Egyptian Liver Library: Rebuilding the Pyramid of Liver Disease Evidence in Egypt

Egypt is considered one of the countries with large liver disease burden in the world being endemic with bilharziasis and hepatitis C for decades. Limitations in health care resource further augment the magnitude of the problem allowing the development of disease specific complications in absence of effective treatments over the past. With discovery of anti-schistosomal therapy and implementation of the national program for eliminating bilharziasis; bilharzial liver disease incidence regressed markedly. However; complications of bilharzial liver disease are still present. The situation has been repeated with hepatitis C which is still a major health problem in Egypt regardless of the availability of highly effective interferon free antiviral regimens. This is mainly due to the large number of infected patients (estimated to be more than 6 million) [1], re-infection and presence of complications that needs further management. The need for addressing these major health problems in Egypt provoked a lot of research in the field of hepatology. Egyptian and non-Egyptian researchers have published a lot of scientific reports about liver diseases in Egypt. Since the ancient age of the pharaohs there were written evidence about liver disease in Egypt. It was reported in the Ebres Papyrus (around 2600 BC) that hardness of the liver occurs secondary to excess alcohol ingestion [2]. This was one of the oldest documented detailed medical literatures in the history of mankind. In the recent age there were a lot reports from Egypt about bilharziasis and other parasitic infestations as the one published by Cobbold in 1982 about injurious parasites in Egypt [3]. Further enormous amount of publications has been released afterwards. Reviewing this evidence and creating an indexed data base for it could be of value for the national and international hepatology platforms. I aim with other colleagues at reviewing all published evidence in the field of hepatology from Egypt up to January 2016 and classifying it by different key words to build a data base of liver disease evidence in Egypt. This data base will be continuously updated by published data after January 1st 2016 and will be the reference for researchers from Egypt and rest of the world. The data base will invite all authors from Egypt to provide their raw data of published articles to be available for further analyses by other researchers. Moreover the data base work team will start a series of systematic reviews and meta analyses for the available relevant data aiming at addressing the areas of strength and areas of weakness in liver disease research in Egypt making further recommendations to the research authorities about what is missing and how it is better to be addressed in their future research calls. This pilot research work can be reproduced elsewhere by other researchers in their own countries making use of their published data and advising their local research authorities to fill up the gaps in liver research in their own countries. Hopefully in the near future we will have these groups working together in a network driving liver research globally.