Magnitude, patterns, and factors associated with liver disease among clinically suspected clients in Eastern Ethiopia: hidden public health tragedy.

Abstract

Background: Liver diseases are a public health problem in developing regions, and the majority of them are asymptomatic. Evidence on the current burden of liver disease and associated context-specific risk factors is scarce in the study area, where various risk factors for liver disease, including khat chewing, smoking, and aflatoxin exposure, are common. This study was to assess the magnitude, patterns, and factors associated with liver disease among patients visiting governmental hospitals in eastern Ethiopia.

Methods: A facility-based cross-sectional study was conducted among randomly selected 388 clinically suspected adults for liver disease visiting a public hospital in Dire Dawa, Ethiopia. Data was collected using a combination of structured questionnaires, physical examinations, and investigations through interviews, medical chart reviews, liver enzymes, and the results of ultrasound examinations. Bivariable and multivariable logistic regression analyses were employed to determine the factors associated with liver disease. Candidate variables in bivariable analysis were selected based on p-values < 0.25, biological plausibility, and evidence of associations from previous studies. The level of significance was considered at a P-value < 0.05, and the adjusted odds ratio with a 95% confidence interval was reported.

Results: A total of 388 (92%) adults were included and liver disease was diagnosed among 295 (76%; 71.5-80.2) of the study participants, where chronic liver disease due to non-viral (65.1%) and viral causes (34.9%) were prevalent. The risk of liver disease was higher among females (AOR = 3.43; 1.80-6.55) and under grade twelve (AOR = 3.90; 1.95-7.82) compared to counterparts. Furthermore, alcohol consumption (AOR = 3.14; 1.33-7.32), khat chewing (AOR = 1.69; 0.91-3.15), a history of hospitalization (AOR = 4.20; 2.29-7.11), and a history of intestinal parasite infection (AOR = 1.17; 0.55-2.49) were found to be positively associated with an increased risk of liver disease among adults.

Conclusions: Liver disease detection rate was found to be high and could be associated with substance use (alcohol and khat), history of hospitalization, and worm infection, which can be incorporated into the prevention strategies of liver diseases.