Causes and Clinical Profiles of Ascites at University of Gondar Hospital, Northwest Ethiopia: Institution-Based Cross-Sectional Study

Abstract

Background. Ascites is a common clinical condition encountered by physicians in day-to-day practice. It is caused by various underlying diseases. Knowing the etiologies is vital because further investigations and definitive treatment largely rely on the specific disease entity considered. Objective. The aim of this study was to determine the epidemiology of causes of ascites and complications among patients with ascites from the medical department at the University of Gondar Hospital. Methods. Data on sociodemography, major symptoms, and signs, risk factors, past medical illnesses, and results of important investigations were collected using pretested questionnaires among all patients with ascites in the University of Gondar Hospital in a sample size of 52. Data were collected by well-trained physicians and analyzed by using SPSS 16. Results were depicted descriptively with measures of central tendency, dispersion, and using tables and graphs. Results. A total of 52 patients were included in this study from November 1, 2018 to March 30, 2019. Thirty (57.7%) of them were males and the majority (77%) of the participants were fifty years old or younger. The mean age was 43.8 (± 14). The majority (86.5%) of the participants were from a rural area. Thirty-eight (73%) patients take alcohol occasionally while 11(21.2%) patients take alcohol frequently or massively. Eight (15.4%) patients reported a history of multiple sexual partners. Herbal medicine use was reported by 28 patients (53.8%). Only 5 (9.6%) patients were overweight. Chronic liver disease (CLD) was the major cause of ascites in this study in 24 (46.2%) patients. The other main causes of ascites were heart failure from various causes (19.2%), tuberculosis and hepatosplenic schistosomiasis contributing to 11.5% each and chronic kidney disease (5.8%). Five (20.8%) CLD patients had spontaneous bacterial peritonitis as a complication. Five (20.8%) and 4 (16.7%) CLD patients had hepatocellular carcinoma and hepatic encephalopathy as complications, respectively. Nine (17.3%) patients had variceal bleeding; six of the patients were diagnosed to have CLD while the remaining patients were having hepatosplenic schistosomiasis. Conclusion. In conclusion, liver cirrhosis is the major cause of ascites in Gondar, Ethiopia, while chronic viral hepatitis infections (hepatitis B (HBV) and C (HCV) viruses) are the main causes of liver cirrhosis. The other major causes included heart failure, tuberculosis, and hepatosplenic schistosomiasis. It is wise to consider and give priority to these diseases whenever one is evaluating a patient with ascites.

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

“…The searches from major databases, institutional repositories, and eligible articles' bibliography resulted in 190 records. After removing duplicates and reasonable exclusion of records, 12 were included in the review [ 24 – 35 ]. Of the twelve, two [ 32 , 33 ] studies represent the same population data and one with additional CLD etiology reports; thus, the additional etiology reports were extracted and analyzed, leaving the duplicate reports from the second article ( Figure 1 ).…”

“…Each component was rated as “yes” or “no”. Most of the studies [ 24 – 28 ] have problems related to the identification of the confounding variables and the lack of strategies for dealing with the confounders. Similarly, an appropriate statistical analysis based on the study objectives was not performed in some studies [ 24 , 25 , 27 – 30 ].…”

“…Most of the studies [ 24 – 28 ] have problems related to the identification of the confounding variables and the lack of strategies for dealing with the confounders. Similarly, an appropriate statistical analysis based on the study objectives was not performed in some studies [ 24 , 25 , 27 – 30 ]. In the present systematic review and meta-analysis, we included all articles fulfilling at least an average score (≥50%) of “yes” on the JBI quality assessment tool ( Table 1 ).…”

Distribution and Determinants of Etiologies and Complications of Chronic Liver Diseases Among Patients at a Tertiary Hospital in a Lower Economic Region of Ghana

“…Liver cirrhosis is the most common cause of ascites [44]. In patients with liver cirrhosis ascites develops mainly due to portal hypertension [45]. Additionally, hypoalbuminemia favors the extravasation of fluid from plasma to the peritoneal cavity and therefore, ascites is rare in patients with liver cirrhosis unless there is existence of both portal hypertension and hypoalbuminemia [46].…”

Ascitic Fluid Cytology Seen in a Tertiary Hospital in Nigeria

“…To achieve a successful treatment in each patient with ascites, adequate [1][2][3][4][5][6][7][8][9] diagnosis is important. A lot of biochemical tests like (serum-ascites albumin gradient, total protein, adenosine deaminase activity, glucose and lactate dehydrogenase, urea and creatinine, amylase and triglycerides) and nonbiochemical tests like (polymorphonuclear leukocyte count, bacterial cultures, PCR bacterial DNA Mycobacterium tuberculosis and cytology) can be done on [1][2][3][4][5][6][7][8][9] the ascitic fluid to help identify its source and nature. In developing countries, ascitic fluid cytology (AFC) and bacterial cultures are the most commonly performed ones.…”