Epidemiology, risk factors, and clinical characteristics of amoebic liver abscess: a systematic review and meta-analysis from India.

Abstract

Amoebiasis and its extraintestinal manifestation amoebic liver abscess (ALA) is an endemic disease in tropical and subtropical countries. However, no meta-analysis on the prevalence, associated risk factors, and clinical markers has been performed. This study aims to bridge this research gap. Based on our inclusion criteria, 18 studies were selected for analysis. Using the "meta" package in RStudio, forest plots, regression analysis, and funnel plots were used to represent the proportional meta-analysis, significance of the correlation, and quality and publication bias of the included studies, respectively. A high prevalence of ALA (67%, p = 1.762 × 10^-15) was noted in cases of liver abscess. ALA was significantly more prevalent in males (86%, p = 2.25 × 10^-8), individuals with poor socioeconomic conditions (75%, p = 0.02496), history of alcohol consumption (63%, p = 1.421 × 10^-8), and diabetic comorbidity (35%, p = 0.01169). There was a significant correlation with abdominal pain (91%, p = 1.286 × 10^-12), infected right lobe (81%, p = 0.002), fever (73%, p = 2.567 × 10^-12), hepatomegaly (69%, p = 1.223 × 10^-5), anemia (69%, p = 1.223 × 10^-5), and jaundice (11%, p = 0005258) in the affected individuals. We conclude that the above-stated risk factors and clinical markers are significantly associated with ALA and suggest that medical professionals in endemic regions must attribute liver abscess to be etiologically amoebic and correlate the disease manifestation with the risk factors and clinical markers. Further, research is needed to better understand disease manifestation.