Hepatitis A: Leading Cause of Paediatric Acute Liver Failure in Bangladesh

Dhaka Shishu (Children) Hospital Journal Pub Date : 2022-12-11 DOI:10.3329/dshj.v37i2.63160

R. Rashid, A. Karim, F. Islam, S. Mahmud, Sk Serjina Anwar

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Abstract

Background: Pediatric acute liver failure (PALF) is a multisystem disorder that gives rise to severe liver failure within days or weeks and occurs in children without pre-existing chronic liver disease. The etiology of PALF varies with age group and geographical area. Objectives: This study was aimed to evaluate the etiological factors of PALF in Bangladeshi children. Methods: This observational study was conducted at the Department of Paediatric Gastroenterology & Nutrition, Bangabandhu Sheikh Mujib Medical University, Bangladesh, from 2017 to 2020. Twenty-six PALF patients were included, purposively, excluding the acute-on chronic liver failure cases. Demographic data, vaccination history, and other information regarding etiology and complications were recorded. During hospital stay following investigations were performed: Serum bilirubin, liver enzymes, prothrombin time, serum albumin, serum creatinine and electrolytes. Fisher’s exact test determined the association between etiologies of PALF and past histories along with other descriptive statistics using the open-source PSPP software. Results: The average age of the 26 studied patients was 8.6±3.5 years, and 73.1% belonged to 5-12 years of age group. Half of the patients had a history of taking street food or unsafe water. Only six patients had a history of ingestion of herbal medicine. None of the patients had history of vaccination against Hepatitis A. The etiology of PALF patients varied. About 54% of the studied patients had HAV infection, in 23.1% etiology was not determined. About 71.4% of the study patients with HAV infection had a history of taking street food or unsafe water, and this association was statistically significant. Conclusion: This study found that hepatitis A virus infection is the leading cause of paediatric acute liver failure in Bangladesh. Timely preventive measures may help in lowering fatality from liver diseases in children in Bangladesh. DS (Child) H J 2021; 37(2): 93-97

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甲型肝炎:孟加拉国儿童急性肝衰竭的主要原因

背景:小儿急性肝衰竭(PALF)是一种多系统疾病，可在数天或数周内引起严重肝功能衰竭，发生在没有慢性肝病的儿童中。PALF的病因因年龄组和地理区域而异。目的:本研究旨在评估孟加拉国儿童PALF的病因。方法:本观察性研究于2017年至2020年在孟加拉国Bangabandhu Sheikh Mujib医科大学儿科胃肠病学与营养学系进行。有目的地纳入了26例PALF患者，排除了急性慢性肝衰竭病例。记录人口统计数据、疫苗接种史和其他有关病因和并发症的信息。住院期间进行以下调查:血清胆红素、肝酶、凝血酶原时间、血清白蛋白、血清肌酐和电解质。Fisher的精确测试确定了PALF病因与过去病史之间的联系，以及使用开源PSPP软件的其他描述性统计数据。结果:26例患者平均年龄8.6±3.5岁，5-12岁年龄组占73.1%。一半的患者有吃过街头食品或不安全的水的历史。只有6例患者有服用草药的历史。所有患者均无甲型肝炎疫苗接种史，其病因各不相同。约54%的患者有甲型肝炎感染，23.1%的患者病因不明。研究中约71.4%的HAV感染患者有街头食品或不安全饮用水的历史，这一关联具有统计学意义。结论:本研究发现甲型肝炎病毒感染是孟加拉国儿童急性肝衰竭的主要原因。及时的预防措施可能有助于降低孟加拉国儿童肝病的死亡率。DS(儿童)H J 2021;37 (2): 93 - 97

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Dhaka Shishu (Children) Hospital Journal

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