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Meta-Analysis
. 2021 Nov 23:2021:8740157.
doi: 10.1155/2021/8740157. eCollection 2021.

Chronic Liver Disease in Ethiopia with a Particular Focus on the Etiological Spectrums: A Systematic Review and Meta-Analysis of Observational Studies

Behailu Terefe Tesfaye  1   2 , Temesgen Mulugeta Feyissa  1   2 , Azmeraw Bekele Workneh  2   3 , Esayas Kebede Gudina  2   4 , Mengist Awoke Yizengaw  1   2
Affiliations
Meta-Analysis

Chronic Liver Disease in Ethiopia with a Particular Focus on the Etiological Spectrums: A Systematic Review and Meta-Analysis of Observational Studies

Behailu Terefe Tesfaye et al. Can J Gastroenterol Hepatol. .

Abstract

Background: In Ethiopia, chronic liver disease (CLD) is the 7th leading cause of death, accounting for about 24 deaths per 100000 populations in 2019. Despite its burden, there is a lack of compiled pieces of evidence on CLD in the country. Thus, this systematic review and meta-analysis is intended to provide the pooled estimates of CLD etiologies and mortality rate in CLD patients in Ethiopia.

Method: PubMed, Google Scholar, ScienceDirect, institutional repositories, national digital library, and the bibliography of the eligible articles information were the source of data for the present review. The keywords "hepatitis, chronic" [Mesh], "end-Stage Liver Disease" [Mesh], "chronic liver disease", "liver cirrhosis" [Mesh], and "Ethiopia" were used for the searches. Overall, we retrieved 199 records and 12 were included in this review. We used the DerSimonian-Laird random-effects models to perform the meta-analysis. We conducted subgroup and meta-regression analyses to account for the heterogeneity of the estimates.

Result: Hepatitis B virus, alcohol, and hepatitis C virus are the three most common etiologies of CLD in Ethiopia accounting for a pooled estimate of 40.0% [95% CI: 29.0, 51.0, I 2 = 96.3, p < 0.001], 17.0% [95% CI: 9.0, 25.0, I 2 = 96.7, p < 0.001], and 15.0% [95% CI: 9.0, 21.0, I 2 = 95.8, p < 0.001], respectively. Unidentified etiology report has a substantial contribution accounting for an estimated pooled proportion of 45% [95% CI: 34.0, 56.0%, Q = 32.08, p < 0.001, I 2 = 87.53] of the CLD cases in the country. On the other hand, the overall hospital mortality rate in CLD patients is 25.0% [95% CI: 2.0, 47.0, I2 = 94.6, p < 0.001] in Ethiopia.

Conclusion: Hepatitis B virus, hepatitis C virus, and alcohol are the three most common contributors to CLD cases in Ethiopia. The authors warrant routine screening and strengthening of preventive and treatment programs for viral hepatitis B and C, further enhancing the alcohol policy of the country.

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Conflict of interest statement

The authors have declare that no conflicts of interest exist.

Figures

Figure 1
Figure 1
PRISMA flow chart showing studies retrieved, screened, and included.
Figure 2
Figure 2
Funnel plot for assessing publication bias across HBV estimates among chronic liver disease patients in Ethiopia, 2021.
Figure 3
Figure 3
Funnel plot for assessing publication bias across HCV infection estimates among chronic liver disease patients in Ethiopia, 2021.
Figure 4
Figure 4
Funnel plot for assessing publication bias across alcoholic hepatitis estimates among chronic liver disease patients in Ethiopia, 2021.
Figure 5
Figure 5
Funnel plot for assessing publication bias across mortality estimates among chronic liver disease patients in Ethiopia, 2021.
Figure 6
Figure 6
Forest plot depicting the estimated proportion of HBV infection among chronic liver disease patients in Ethiopia, 2021.
Figure 7
Figure 7
Forest plot depicting the estimated proportion of HCV infection among chronic liver disease patients in Ethiopia, 2021.
Figure 8
Figure 8
Forest plot depicting the estimated proportion of alcoholic hepatitis among chronic liver disease patients in Ethiopia, 2021.
Figure 9
Figure 9
Forest plot depicting the estimated proportion of mortality among chronic liver disease patients in Ethiopia, 2021.
See this image and copyright information in PMC

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