Chronic liver disease in black children in Durban, South Africa

Abstract

In a prospective study of 130 South African black children with chronic liver disease, it was found that the aetiology differed from that reported from developed countries. The most common cause of chronic liver disease (CLD) was HBsAg (33 of 55 with cirrhosis and 24 of 28 with chronic active hepatitis) and Schistosoma mansoni infestation (41 children). Inherited, auto-immune, iatrogenic and cryptogenic disorders, which are the usual causes in the developed world, were less common. The majority of children seen in this series were in an asymptomatic compensated state in contrast to reports from some developed countries. It is concluded that because infection is a common cause of CLD in the Third World it may be preventable in many cases.

Childhood liver diseases in Ga-Rankuwa Hospital, South Africa

“…This seven year study has shown that biliary atresia and neonatal hepatitis are the most common childhood liver conditions at Ga-Rankuwa Hospital. These findings differ significantly from the observations made by Mackenjee et al (2) and Obafunwa et al (3). In their material both biliary atresia and neonatal hepatitis were encountered very rarely.…”

“…In their material both biliary atresia and neonatal hepatitis were encountered very rarely. These findings, however, concur with western observations where neonatal hepatitis and biliary atresia are the most common liver diseases in children (2,3).…”

“…This figure is comparable to that of Obafunwa et al(3) who found this condition in 8.3% of their cases. Mackenjee et al (2) observed a higher figure for chronic active hepatitis (21.5%). Twenty four of their cases (24/28 or 85.7%) were positive for HBsAg which is comparable to our figure of 71.4%.…”

“…The patients usually present with jaundice, hepatomegaly, ascites or portal hypertension. Although many papers have been published on liver diseases in adults, very little is written on liver diseases in children (2). This paucity of literature on liver diseases in childhood is even more significant in the third world countries (2,3).…”

“…Papers published from the third world showed a different pattern when compared with those from the developed communities. Infections seem to dominate and metabolic diseases are rare (2,3).…”