Distribution of Liver Disease in Bangladesh: A Cross-country Study

Abstract

Introduction ‘Hepatology’, as an independent discipline of medical science, has recently been established in Bangladesh. The aim of this study was to formulate the distribution of pattern of liver diseases in this country.Materials and methods In this retrospective study, data regarding patients of liver diseases from the seven different administrative divisions of Bangladesh between January 2012 and 2013 were compiled.Results The study included 59,227 patients (age ranged 15-95 years). Majority of the patients were males (67.9%). Although all patients appeared at the department of hepatology, 13.2% were diagnosed with liver diseases, but a vast majority of patients (77.35%) were suffering from nonulcer dyspepsia or irritable bowel syndrome. Patients with liver diseases were mostly suffering from chronic liver diseases (CLDs) (37 -69%). Complication of CLD, like hepatic encephalopathy, was less frequent in regions with better healthcare system. Nonviral infections, like liver abscess and biliary ascarisis, were not uncommon. Acute hepatitis was another very common entity and contributed to approximately 20% cases.Conclusion This study provides insight about heterogeneous distribution pattern of liver diseases in different regions of Bangladesh.How to cite this article: Rahman S, Ahmed MF, Alam MJ, Debnath CR, Hoque MI, Hussain MM, Shamsul Kabir AKM, Karim MF, Khondokar FA, Mahtab MA, Masud MG, Mollick MKU, Moben AL, Noor-E-Alam SM, Podder PK, Raha AK, Rahim MA, Rashid MHO, Zaki KMJ, Akbar SMF. Distribution of Liver Disease in Bangladesh: A Cross-country Study. Euroasian J Hepato-Gastroenterol 2014;4(1):25-30.

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

“…In a survey involving 59 227 patients from all regions of Bangladesh and encompassing most medical institutions in the country, alcohol-related liver diseases occurred in less than 0·8% of patients with liver diseases. 176 Because of religious beliefs and social taboos, alcohol use is uncommon in Bangladesh, although home-made alcohol is consumed by different tribes. The annual per capita consumption of pure alcohol in adults aged at least 15 years is very low in Bangladesh (0·2 L in 2010 and 0·0 L in 2016) compared with 4·5 L in the WHO-defined southeast Asia region in 2016.…”

“…The involvement of the health workforce in the private sector has increased over the past two decades, as shown by the estimated 62% of medical doctors working in the private sector in 2013. 176 Moreover, the private sector has seen tremendous growth in teaching institutions in that timeframe. There were no medical colleges or any private teaching institutions in 1996, but by 2011, 44 private medical colleges were established.…”

“…There is one bed for every 1699 people and a community clinic (n=12 527) for every 6000 people for primary health-care services. 176,359 However, these clinics lack facilities and expertise for the diagnosis and management of liver diseases.…”

“…Nevertheless, the hospital attendance of patients with liver disease has increased rapidly during the past couple of decades, and the sole medical university of Bangladesh experiences a tremendous burden of patients with hepatitis, at both its outpatient and inpatient departments. 176 The number of hepatologists has increased several times over past two decades, but is not sufficient to cope with the increasing burden of patients with liver diseases. Japan has one of the highest densities of hospitals globally, with a total of 7426 hospitals nationwide, of which 80% are privately owned.…”

Prevalence and risk factors of non‐alcoholic fatty liver disease in Bangladesh

“…Bangladesh is also experiencing an increasing trend of NAFLD due to changing dietary patterns and sedentary lifestyles . The World Health Organization (WHO) has been documented in May 2014 stating that 2.82% of total deaths in Bangladesh are due to liver diseases.…”