ABSTRACT Background Chronic liver diseases (CLD) leading to liver fibrosis and cirrhosis are a major cause of morbidity and mortality in sub‐Saharan Africa and pose a significant burden on its health care systems. We aimed to elucidate the prevalence of fibrosis/cirrhosis in patients seeking health care in Kumasi, Ghana, and its underlying aetiologies. Methods In this cross‐sectional study, we performed sonography, transient elastography as well as biochemical and virological analyses. Results Transient elastography indicated fibrosis/cirrhosis in 24.5% (113/461) of participants. Liver cirrhosis was significantly associated with known hepatitis B virus (HBV) infection, lack of formal education, hospitalisation, and male sex. Prevalence of active hepatitis B was significantly higher in patients with liver cirrhosis compared to controls (54.6% 30/55 vs. 17.1% 19/111), as was anti‐HBc (94.6% 52/55 vs. 80.2% 89/111). CLD was mainly attributed to HBV (27.3%, 30/110), alcohol abuse (11.8%, 13/110), a combination of both (10.9%, 12/110), and metabolic dysfunction‐associated steatotic liver disease (MASLD) (20%, 22/110). Antiviral treatment was indicated in 24 patients with active hepatitis B (number‐needed‐to‐screen: 19.2). Hepatitis C and D viruses were of minor importance (2.7% 3/110 and 0.9% 1/110, respectively). Conclusions We found a high prevalence of CLD, predominantly caused by HBV, MASLD and alcohol. We confirmed the use of transient elastography as a non‐invasive and easily applicable tool in resource‐limited settings. Our findings underscore the need for systematic screening of hospitalised patients, especially men, in sub‐Saharan Africa. Comprehensive screening, treatment, vaccination and prevention programs for HBV, as the leading cause of chronic liver disease, are warranted.
Lehmann et al. (Sat,) studied this question.