Liver Disease in Sri Lanka

Wijewantha, Hasitha Srimal

doi:10.5005/jp-journals-10018-1217

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…In another study done on 81 patients with cirrhosis who were referred for liver transplantation, none had hepatitis B or C [49]. Even though nationwide data on prevalence of hepatitis C virus (HCV) in Sri Lanka is not available, studies conducted in various specific groups of population have shown a seroprevalence of <1% [46]. Therefore, we assume that not having the serology status would not have made difference to our results.…”

Section: Discussionmentioning

confidence: 85%

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Non-alcoholic fatty liver disease and pregnancy complications among Sri Lankan women: A cross sectional analytical study

et al. 2019

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Background Non-alcoholic fatty liver disease (NAFLD) is the commonest cause of liver disease worldwide and is the hepatic manifestation of metabolic syndrome. Effects of NAFLD on pregnancy is still unclear with few studies showing an association to gestational diabetes and pre-eclampsia. We aimed to describe the association between the NAFLD and pregnancy complications. This is the first study, to our knowledge, in a South Asian population. Method A cross sectional analytical study was done in Teaching Hospital, Ragama, Sri Lanka. Women carrying a singleton pregnancy, admitted for delivery were assessed for NAFLD with liver ultrasound scan. Data were extracted from interviewer administered questionnaire and antenatal and inpatient records. Pregnancy complications and labour outcomes were compared between the women with NAFLD and women without NAFLD (non-NAFLD). Results Out of the 573 women who participated, 18.2% (n = 104) were found to have NAFLD. Out of them, 58 (55.8%), 32(30.8%), and 14(13.5%) had fatty liver grade 1,2 and 3 respectively. Women with NAFLD were 2 times more likely to develop gestational hypertension and pre-eclampsia compared to the women in the non-NAFLD group, after adjusting for BMI, age and Hyperglycaemia in pregnancy [Adjusted OR 2.09, (95% CI 1.07–4.10)]. There was no association between the grade of steatosis and a composite outcome of gestational hypertension and pre-eclampsia, within the NAFLD group. Composite outcome of gestational diabetes mellitus and diabetes in pregnancy diagnosed during pregnancy was a significant complication in the NAFLD group compared to non-NAFLD group in the bivariate analysis (27.2% vs 17.7%; p<0.05), but the significance disappeared after adjusting for confounders. The current study did not demonstrate a significant association between NAFLD with preterm labour, caesarean section rate, low birth weight, and Apgar score of the baby. Conclusion Women with NAFLD had a 2-fold higher risk of developing gestational hypertension and pre-eclampsia during pregnancy compared to women without NAFLD, after controlling for other confounding variables.

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Section: Discussionmentioning

confidence: 85%

“…We excluded hepatitis by history alone. Hepatitis B infection is not common in Sri Lanka and is not considered a major health problem [46]. Studies conducted on different population groups, including blood donors, pregnant mothers, and prison inmates, have shown prevalence of hepatitis B to be less than 2% [47].…”

Section: Discussionmentioning

confidence: 99%

Non-alcoholic fatty liver disease and pregnancy complications among Sri Lankan women: A cross sectional analytical study

et al. 2019

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“…In addition, acute liver failure, though rare, is an important disease entity with very high rates of mortality. In Sri Lanka, alcohol remains a leading cause of liver diseases followed by NAFLD with a relatively lesser burden of chronic viral hepatitis-related liver disease compared to countries in the region and a very low prevalence of hepatitis B and C [4,5]. The prevalence of NAFLD is 18% among rural and 32.6% among urban adult population [6,7].…”

Section: Introductionmentioning

confidence: 99%

Challenges of liver transplantation programs in low‐ and middle‐income countries: An experience from Sri Lanka

Jayarathna,

Dassanayake,

Dorji

et al. 2024

Public Health Challenges

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Liver diseases lead to 1.3 million deaths per year around the world, the majority of which are secondary to cirrhosis. In the management of liver diseases in chronic and acute conditions, liver transplant (LT) plays a major role in improving the survival and quality of life of patients. LT programmes require the technical capabilities in performing the pre‐transplant evaluation, transplant surgery and post‐transplant care supported by adequate infrastructure and a set of trained teams. Globally, there were 28,000 deceased donor LTs, and 14,000 living donor LTs were performed in 2021. In the South Asia region, India, Pakistan and Sri Lanka conducted 2998 LTs in 2021. Many countries report sociocultural, religious and legislative barriers to acquiring adequate donor livers. We describe the challenges in LT programmes in low‐ and middle‐income countries and experiences from Sri Lanka. Sri Lanka carried out its first LT in 2010, and the service is provided free of charge in the state health sector. In Sri Lanka, the common indications for LT in adults are non‐alcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma and alcoholic liver disease. In children, the indications are biliary atresia, hepatocellular carcinoma and Wilson disease. The common challenges include a lack of an adequate number of doctors and post‐transplant team members, a low number of organ donors and a long waiting list, all of which can be disadvantageous for transplant programmes. To continue providing LT services, there is a need to adopt multimodal strategies in the areas of providing additional skills training to the operating team and promoting organ donation culture in the background of supportive organ donation legislation. With the adoption of the national strategic plan for organ, tissue and cell transplantation, the country hopes to strengthen its capacity of providing transplant services to its people.

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“…2 However, it is a rare disease in Sri Lanka and there is no data available on its prevalence at a national level. 3 Co-infection of hepatitis E and P. falciparum malaria are rarely reported in the literature. 4 This is the first reported case in Sri Lanka of a patient co-infected with both hepatitis E and P. falciparum malaria, and both infections were imported.…”

Section: Introductionmentioning

confidence: 99%

The first reported case of co-infection of imported hepatitis E and <em>Plasmodium falciparum</em> malaria in Sri Lanka

Senarathne,

Rajapakse,

De Silva

et al. 2023

Sri Lankan J Infec Dis

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Global travel and tourism, especially across tropical countries, may lead to importation of malaria and other infectious diseases into Sri Lanka. This case report describes the first co-infection of imported hepatitis E and Plasmodium falciparum malaria in a tourist diagnosed in Sri Lanka. The patient was initially diagnosed with uncomplicated P. falciparum malaria and was started on treatment with oral Artemisinin-based Combination Therapy (ACT). Deterioration of hepatic enzymes and hyperbilirubinaemia despite the rapid parasitological response to antimalarials led to further investigation and diagnosis of co-infecting hepatitis E in this patient. The importance of clinicians being vigilant on travel associated co-infections is highlighted to ensure early diagnosis and better patient management.

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Liver Disease in Sri Lanka

Cited by 8 publications

References 15 publications

Non-alcoholic fatty liver disease and pregnancy complications among Sri Lankan women: A cross sectional analytical study

Non-alcoholic fatty liver disease and pregnancy complications among Sri Lankan women: A cross sectional analytical study

Challenges of liver transplantation programs in low‐ and middle‐income countries: An experience from Sri Lanka

The first reported case of co-infection of imported hepatitis E and <em>Plasmodium falciparum</em> malaria in Sri Lanka

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