Prevalence of fatty liver disease and associated factors among outpatients at Muhas academic medical centre

Abstract

Background: Fatty liver disease has become an important cause of chronic liver disease and an alarming public health problem. Several studies around the globe have revealed the prevalence of fatty liver disease to range between 10% and 63.5%. In recent times, fatty liver disease has gained global prominence because of its associated increased risk of end stage liver disease, liver failure and hepatocellular carcinoma. In general, patients with fatty liver disease have increased all-cause mortality and liver-related mortality compared to the general population thus its prevention, diagnosis, and management is crucial in any given population. There is limited information regarding fatty liver disease in a Tanzanian population. Objective: To determine the prevalence, awareness and associated factors for fatty liver disease among outpatients at MUHAS Academic Medical Centre. Methodology: A cross-sectional study conducted from June 2018 to November 2018 at MUHAS Academic Medical Centre – Dar es Salaam, Tanzania. Consenting patients attending internal medicine clinics were interviewed, examined and investigated. Socio demographic information, clinical, laboratory, and assessment of awareness about fatty liver disease parameters were gathered during the interviews. Fatty liver disease was identified with ultrasound imaging. Continuous variables were compared with the use of student’s t-test and categorical data with the use of chi-squared test. To assess for associated factors, we performed logistic regression analyses, p<0.05 was used to denote significance. Results: A total of 432 outpatients were enrolled. The prevalence of fatty liver disease was 13.9%. An overwhelming majority of the subjects stated that their physicians did not have a discussion about fatty liver disease. Independent associated factors of fatty liver disease were the male gender, having diabetes mellitus, waist circumference >99M/80F, high total cholesterol >220mg/dl, high triglycerides >170mg/dl, and low HDL < 40mg/dl. Conclusion: Fatty liver disease is not uncommon among outpatients in Tanzania. A significant number of people among the general community have never had a discussion about fatty liver disease with their physician. Factors that were associated with fatty liver vi disease in this current setting were similar to the ones reported in several other settings around the globe. Several strategies to improve health education are vital. Early diagnosis and timely management of fatty liver disease will certainly improve the quality of life and its expectancy at large