Prevalence and risk factors of gallstone disease in patients undergoing ultrasonography in Mulago Hospital, Uganda

Abstract

BACKGROUND: Gallstone disease (GSD) is still the most prevalent medical condition in the pancreatobiliary system. It is a global problem and remains a common cause of surgical intervention, contributing substantially to health care costs. The burden of GSD and its complications are major public health issues globally. Most patients are asymptomatic, and approximately 20% become symptomatic after 10 years of follow-up. Its prevalence however, varies widely among different populations and remains unknown in Uganda. OBJECTIVE: The aim of the study was to determine the prevalence, and associated risk factors of GSD in patients undergoing abdominal ultrasonography at Mulago National Referral hospital. METHODS: This was a cross-sectional study, conducted at the Department of Radiology in Mulago hospital. Convenient sampling was used to recruit individuals having an abdominal ultrasound scan at the Radiology department. Questionnaires were used to assess risk factors, and an abdominal exam was performed for individuals with gallstones to assess symptomatology. RESULTS: The prevalence of GSD was 22%. Statistically significant factors associated with GSD were a history of hormonal contraceptive use OR 3.2 (1.88-5.41) and a history of previous biliary symptoms OR 2.9 (1.68-4.91). Ninety-four percent of individuals with gallstones had epigastric/right upper quadrant pain (RUQ). CONCLUSION: The prevalence of GSD is high in Mulago hospital; use of hormonal contraceptives and a previous history of biliary symptoms were significant risk factors for GSD in this study. Majority of patients with GSD were symptomatic with epigastric pain as the cardinal symptom. We recommend a countrywide screening program using abdominal ultrasonography to determine the prevalence of GSD in the general population. There is need to study further the risk of hormonal contraceptive use and GSD.