexplained chronic liver disease in ethiopia: a cross-sectional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812015/
https://www.ncbi.nlm.nih.gov/pubmed/29439653
http://dx.doi.org/10.1186/s12876-018-0755-5
work_keys_str_mv AT orlienstianmagnusstaurung unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT ismaelnejibyusuf unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT ahmedtekabeabdosh unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT berhenega unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT lauritzentrine unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT roaldborghild unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT goldinrobertdavid unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT stenejohansenkathrine unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT dyrholriiseannemargarita unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT gundersensveingunnar unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT morganmarshayvonne unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy
AT johannessenasgeir unexplainedchronicliverdiseaseinethiopiaacrosssectionalstudy