Health impact of hepatic-venous-occlusive disease in a small town in Ethiopia—Case study from Tahtay koraro district in Tigray region, 2017


Autoři: Kissanet Tesfay Weldearegay aff001;  Mekonnen Gebremichael Gebrekidan aff002;  Alefech Adissu Gezahegne aff001
Působiště autorů: Mekelle University College of Health Science School of Public Health, Department of Epidemiology, Mekelle, Ethiopia aff001;  Tigray Regional Health Bureaus, Mekelle, Ethiopia aff002
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224659

Souhrn

Background

Hepatic venous-occlusive disease is blockage of microscopic veins in the liver causing 20–50% mortality. Ingestion of pyrrolizidine alkaloid plant, radiation therapy, and post-bone-marrow-transplant reactions are the commonest causes. In Ethiopia, a venous-occlusive disease outbreak was identified in 2002 in Tahtay Koraro district, Tigray. Suspected due to ingestion of the toxic pyrrolizidine alkaloid plant Ageratum conyzoids, found throughout the district. We aimed to describe the surveillance data of venous-occlusive disease from September 2006 to August 2016 in Tahtay koraro district, Ethiopia, 2017.

Methodology

We defined a possible Hepatic venous-occlusive disease case as any patient with abdominal pain for at least 2 weeks, abdominal distention, and hepato-splenomegaly during September 2006-August 2016. We reviewed previous district line lists, weekly reports, and clinical records to identify and describe cases. Agricultural interventions were obtained from the agricultural offices of the district.

Result

We identified 179 possible cases with 83 deaths with a case-fatality rate of 46.3%. Among cases, 110 (61.5%) were males and 113 (63%) were >15 years. In total, 164 (91.6%) cases were from one village (Kelakil). The pick number of cases of VOD in this village was during 2008/09 which was 1076. The highest incidence (86/100,000) occurred in 2008. During the study period, 2,746 years of potential life were lost due to Hepatic venous-occlusive disease. Mechanical removal of the Ageratum started in 2011.

Conclusion

Hepatic venous-occlusive disease was an ongoing problem in Tahtay Koraro; However, the problem has largely been alleviated by displacing people from the affected area and removing the causative weed. More research is needed to understand why Kelakil village was more affected despite the widespread presence of the weed. Chemical and mechanical removal of the Ageratum could strengthen intervention activities.

Klíčová slova:

Age groups – Alcohol consumption – Alkaloids – Ethiopia – Flowering plants – Ingestion – Liver diseases – Weeds


Zdroje

1. Richardson P, Guinan E. The pathology, diagnosis, and treatment of hepatic veno‐occlusive disease: current status and novel approaches. British journal of haematology. 1999;107(3):485–93. doi: 10.1046/j.1365-2141.1999.01680.x 10583247

2. Bearman S. Avoiding hepatic veno-occlusive disease: what do we know and where are we going? Bone marrow transplantation. 2001;27(11):1113. 11551020

3. Coppell JA, Brown SA, Perry DJ. Veno-occlusive disease: cytokines, genetics, and haemostasis. Blood Reviews. 2003;17(2):63–70. 12642120

4. T.Orfanidis N. Veno-occulusive disease of the liver 2016.

5. Bearman SI. The syndrome of hepatic veno-occlusive disease after marrow transplantation. Blood. 1995;85(11):3005–20. 7756636

6. Altaee MY. An outbreak of veno-occlusive disease of the liver in northern Iraq. 1998.

7. Carreras EGA, Rozman C. hepatic veno-occulusive disease after bone marrow transplant. Blood Reviews. 1993;7:43–51. 8467232

8. Chen Z, Huo J-R. Hepatic veno-occlusive disease associated with toxicity of pyrrolizidine alkaloids in herbal preparations. Neth J Med. 2010;68(6):252–60. 20558855

9. Senzolo M, Germani G, Cholongitas E, Burra P, Burroughs A. Veno occlusive disease: update on clinical management. World journal of gastroenterology: WJG. 2007;13(29):3918 17663504

10. Kakar F, Akbarian Z, Leslie T, Mustafa ML, Watson J, van Egmond HP, et al. An outbreak of hepatic veno-occlusive disease in Western Afghanistan associated with exposure to wheat flour contaminated with pyrrolizidine alkaloids. Journal of toxicology. 2010;2010.

11. Tandon BN, Tandon H, Tandon R, Narndranathan M, Joshi Y. An epidemic of veno-occlusive disease of liver in central India. The Lancet. 1976;308(7980):271–2.

12. Chiu C, Buttke D, Welde G, Luce R, Debela A, Bitew A, et al. Evaluation of the Pyrrolizidine Alkaloid Induced Liver Disease (PAILD) Active Surveillance System in Tigray, Ethiopia. 2013.

13. Debella A, Abebe D, Tekabe F, Mamo H, Abebe A, Tsegaye B, et al. Toxicity study and evaluation of biochemical markers towards the identification of the causative agent for an outbreak of liver disease in Tahtay Koraro Woreda, Tigray. Ethiopian medical journal. 2012;50:27–35. 22946293

14. Mesfin G, Ali A, Seboxa T, Bane A, Tensae MW, Gebressilassie S, et al. An epidemiological study into the investigation of liver disease of unknown origin in a rural community of northern Ethiopia, 2005. Ethiopian medical journal. 2012:1–8.

15. Abebe D, Debella A, Tekabe F, Mekonnen Y, Degefa A, Mekonnen A, et al. An outbreak of liver disease in Tahtay Koraro Woreda, Tigray region of Ethiopia: a case-control study for the identification of the etiologic agent. Ethiopian medical journal. 2012;50:17–25. 22946292

16. Tahtay Koraro Woreda Health Office Report. 2016.

17. Afewerki M IT, Ahmed B. Technical report on pyrrolizidine alkaloids induced hepatic veno-occulusive disease (hepatic-VOD) from north western zones of Tigray, Ethiopia Addis Ababa Ethiopian public health association, April 2013.


Článek vyšel v časopise

PLOS One


2019 Číslo 11