Biochemical pattern of alcoholic liver disease among alcohol abusers attending rehabilitation centres in Dar es Salaam
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Date
2025
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Publisher
Kairuki University
Abstract
Background: Alcoholic Liver Disease (ALD) is a significant public health concern in Tanzania, driven by high rates of Alcohol Use Disorder (AUD). ALD contributes substantially to cirrhosis, liver failure, and hepatocellular carcinoma, straining the healthcare system. Despite its impact, liver biochemical patterns such as Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Gamma-Glutamyl Transferase (GGT), bilirubin, and albumin remain poorly characterized among Tanzanian alcohol abusers, especially those in rehabilitation centers where mental health often overshadows physical assessments.
Objective: To determine the distribution of biochemical patterns of ALD among alcohol abusers attending rehabilitation centers in Dar es Salaam.
Methodology: A cross-sectional descriptive study was conducted from August 2024 to July 2025. A multi-stage, stratified sampling design was employed to select participants from rehabilitation centers in Dar es Salaam. Three centers were chosen using simple random and proportional stratified sampling, and participants were recruited through consecutive sampling. Socio-demographic and clinical data were collected using structured questionnaires. Venous blood samples were tested for ALT, AST, GGT, bilirubin, albumin, HBsAg, and anti-HCV using a Mindray BS-240 analyzer. Data were analyzed using SPSS version 23, with a p-value <0.05 considered statistically significant.
Results: Of 168 analyzed participants, the mean age was 37.8 years (±9.97), and 147 (87.5%) were male. Most had secondary 73 (43.5%) and university education 61 (36.3%). Early alcohol initiation was common (median age: 14 years). Alcoholic hepatitis (AH) was diagnosed in 19 participants (11.3%). Elevated AST showed a statistically significantassociation with higher income (p=0.011). ALT elevation was significantly more common in participants without AH than with AH (36 [24.2%] vs. 1 [5.3%], p=0.047. Conversely, GGT (9 [47.4%]) and AST (6 [31.6%]) were the most elevated markers in the AH group.
Conclusion: This study reveals an evolving Alcoholic Liver Disease profile in Tanzania, which increasingly affects educated, middle-aged, and affluent males. Early alcohol initiation and consumption of high-potency spirits contribute to liver injury. Elevated AST and GGT with normal ALT characterize AH, underscoring the limitations of single biomarkers and the need for integrated diagnostics using AST: ALT ratios and clinical assessment.
Recommendation: Integrate multimodal liver screening into rehabilitation and primary care services. Enforce stricter alcohol control policies, promote targeted public health education, and provide socioeconomic support. Longitudinal cohort studies are essential to
understand ALD progression and guide tailored interventions.
Description
A dissertation submitted in (partial) fulfillment of the requirements for the degree of Master of Medicine (internal medicine) at Kairuki university
Keywords
alcohol abuse, liver disease, multimodal liver screening
Citation
Sabuka, Joyce E., 2025. Biochemical pattern of alcoholic liver disease among alcohol abusers attending rehabilitation centres in Dar es Salaam. Dissertation. Kairuki University