Etiology of Chronic Liver Disease in Ethiopia: A Case Control Study with Special Reference to Viral Hepatitis and Alcohol.

Introduction: Chronic diseases of the liver are a global health problem with high morbidity and mortality. Viral hepatitis is the predominant cause for liver disease in low and middle-income countries. Viral hepatitis is also frequent in high-income countries but mainly as a complication to drug abuse or iatrogenic to treatment. In high-income countries non-fatty-liver-disease and complications to alcohol consumption are the most frequent etiology of liver disease. Viral hepatitis B and C is prevalent in Ethiopia but there are only few studies done in relation to chronic liver disease and a relationship between the increasing alcohol consumption and chronic liver disease.

Objective: A The aim of the study was to assess the association between chronic liver disease in Ethiopia and infection with viral hepatitis and possible relation to alcohol consumption.

Methods and material: An unmatched case control study was conducted in Addis Ababa. Cases were chronic liver disease patients (n = 812) and controls were patients without liver disease (n = 798). Data were collected from the records of patients treated at a specialized clinic of Gastrsoenterology and Hepatology in Addis Ababa from 1^st January 2013 - 31^st, December 2013.

Results: The odds of having hepatitis infection among chronic liver disease was AOR = 100.96, (95%CI: 62.15 - 164.02) for HBV and AOR = 59.2, (95%CI: 27.23 - 130.9) for HCV. Consumption of alcohol was associated with chronic liver disease (OR: 8.23 95%CI: 3.76 - 12.70). Liver enzymes were elevated significantly in patients with hepatitis and alcohol consumption compared to patients without alcohol consumption.

Conclusion: Viral hepatitis infections are strongly associated with chronic liver disease. Prevention of viral hepatitis infections and control of alcohol consumption need to be strengthened in order to reduce the burden of chronic liver disease in Ethiopia.