Facteurs associés à la dénutrition chez les patients atteints de maladies hépatiques chroniques suivis dans les hôpitaux nationaux (CHUK, HPRC et HMK) de Bujumbura, Burundi, 2026

Abstract

Introduction: Chronic liver diseases constitute a major public health problem, progressing to severe complications and high mortality. They are mainly caused by viral hepatitis, alcohol consumption, and metabolic disorders, which are often associated with malnutrition, particularly at the stage of cirrhosis. The objective of identify was to investigate the factors associated with malnutrition among patients with chronic liver diseases recruited from the national hospitals of Bujumbura. Methodology: To identify factors associated with malnutrition in patients with chronic liver disease, we conducted a matched case-control study on a sample of 72 cases and 144 controls, who met the inclusion criteria, recruited from 3 national hospitals (CHUK, HPRC and HMK) of Bujumbura. The study was conducted over a seven-month period, from November 3, 2025 to June 5, 2026. Data were collected using a structured questionnaire administered through KoboCollect and complemented by anthropometric measurements. Descriptive, bivariate, and multivariate analyses were performed using STATA version 15.1. A 95% confidence interval (95% IC) was used, and the level of statistical significance was set at a p-value of less than 0.05 (p < 0.05). Results: At the end of the multivariable analysis, the variables significantly associated with malnutrition among patients with chronic liver diseases were alcohol consumption (aOR = 5.04; 95% CI [1.61–15.77]; p = 0.005), advanced disease stage C (aOR = 5.28; 95% CI [1.55–17.93]; p = 0.008), positive C-reactive protein (CRP) status (aOR = 6.88; 95% CI [2.60–18.17]; p < 0.001), and dietary restriction (aOR = 5.77; 95% CI [2.23–14.92]; p < 0.001). Conversely, access to health insurance coverage (aOR = 0.03; 95% CI [0.01–0.09]; p < 0.001) and consuming three or more meals per day (aOR = 0.16; 95% CI [0.06–0.43]; p < 0.001) were identified as protective factors against malnutrition. Conclusion: Undernutrition in patients with chronic liver disease is a major clinical problem that can worsen disease progression and reduce the effectiveness of treatment. This study highlighted several factors significantly associated with malnutrition, including lack of health insurance coverage, alcohol consumption, advanced disease stage C, positive CRP, infrequent daily meals, and dietary restrictions. Early and appropriate nutritional intervention, combined with regular medical follow-up, is therefore essential to improve the nutritional status and prognosis of these patients.