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

Area of Science:

• Hepatology
• Gastroenterology
• Public Health

Background:

• Hepatitis B virus (HBV) is a presumed major cause of chronic liver disease (CLD) in sub-Saharan Africa.
• Other etiological factors contributing to CLD in the region are poorly documented, hindering targeted interventions.
• This study aimed to investigate the spectrum of CLD causes and associated risk factors in eastern Ethiopia.

Purpose of the Study:

• To explore the etiological spectrum of chronic liver disease (CLD) in eastern Ethiopia.
• To identify potential underlying risk factors for the development of CLD in this population.

Main Methods:

• A cross-sectional study involving 150 adults with diagnosed CLD was conducted in eastern Ethiopia.
• Data collection included semi-structured interviews on substance use (alcohol, herbal medicines, khat), clinical examinations, laboratory tests, and abdominal ultrasonography.
• Liver biopsy was performed on a subset of patients with unexplained liver injury.

Main Results:

• Hepatitis B virus (HBV) infection was identified as the cause in 36.7% of CLD patients; other agents in 8.0%.
• No etiological factors were identified in 55.3% of cases.
• High prevalence of daily khat use (78.0%) was observed, while alcohol abuse was rare (2.0%). Histological evidence of toxic liver injury was noted in unexplained cases.

Conclusions:

• The etiology of CLD in eastern Ethiopia is predominantly unexplained.
• Widespread khat consumption, coupled with histopathological findings of toxic liver injury, suggests a potential association requiring further investigation.