Sonographic Prevalence of Gallstone among Adult Subjects in Nnewi Anambra State, Nigeria

ABSTRACT 

Gallbladder stones are sometimes silent disease and often neglected, and could cause life threatening medical complications when it manifests clinically. The aim of this study is to determine the prevalence of gallbladder stone in the adult population of Nnewi, Anambra State, Nigeria. A cross sectional study was conducted during a period of 34 months; from June, 2011 to April, 2014. A convenience sample of 3501 consecutive consenting subjects who met the inclusion criteria was evaluated. Ultrasound examination was carried out on each participant with special emphasis on the biliary system, and the presence or otherwise of gallstone was documented. The weight of each participant was measured with a simple bathroom weighing balance. With each participant barefooted and standing in Frankfurt position, their heights were measured using a meter rule. Body mass index was calculated from the weight and height measurements. The age of each subject was recorded. Participants were aged between 18 and 92 years; 49.4% males (n = 1731) and 50.6% females (n = 1770). Only 4.4% of the subjects (n = 154) had gallstones. Twenty-seven percent (n = 41) of the subjects with stone were men, whereas 73% (n = 154) of the subjects with stones were women. Body mass index (BMI) was identified as the most prominent factor of gallstone formation, with obese subjects having greatest gallstone prevalence. Incidence according to age showed no 2 definite pattern. About 27% of the total gallstone incidents was symptomatic, only slightly above five percent was associated with cholecystitis. Generally, low prevalence rate of gallstone was noted within the studied population. The study showed that there is low prevalence of gallstone among adult population in Nnewi, Nigeria. It also revealed that increasing BMI value and sex appear to be risk factors for gallstone occurrence.

TABLE OF CONTENTS

Title………………………………………………………………………………………..ii

Approval page……………………………………………………………………………..iii

Acknowledgement………………………………………………………………………..iv

Table of Content …………………………………………………………………………..v-vii

List of Tables……………………………………………………………………………….viii

List of Figures………………………………………………………………………………viii

Abstract…………………………………………………………………………………….1-2

CHAPTER ONE: INTRODUCTION

1.1 Background of the Study………………………………………………………….3-6

1.2 Statement of Problem …………………………………………………………….6-7

1.3 Objectives of the Study …………………………………………………………..7

1.4 Significance of the Study ………………………………………………………....7

1.5 Scope of the Study…………………………………………………………………8

1.6 Definition of Operational Terms…………………………………………………...8-9

CHAPTER TWO : LITERATURE REVIEW

2.1 Introduction ……………………………………………………………………….10

2.2 Anatomyof gallbladder………………………………………………………………10

2.3 Pathogenesis of Gallstone …………………………………………………………11

2.4 Clinical Manifestation of Gallstones ………………………………………….......12-13

2.5 Complications of Gallstones ………………………………………………. …… 13-14

2.6 Risk and Protective Factors of Gallstone Development ………………………… 14-16

2.7 Incidence of Gallstone ……………………………………………………………16-20

CHAPTER THREE: RESEARCH METHODOLOGY

3.1 Research Design …………………………………………………………………...21

3.2 Duration of Study …………………………………………………………………21

3.3 Target Population ………………………………………………………………….21

3.4 Sampling Technique ………………………………………………………………21

3.5 Sample Size ……………………………………………………………………....22

3.6 Selection Criteria ……………………………………………………………….....22

3.7 Informed Consent/ Ethical Clearance ……………………………………………..23

3.8 Method of Data Collection ……………………………………………………….23-25

3.9 Scanning Technique ………………………………………………………………25-26

3.10 Methods of Data Analysis ……………………………………………………....26

CHAPTER FOUR: RESULTS

CHAPTER FIVE: DISCUSSION AND CONCLUSION

5.1 Distribution of Gallstone According to Sex and Age ……………………………34-35

5.2 Gallstone Prevalence According to Body Mass Index ………………………….35

5.3 Symptomatic Presentation of Gallstones ………………………………………….36

5.4 Comparison of Findings with Other Epidemiological Reports ……….................. 36-37

5.5 Summary of findings ………………………………………………………………37-38

5.6 Conclusion ……………………………………………………………………….38

5.7 Limitations of the Study …………………………………………………………38

5.8 Recommendations for Further Study ……………………………………………38-39

5.9 Area of study ……………………………………………………………………39

REFERENCES ………………………………………………………………………….40-44

APPENDIX I: Ethical clearance …………………………………………………………….45

APPENDIX II: Informed consent form …………………………………………………….46

Declaration by the researcher ……………………………………………………………. 46

Appendix iii: data collected from the participants …………………………………………47-95