Luis Antonio Díaz1, Francisco Idalsoaga1, Eduardo Fuentes-López2, Andrea Márquez-Lomas3, Carolina A Ramírez4, Juan Pablo Roblero5, Roberta C Araujo6, Fátima Higuera-de-la-Tijera7, Luis Guillermo Toro8, Galo Pazmiño9, Pedro Montes10, Nelia Hernandez11, Manuel Mendizabal12, Oscar Corsi13, Catterina Ferreccio14,15, Mariana Lazo16,17,18, Mayur Brahmania19, Ashwani K Singal20, Ramon Bataller21, Marco Arrese1, Juan Pablo Arab1. 1. Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. 2. Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. 3. Escuela de Medicina, Universidad Anáhuac Mayab, Mérida, México. 4. Departamento de Anestesiología, Clínica Las Condes, Santiago, Chile. 5. Sección Gastroenterología, Hospital Clínico Universidad de Chile, Escuela de Medicina Universidad de Chile, Santiago, Chile. 6. Gastroenterology Division, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. 7. Servicio de Gastroenterología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México. 8. Hepatology and Liver Transplant Unit, Hospitales de San Vicente Fundación de Medellín y Rionegro, Medellin, Colombia. 9. Department of Gastroenterology, Pontificia Universidad Católica del Ecuador, Quito, Ecuador. 10. Department of Gastroenterology, Hospital Nacional Daniel A. Carrión, Callao, Perú. 11. Clínica de Gastroenterología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República Uruguay, Montevideo, Uruguay. 12. Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Buenos Aires, Argentina. 13. Departamento de Medicina Interna, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. 14. Public Health Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. 15. Advanced Center for Chronic Diseases, ACCDis, Santiago, Chile. 16. Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA. 17. Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA. 18. Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. 19. Department of Medicine, Division of Gastroenterology, Western University, London Health Sciences Center, London, ON, Canada. 20. Division of Transplant Hepatology, Department of Medicine, Avera Transplant Institute, University of South Dakota Sanford School of Medicine, Sioux Falls, SD. 21. Center for Liver Diseases, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA.
Abstract
BACKGROUND AND AIMS: Alcohol-associated liver disease (ALD) is the leading cause of liver-related mortality in Latin America, yet the impact of public health policies (PHP) on liver disease is unknown. We aimed to assess the association between alcohol PHP and deaths due to ALD in Latin American countries. APPROACH AND RESULTS: We performed an ecological multinational study including 20 countries in Latin America (628,466,088 inhabitants). We obtained country-level sociodemographic information from the World Bank Open Data source. Alcohol-related PHP data for countries were obtained from the World Health Organization Global Information System of Alcohol and Health. We constructed generalized linear models to assess the association between the number of PHP (in 2010) and health outcomes (in 2016). In Latin America, the prevalence of obesity was 27% and 26.1% among male and female populations, respectively. The estimated alcohol per capita consumption among the population at 15 years old or older was 6.8 L of pure alcohol (5.6 recorded and 1.2 unrecorded). The overall prevalence of alcohol use disorders (AUD) was 4.9%. ALD was the main cause of cirrhosis in 64.7% of male and 40.0% of female populations. A total of 19 (95%) countries have at least one alcohol-related PHP on alcohol. The most frequent PHP were limiting drinking age (95%), tax regulations (90%), drunk-driving policies and countermeasures (90%), and government monitoring systems and community support (90%). A higher number of PHP was associated with a lower ALD mortality (PR, 0.76; 95% CI, 0.61-0.93; P = 0.009), lower AUD prevalence (PR, 0.80; 95% CI, 0.65-0.99; P = 0.045), and lower alcohol-attributable road traffic deaths (PR, 0.81; 95% CI, 0.65-1.00; P = 0.051). CONCLUSIONS: Our study indicates that in Latin America, countries with higher number of PHP have lower mortality due to ALD, lower prevalence of AUD, and lower alcohol-attributable road traffic mortality.
BACKGROUND AND AIMS: Alcohol-associated liver disease (ALD) is the leading cause of liver-related mortality in Latin America, yet the impact of public health policies (PHP) on liver disease is unknown. We aimed to assess the association between alcohol PHP and deaths due to ALD in Latin American countries. APPROACH AND RESULTS: We performed an ecological multinational study including 20 countries in Latin America (628,466,088 inhabitants). We obtained country-level sociodemographic information from the World Bank Open Data source. Alcohol-related PHP data for countries were obtained from the World Health Organization Global Information System of Alcohol and Health. We constructed generalized linear models to assess the association between the number of PHP (in 2010) and health outcomes (in 2016). In Latin America, the prevalence of obesity was 27% and 26.1% among male and female populations, respectively. The estimated alcohol per capita consumption among the population at 15 years old or older was 6.8 L of pure alcohol (5.6 recorded and 1.2 unrecorded). The overall prevalence of alcohol use disorders (AUD) was 4.9%. ALD was the main cause of cirrhosis in 64.7% of male and 40.0% of female populations. A total of 19 (95%) countries have at least one alcohol-related PHP on alcohol. The most frequent PHP were limiting drinking age (95%), tax regulations (90%), drunk-driving policies and countermeasures (90%), and government monitoring systems and community support (90%). A higher number of PHP was associated with a lower ALD mortality (PR, 0.76; 95% CI, 0.61-0.93; P = 0.009), lower AUD prevalence (PR, 0.80; 95% CI, 0.65-0.99; P = 0.045), and lower alcohol-attributable road traffic deaths (PR, 0.81; 95% CI, 0.65-1.00; P = 0.051). CONCLUSIONS: Our study indicates that in Latin America, countries with higher number of PHP have lower mortality due to ALD, lower prevalence of AUD, and lower alcohol-attributable road traffic mortality.
Authors: Luis Antonio Díaz; Gustavo Ayares; Jorge Arnold; Francisco Idalsoaga; Oscar Corsi; Marco Arrese; Juan Pablo Arab Journal: Curr Treat Options Gastroenterol Date: 2022-06-16