A glance at gallstones in South Africa: a one year review of sonographic findings at a tertiary hospital

Abstract

Background. Gallstones (GS) have historically been thought to be uncommon in Sub-Saharan Africa. There are scanty data on the current prevalence of GS in South Africa despite a significant change in the GS risk factor prevalence. Objectives. To determine the prevalence and risk factors for GS among adult patients undergoing abdominal ultrasound scans at a tertiary institution. Methods. We conducted a retrospective cross sectional analysis of all adult abdominal ultrasound scan reports from the radiology department of the institution in the year 2009. Basic demographics, presence, symptoms and complications of gallstones were collected. Logistic regression was used to explore both dependent and independent risk factors for developing GS. Results. Of the 3 494 reports analysed, 284(8.1%) had GS [95% confidence interval 7.2 - 9.1], with 70% being female. Gallstone prevalence was 10.2% and 5.5% for females and males respectively with a symptomatic to asymptomatic GS ratio of 1:1.9. Complications were seen in 6.3% of all patients with GS, with cholecystitis being the commonest (61%). The GS prevalence by population group was significantly higher in the white population which was an independent risk factor [adjusted OR 2.44(1.86-3.20)]. Other independent risk factors for GS were female gender [adjusted OR 1.97(1.51-2.56)] and increasing age [adjusted OR 1.03(1.02-1.04)]. Conclusion. In this hospital based study, the prevalence of GS among adult patients was slightly higher than in other previous African studies. Independent risk factors for GS were increasing age, white race and female gender. Further community based surveys are necessary to determine the true prevalence of GS among adults in South Africa.