Distribution and Determinants of Etiologies and Complications of Chronic Liver Diseases Among Patients at a Tertiary Hospital in a Lower Economic Region of Ghana

Matthew Aidoo,Baba Sulemana Mohammed

doi:10.11648/j.cajph.20200605.16

Abstract

There is dearth of data on the epidemiology of chronic liver diseases (CLDs) in northern Ghana. To this extent, we intended to investigate the distribution and determinants of the etiologies and complications of CLDs at the Tamale Teaching Hospital, a referral hospital of northern Ghana. The medical records of patients with CLDs admitted at the medical ward of Tamale Teaching Hospital from June to December 2019 were reviewed in a retrospective cross-sectional study. Out of 180 patients reviewed, 130 (72.2%) were males; the age range was 18–86 years, with a mean age of 41 43 years. Etiologies of CLDs comprised hepatis B viral infection (53.3%), hepatitis C viral infection (21.7%), unknown (9.4%), hepatocellular carcinoma (8.9%), and alcoholic liver disease (6.7%). Among the complications of CLDs; cirrhosis (71.1%), hypoalbuminemia (59.4%), ascites (58.3%) and jaundice (52.2%) occurred in more than half of the patients. Age (p=<0.001), education (p=0.005) and intake of herbal medicine (p=0.001) were associated with the etiologies of CLDs. There was a significant association between the etiologies of CLDs and complications; cirrhosis (p=<0.001), hypoalbuminemia (p=0.003), ascites (p=<0.001), and jaundice (p=0.009). Hepatitis B and hepatitis C viral infections were the main etiologies of CLDs. Young/middle age, non-education and intake of herbal medicine were risk factors for the main etiologies of CLDs. Cirrhosis, hypoalbuminemia, ascites, and jaundice were the major complications of CLDs. Chronic hepatitis B and C viral infections were risk factors for developing the major complications of CLDs. Implementation of integrated public health strategies targeted at risk groups (young/middle age adults, illiterates, consumers of herbal medicine, patients with hepatitis B and C viral infections) may help curtail the burden of CLDs in northern Ghana.

Highlights

Chronic liver diseases (CLDs) are persistent inflammatory conditions of the liver in which the biochemical and histopathological abnormalities of the liver are present over a long period [1]
It consists of a wide range of liver pathologies of different etiologies existing on a continuum between chronic hepatitis, cirrhosis and hepatocellular carcinoma
Diagnosis of CLD was made among patients with evidence of liver disease by liver function test (S1 Table) The diagnosis was done according to the following criteria: (i) abdominal imaging showing hepatic parenchyma heterogeneity and/or surface irregularity suggestive of chronic hepatitis, cirrhosis, or hepatocellular carcinoma [6] or (ii) presence of clinical features of decompensated liver diseases such as ascites, bleeding, jaundice, and hepatic encephalopathy [7]

Summary

Introduction

Chronic liver diseases (CLDs) are persistent inflammatory conditions of the liver in which the biochemical and histopathological abnormalities of the liver are present over a long period [1]. It consists of a wide range of liver pathologies of different etiologies existing on a continuum between chronic hepatitis, cirrhosis and hepatocellular carcinoma. CLDs exemplify a critical global public health problem, because it causes substantial morbidity and mortality worldwide. The morbidity and mortality of CLDs are mainly due to its complications (ascites, hepatic encephalopathy, hepatorenal syndrome, variceal hemorrhage and hepatocellular carcinoma). It is important to identify the geographical epidemiology of CLDs to help implement specific strategies to curtail the burden of CLDs in that setting

Methods

Results

Discussion

Conclusion