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Hegazy MA, Elshafei A, Salem MR, Ashoush O, Abdelghani A. Non-alcoholic fatty liver disease related knowledge among a sample of Egyptians: an exploratory cross-sectional study. Front Public Health 2024; 11:1290842. [PMID: 38872989 PMCID: PMC11173582 DOI: 10.3389/fpubh.2023.1290842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/29/2023] [Indexed: 06/15/2024] Open
Abstract
Introduction The global prevalence of Non-alcoholic fatty liver disease (NAFLD) is about 25% worldwide making it an actual health disaster. This study aimed to assess non-alcoholic fatty liver disease (NAFLD)-related knowledge in a sample of Egyptians. Materials and methods This exploratory cross-sectional study was conducted on 3,124 individuals using 2000 online and 1,124 printed questionnaire forms. These questionnaires, covering sociodemographic characteristics and fatty liver-related knowledge, comprised 30 items. These items include ten questions on definition, symptoms, and complications: 14 about risk factors, and six about prevention and therapy. The data were analyzed using SPSS. Categorical variables were expressed in proportions and percentages. Chi-square and Fisher's exact tests were applied as appropriate. For quantitative variables, the t-test, Mann-Whitney U test, Kruskal-Wallis test, and ANOVA test were used for comparisons. Results A total of 3,124 respondents were enrolled in the current study. More than half (57%) were females, and 25% ranged in age from 18 to 29. 10.8% of the participants believed that fatty liver patients were asymptomatic, and 34% knew that fatty liver disease was caused by fat accumulation. Regarding predisposing factors, hypercholesterolemia, increased fat in the diet, and obesity had the highest proportion of accurate responses (60, 54, and 46.6%, respectively). On the other hand, 89.3% believed it could be prevented, and 81.4% of the respondents knew that weight reduction could prevent the condition. All respondents (100%) stated wrongly that it was a familial disease related to aging, and most participants (97.3%) did not believe that fatty liver could be treated. Females demonstrated a significantly higher score in preventive measures, while the employed participants scored significantly higher in general knowledge of fatty liver, risk factors, and preventive measures. Conclusion Despite the increasing NAFLD prevalence, the current study indicated that Egyptians had fair to moderate knowledge about fatty liver and its risk factors, preventive measures, and therapy. However, a false belief was documented by all respondents that it is a disease that runs in families and occurs only in old age. A fundamental shift in healthcare management with a prioritization of prevention, proactive measures, and early detection of NAFLD should be emphasized.
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Affiliation(s)
- Mona A. Hegazy
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Arwa Elshafei
- Public Health and Community Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
- Public Health and Community Medicine Department, Armed Forces College of Medicine, Cairo, Egypt
| | - Marwa Rashad Salem
- Public Health and Community Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Omar Ashoush
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Abdelghani
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Abdulfattah AA, Elmakki EE, Maashi BI, Alfaifi BA, Almalki AS, Al Alhadi N, Majrabi H, Kulaybi A, Salami A, Hakami FI. Awareness of Non-alcoholic Fatty Liver Disease and Its Determinants in Jazan, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e53111. [PMID: 38414702 PMCID: PMC10897741 DOI: 10.7759/cureus.53111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2024] [Indexed: 02/29/2024] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic steatosis. It is the leading cause of liver-related mortality, end-stage liver disease, and the need for liver transplantation. This study aimed to assess the level of awareness regarding NAFLD among the adult population in Jazan, Saudi Arabia, and to explore the determinants of the awareness level. Method This descriptive cross-sectional study was conducted among the general population of Jazan, Saudi Arabia, under the supervision of Jazan University, excluding those with end-stage liver failure. An online self-administered questionnaire, adopted from the literature, was sent through different social media platforms. A total of 1,034 people participated in this study. The chi-square test and multiple linear regression were used to identify the predictors of NAFLD awareness. Results Fifty-three percent of the participants were aware of NAFLD. The mean score of the participants' awareness was 22.7 ± 4.9 out of 40 points. Employed (95% confidence interval (CI): -1.9, -0.03; p = 0.044) and private business individuals (95% CI: -3.5, -1.1; p < 0.001) had a lower awareness level than students. The higher income level was associated with greater awareness (95% CI: 0.36, 2.4; p = 0.008). Those who had never heard of NAFLD had nearly twice as much awareness (95% CI: -3.0, -0.67; p = 0.002). Conclusions Nearly half the study participants displayed good awareness of NAFLD. However, efforts must focus on awareness campaigns, encouraging health-seeking behaviors, and targeted screening for early detection and treatment, especially in at-risk populations, since many participants were unaware of NAFLD.
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Affiliation(s)
| | | | | | | | | | | | - Hamad Majrabi
- Emergency Department, King Fahad Central Hospital, Jazan, SAU
| | | | - Ayoub Salami
- Emergency Department, King Fahad Central Hospital, Jazan, SAU
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Hui S, Bell S, Le S, Dev A. Hepatocellular carcinoma surveillance in Australia: current and future perspectives. Med J Aust 2023; 219:432-438. [PMID: 37803907 DOI: 10.5694/mja2.52124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/04/2023] [Indexed: 10/08/2023]
Abstract
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide, and is increasing in incidence in Australia. For most people with cirrhosis and chronic hepatitis B, HCC screening and surveillance is recommended with 6-monthly ultrasound. However, most patients with HCC are still diagnosed outside of surveillance with incurable disease. While HCC surveillance almost certainly reduces cancer-related mortality, the potential harms of surveillance are incompletely understood. Surveillance uptake remains suboptimal in many contexts, and stems from a combination of patient, clinician and system level barriers. Improved case-finding strategies may be required to identify high risk individuals in need of surveillance, as cirrhosis and viral hepatitis are often asymptomatic. HCC prediction models and novel surveillance tools such as biomarker panels, computed tomography and magnetic resonance imaging may have a future role in personalised HCC surveillance. Analyses suggest surveillance may be cost-effective, but Australian data remain limited. A centralised HCC surveillance program may ultimately have a role in delivering improved and more equitable care.
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Affiliation(s)
- Samuel Hui
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, VIC
| | - Sally Bell
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, VIC
| | - Suong Le
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, VIC
| | - Anouk Dev
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, VIC
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Lee JH, Jung JH, Park H, Oh JH, Ahn SB, Yoon EL, Jun DW. A survey on the awareness, current management, and barriers for non-alcoholic fatty liver disease among the general Korean population. Sci Rep 2023; 13:15205. [PMID: 37709931 PMCID: PMC10502016 DOI: 10.1038/s41598-023-42176-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is often diagnosed incidentally during medical evaluation for diseases other than liver disease or during health checkups. This study aimed to investigate the awareness, current status, and barriers to the management of NAFLD in the general population. This cross-sectional study used an online survey, which consisted of 3-domain and 18-item questionnaires. The content validity index for each item of the questionnaire was rated above 0.80. Most respondents (72.8%) reported having heard of the term 'NAFLD', and a large proportion of the general population (85.7%) recognized the possibility of developing fatty liver without consuming alcohol. Awareness of the terminology of NAFLD and that NAFLD is a disease that needs to be managed is relatively high. However, the knowledge that NAFLD can progress to end-stage liver disease and new cardiovascular diseases is lacking. Only 25.7% of the general population is aware that NAFLD increases the incidence of heart and cerebrovascular diseases. Only 44.7% of those who were incidentally diagnosed during a health check-up were provided with any specific guidance on NAFLD, and more than half (55.3%) were not provided with education or guidance on NAFLD or did not remember it. Only 40.2% of people diagnosed with NAFLD incidentally visited a clinic. The reason for not visiting a clinic for the evaluation of NAFLD varied greatly depending on sex and age group. Only 40.2% of patients visited the clinic after being diagnosed with NAFLD. The reasons for not visiting the clinic after NAFLD diagnosis differed significantly according to sex and age.
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Affiliation(s)
- Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University, College of Medicine, Daejeon, Republic of Korea
- Department of Medicine, Hanyang University School of Medicine, Seoul, Korea
| | - Jang Han Jung
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University, College of Medicine, Chuncheon, Republic of Korea
| | - Huiyul Park
- Department of Family Medicine, Myongji Hospital, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Joo Hyun Oh
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, College of Medicine, Daejeon, Republic of Korea
| | - Sang Bong Ahn
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, College of Medicine, Daejeon, Republic of Korea
| | - Eileen Laurel Yoon
- Department of Internal Medicine, Hanyang University, College of Medicine, 222 Wangsimni-ro, Seongdong-ru, Seoul, 04763, Republic of Korea.
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea.
- Department of Internal Medicine, Hanyang University, College of Medicine, 222 Wangsimni-ro, Seongdong-ru, Seoul, 133-791, Republic of Korea.
| | - Dae Won Jun
- Department of Internal Medicine, Hanyang University, College of Medicine, 222 Wangsimni-ro, Seongdong-ru, Seoul, 04763, Republic of Korea.
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea.
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Ong J, Alswat K, Hamid S, El-Kassas M. Nonalcoholic Fatty Liver Disease in Asia, Africa, and Middle East Region. Clin Liver Dis 2023; 27:287-299. [PMID: 37024208 DOI: 10.1016/j.cld.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. The global prevalence of the disease varies according to the geographical region. Despite having distinct models for the western patterns of NAFLD, Africa, Asia, and the Middle East regions exhibited varying prevalence rates of NAFLD. The disease burden is anticipated to significantly increase in these areas. Furthermore, with an increase in NAFLD risk factors in these regions, the disease burden is expected to rise even more. Policies at the regional and international levels are required to address such growing burden of NAFLD consequences.
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Affiliation(s)
- Janus Ong
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Khalid Alswat
- Department of Medicine, Liver Disease Research Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saeed Hamid
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Ain Helwan, Cairo 11795, Egypt.
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Ding R, Morvil G, Goh BBG, Krishnamoorthy TL, Chia PY, Tan HK, Ekstrom VSM, Cheah CCM, Tan JYT, Teo PSE, Chang PEJ, Tan CK, Xin X, Chow WC, Kumar R. Perception of disease, well-being and financial burden by patients with chronic hepatitis B: A self-reported assessment. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022; 51:378-380. [PMID: 35786760 DOI: 10.47102/annals-acadmedsg.202216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Ruojun Ding
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
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Lee MH, Ahn SH, Chan HLY, Choudhry A, Alvani Gani R, Mohamed R, Ong JP, Shukla A, Tan CK, Tanwandee T, Thuy PTT, Neo BL, Tsang V, Youn J, Singh S. Contextual and individual factors associated with knowledge, awareness and attitude on liver diseases: A large-scale Asian study. J Viral Hepat 2022; 29:156-170. [PMID: 34817896 DOI: 10.1111/jvh.13636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 09/27/2021] [Accepted: 11/15/2021] [Indexed: 12/13/2022]
Abstract
There are limited data to provide better understanding of the knowledge/awareness of general population towards liver health in Asia. We sought to identify the knowledge gaps and attitudes towards liver health and liver diseases as well as evaluate associated individual-level and macro-level factors based on contextual analysis. An online survey assessing knowledge, awareness and attitudes towards liver health and disease was conducted among 7500 respondents across 11 countries/territories in Asia. A liver index was created to measure the respondents' knowledge level and the degree of awareness and attitudes. Multilevel logistic regression was performed to identify individual factors and contextual effects that were associated with liver index. The overall liver index (0-100-point scale) was 62.4 with 6 countries/territories' liver indices greater than this. In the multilevel model, the inclusion of geographical information could explain for 9.6% of the variation. Residing in a country/territory with higher HBV prevalence (80% IOR: 1.20-2.79) or higher HCV death rate (80% IOR: 1.35-3.13) increased the individual probability of obtaining a high overall liver index. Individual factors like age, gender, education, household income, disease history and health screening behaviour were also associated with liver index (all p-values<0.001). The overall liver index was positively associated with the two macro-level factors viz. HBV prevalence and HCV death rate. There is a need to formulate policies especially in regions of lower HBV prevalence and HCV death rate to further improve the knowledge, awareness and attitudes of the general public towards liver diseases.
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Affiliation(s)
- Mei Hsuan Lee
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (ROC)
| | - Sang Hoon Ahn
- Yonsei University College of Medicine, Yonsei University, Seodaemun-gu, South Korea
| | - Henry L Y Chan
- Institute of Digestive Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Asad Choudhry
- Chaudhry Hospital, Ghulam Dastagir Khan Rd, Gujranwala, Pakistan
| | - Rino Alvani Gani
- Hepatobiliary Division, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Rosmawati Mohamed
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Janus P Ong
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Akash Shukla
- King Edward Memorial Hospital, Global Hospital, Mumbai, India
| | - Chee Kiat Tan
- Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore, Singapore
| | - Tawesak Tanwandee
- Department of Medicine, Siriraj Hospital, Mahidol University, Nakhon Salaya, Thailand
| | - Pham Thi Thu Thuy
- Hepatology Department in Ho Chi Minh Medic Medical Center, City Ho Chi Minh, Vietnam
| | | | | | - Jin Youn
- Gilead Sciences, Hong Kong, China
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