Magnitude and Associated Factors of Chronic Liver Disease in Children at Tikur Anbessa Specialized Hospital Five Years Trend Analysis, Addis Ababa, Ethiopia, 2025
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2025-04
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Addis Ababa University
Abstract
Background: Chronic liver disease (CLD) in children, characterized by progressive liver dysfunction lasting over six months, poses significant global health challenges. Pediatric CLD incidence is notably high in Africa (9.9–14.7 per 100,000), with Ethiopia reporting 24 adult CLD deaths per 100,000 population in 2019 [6,9,12]. Limited local data contribute to diagnostic delays, underreporting, and inadequate health policies. This study assessed the magnitude and associated factors of pediatric CLD at Tikur Anbessa Specialized Hospital (TASH), Ethiopia, to address epidemiological and diagnostic gaps.
Methods: A hospital-based cross-sectional study was conducted at TASH from December 2024 to January 2025, involving 240 children with CLD. Retrospective data were extracted from medical charts and the digital iCare system using structured questionnaires. Bivariate and multivariate logistic regression analyses identified factors associated with cirrhotic CLD.
Results: Among participants (55% male, mean age 6.4 years ±4.4 SD), CLD magnitude was 4.8%. Cholestatic liver disease was the most common etiology, yet 60% of cases had undetermined causes. Portal vein thrombosis (5.8%) and autoimmune hepatitis (5.5%) were other etiologies, alongside chronic viral hepatitis (HBV/HCV/CMV: 4.1%) and rare causes like congenital hepatic fibrosis, Gaucher’s disease, and schistosomiasis. Factors significantly associated with cirrhotic CLD included age 5–10 years (P=0.02), symptom duration 6–12 months (P=0.007), variceal bleeding (P=0.001), elevated alkaline phosphatase (ALP; P=0.024), prolonged INR/prothrombin time (P=0.037), APRI score >2 (P=0.001), and undetermined etiology. Mortality was 10.8 %, with cirrhosis and undetermined etiology strongly linked to death (AOR=3.2, 95% CI: 0.5–5, P=0.001).
Conclusion: Pediatric CLD burden and mortality are substantial in Ethiopia, with a high proportion of cases remaining etiologically undefined. Findings underscore the urgency for enhanced diagnostic capacity and tailored public health interventions. Prospective multicenter studies with larger samples are recommended to inform national policies for CLD prevention and management.
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Chronic Liver Disease in Children