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Asian Tribune is published by World Institute For Asian Studies|Powered by WIAS Vol. 12 No. 727

Sri Lanka records the highest male death rate from liver diseases

By Manjari Peiris

Sri Lanka records the highest male death rate from liver diseases for all ages and 35-64 yrs in selected countries in Asia. It also records the highest male - female mortality ratio in the world; female mortality is higher than some Western countries, revealed Dr. Prasantha de Silva, Consultant Community Physician, Mental Health Directorate, Ministry of Healthcare and Nutrition.

The causes of death due to liver diseases are Cirrhosis of the liver (heavy long term alcohol consumption, Cryptogenic Cirrhosis, non-alcoholic Steatohepatitis, Hepatitis B and C) and malignancy (primarily due to Hepatitis B and C and secondary).

Alcoholic liver cirrhosis is the main contributor to liver mortality in the world, the advanced stage of the disease prior to liver failure, latency period of 10-15 years (Corraro et al., 1999; Norstrom and Ramstad 2005; Leon et al., and McCambridge 2006). Only around 10 per cent of heavy alcohol drinkers develop Cirrhosis (Lelbach 1976).

Cryptogenic Cirrhosis is a metabolic syndrome which resembles alcoholic liver disease, but occurs among those who do not drink or drink little alcohol. It aggravates with alcohol consumption. It is also called as Non- Alcoholic Steatohepatitis which is common both among males and females.

Hepatitis B and C is a significant contributor in some countries. There was a decline in liver mortality in Japan due to control of Hepatitis B (Negri et al., 2004). It has become a significant contributor in Mexico, Hungary and Romania. It is very low in Sri Lanka (De Silva HJ et al., 1998).

When liver mortality is compared with per capita consumption, more information is available than per capita consumption. It is an indicator of heavy long term consumption and is associated with a range of problems to the society and by sex and age group as well. It does not affect by legality of the alcoholic product and not affected by population proportion of abstainers. Per capita consumption is sensitive to even short term changes of consumption (“Reservoir Analogy Effect”) (Nordstrom 1987).

This study has been made to compare death rates from liver diseases among Sri Lankan males and females in all ages and those between aged 35-64 years with selected Western and Asian countries.

Dr. Prasantha de Silva mentioned that deaths due to liver diseases and age specific population were used from Registrar General Department for 2001 to calculate the death rates.

The rates were standardized to age groups of world population standards used by Bosetti et al., (2007) compared with the selected 41 countries. The comparison was for men and women for all ages and those aged between 35-64 years.

Dr. de Silva recommends for future research to ascertain whether Sri Lanka is the highest in the world in liver death rates due to alcohol consumption, as to it could be due Non-Alcoholic Steatohepatitis Hepatitis B & C, the reason for male female ratio becoming the highest in Sri Lanka and as to what reason the male female ratio indicating high tolerance among married females towards males’ long term heavy drinking, etc.

- Asian Tribune -

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