Pattern of liver diseases among children attending the National Hospital Abuja, Nigeria

Abstract

Background: Diseases of the liver contribute to childhood morbidities and mortality. Early recognition and proper management of liver diseases can limit the progression to irreparable damage which requires liver transplant. However, there is scarcity of data in the pattern of liver disease in Nigerian children.

Objective: To describe the pattern of paediatric liver diseases among children seen at the National Hospital, Abuja.

Methods: A retrospective, descriptive study conducted at the Paediatric Gastroenterology, Hepatology and Nutrition (PGHAN) clinic and the Emergency Paediatric Unit (EPU) of National Hospital Abuja, over a 5- year period (2009 – 2014). The diagnosis of liver diseases was made from clinical and laboratory features. The data extracted from the retrieved hospital records were analyzed.

Results: Forty-two out of 52 documented cases were analyzed. The children were aged 2 months to 15 years with the mean of 7.24 ± 4.77 years. Twenty-six (62.0%) were aged >5 years (p>0.05). They comprised 31 (73.8%) males and11 (26.2%) females; 28 (66.7%) belonged to the lower socioeconomic classes while 23 (54.8%) had various forms malnutrition. Common symptoms included jaundice (30; 71.4%), abdominal pain (17; 40.5%), fever (15; 35.7%), abdominal swelling (12; 28.6%) and bleeding (8; 19.0%). The signs included jaundice (30; 71.4%), hepatomegaly (16; 38.1%) and splenomegaly (8; 19.0%). Twenty-four (57.1%) had chronic viral infections while the others included neonatal hepatitis syndrome and biliary atresia (6; 14.3%), acute hepatitis (6; 14.3%) and chronic hepatitis of unidentified aetiology (4; 9.5%). Overall, the mean values of the liver enzymes and serum bilirubin were elevated while the mean values of total serum proteins and albumin levels were reduced. Five (11.9%) children improved and were discharged, 15 (35.7%) were lost to follow up with three deaths.

Conclusion: Risk factors associated with liver diseases in this study included age over 5 years and lower socio-economic classes. Jaundice was the commonest clinical presentation while the most common aetiology was chronic Hepatitis B virus infection.

Keywords: Children, Liver Diseases, Pattern