There is not enough literature on diagnosis and management of alcohol use disorder and alcohol-associated liver diseases in Ghana. This study aimed at reviewing the diagnosis and management of Alcohol Use Disorder and Alcohol-associated Liver Diseases in accordance with the 2019 Practice Guidance from the American Association for the Study of Liver Diseases and the National Institute for Clinical Excellence (NICE) guidelines short version draft (2017). The study was conducted at the St Joseph Hospital, Koforidua. Over a two-year period (January 2020 - December 2021), twenty-one patients diagnosed and managed for alcohol use and alcohol-associated liver diseases were retrieved for review. Five out of the twenty-one folders were finally reviewed after meeting the inclusion criteria. All patients were males and aged between 39 and 68 years. Results indicated that the diagnosis of Alcohol Use Disorder and Alcohol-associated Liver Diseases remains a challenge in the Ghanaian setting. There is a poor treatment/management protocol for alcohol-associated liver diseases due to clinician factors like the non-involvement of a multidisciplinary team of experts and the unavailability of diagnostic investigations. Larger clinical studies should be encouraged to develop locally based diagnostic and treatment/management protocols for Ghana. Clinicians must also develop the habit of involving a multidisciplinary team of experts in the management of alcohol-associated liver diseases.
Cite this paper
Danquah, A. , Kankam, O. A. and Daniyalo, K. A. (2023). Diagnosis and Treatment of Alcohol Use Disorder and Alcohol-Associated Liver Disease in Ghana: The St Joseph Hospital, Koforidua in Focus. Open Access Library Journal, 10, e163. doi: http://dx.doi.org/10.4236/oalib.1110163.
Håkansson, A. and Ek, J. (2018) Pilot Study of Problem Gambling in Specialized Substance Use Disorder Treatment—High Lifetime Prevalence of Problem Gambling in Opioid Maintenance Treatment Patients. Open Journal of Psychiatry, 8, 233-243.
https://doi.org/10.4236/ojpsych.2018.83020
Aslam, A. and Kwo, P.Y. (2023) Epidemiology and Disease Burden of Alcohol Associated Liver Disease. Journal of Clinical and Experimental Hepatology, 13, 88-102.
https://doi.org/10.1016/j.jceh.2022.09.001
Ayares, G., Idalsoaga, F., Díaz, L.A., Arnold, J. and Arab, J.P. (2022) Current Medical Treatment for Alcohol-Associated Liver Disease. Journal of Clinical and Experimental Hepatology, 12, 1333-1348. https://doi.org/10.1016/j.jceh.2022.02.001
Jophlin, L. and Singal, A.K. (2022) Liver Biopsy in Patients with Alcohol-Associated Liver Disease with Acute-on-Chronic Liver Failure. Journal of Clinical and Experimental Hepatology, 12, 544-550. https://doi.org/10.1016/j.jceh.2021.08.009
Mitchell, M.C., Friedman, L.S. and McClain, C.J. (2017) Medical Management of Severe Alcoholic Hepatitis: Expert Review from the Clinical Practice Updates Committee of the AGA Institute. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association, 15, 5-12.
https://doi.org/10.1016/j.cgh.2016.08.047
Saberi, B., Dadabhai, A.S., Jang, Y., Gurakar, A. and Mezey, E. (2016) Current Management of Alcoholic Hepatitis and Future Therapies. Journal of Clinical and Translational Hepatology, 4, 113-122. https://doi.org/10.14218/JCTH.2016.00006
Im, G.Y. and Lucey, M.R. (2016) Practical Concerns and Controversies in the Management of Alcoholic Hepatitis. Gastroenterology & Hepatology, 12, 478-489.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114494
Dugum, M. and McCullough, A. (2015) Diagnosis and Management of Alcoholic Liver Disease. Journal of Clinical and Translational Hepatology, 3, 109-116.
https://doi.org/10.14218/JCTH.2015.00008
GBD 2017 Cirrhosis Collaborators (2020) The Global, Regional, and National Burden of Cirrhosis by Cause in 195 Countries and Territories, 1990-2017: A Systematic Analysis for the Global Burden of Disease Study 2017. The Lancet Gastroenterology & Hepatology, 5, 245-266. https://doi.org/10.1016/S2468-1253(19)30349-8
Arab, J.P., Díaz, L.A., Baeza, N., Idalsoaga, F., Fuentes-López, E., Arnold, J., Ramírez, C.A., Morales-Arraez, D., Ventura-Cots, M., Alvarado-Tapias, E., Zhang, W., Clark, V., Simonetto, D., Ahn, J.C., Buryska, S., Mehta, T.I., Stefanescu, H., Horhat, A., Bumbu, A., Dunn, W. and Bataller, R. (2021) Identification of Optimal Therapeutic Window for Steroid Use in Severe Alcohol-Associated Hepatitis: A Worldwide Study. Journal of Hepatology, 75, 1026-1033.
https://doi.org/10.1016/j.jhep.2021.06.019
O’Shea, R.S., Dasarathy, S. and McCullough, A.J. (2010) Alcoholic Liver Disease. American Journal of Gastroenterology, 105, 14-32.
https://doi.org/10.1038/ajg.2009.593
Sohail, U. and Satapathy, S.K. (2012) Diagnosis and Management of Alcoholic Hepatitis. Clinics in Liver Disease, 16, 717-736.
https://doi.org/10.1016/j.cld.2012.08.005
Crabb, D.W., Im, G.Y., Szabo, G., Mellinger, J.L. and Lucey, M.R. (2020) Diagnosis and Treatment of Alcohol-Associated Liver Diseases: 2019 Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology (Baltimore, Md.), 71, 306-333. https://doi.org/10.1002/hep.30866
Premkumar, M. and Anand, A.C. (2022) Overview of Complications in Cirrhosis. Journal of Clinical and Experimental Hepatology, 12, 1150-1174.
https://doi.org/10.1016/j.jceh.2022.04.021
Shah, A.S. and Amarapurkar, D.N. (2018) Natural History of Cirrhosis of Liver after First Decompensation: A Prospective Study in India. Journal of Clinical and Experimental Hepatology, 8, 50-57. https://doi.org/10.1016/j.jceh.2017.06.001
