New Clinical Guidelines for Cirrhosis Management Released
Announcement – March 10, 2025
Hepatology Society of Somalia (HSS)
Introduction
The Hepatology Society of Somalia (HSS) has officially released the Updated Clinical Guidelines for the Diagnosis and Management of Cirrhosis, providing Somali clinicians with the most advanced, evidence-based protocols for managing one of the country’s leading causes of liver-related mortality.
These guidelines incorporate the latest international standards from AASLD, EASL, APASL and adapt them for Somalia’s healthcare realities, resource limitations, and epidemiological patterns.
Why These Guidelines Matter
Cirrhosis remains a major public-health concern in Somalia due to the high prevalence of:
- Viral hepatitis B & C
- Alcohol-related liver disease
- Metabolic liver conditions
- Late presentation and limited screening
The new guidelines aim to:
- Improve early detection
- Standardize patient care across all regions
- Reduce complications such as variceal bleeding and HCC
- Promote uniform treatment pathways for clinicians
Key Updates in the New Guidelines
1. Early Diagnosis Protocols
The new guidelines strengthen:
- Screening for patients with chronic hepatitis
- Use of APRI, FIB-4, FibroScan (where available)
- Mandatory ultrasound every 6 months for high-risk patients
2. Simplified Staging of Cirrhosis
Clear definitions for:
- Compensated cirrhosis
- Decompensated cirrhosis
- Acute-on-chronic liver failure (ACLF)
A new algorithm assists clinicians in rapid triage and referral.
3. Variceal Screening & Management
Protocols now include:
- When to use non-selective beta-blockers
- Indications for endoscopy
- Emergency management of variceal bleeding
4. Ascites & Infection Management
Updated recommendations for:
- Ascites grading
- Albumin use
- SBP diagnosis and treatment
- Diuretic-based therapy
5. Hepatic Encephalopathy (HE)
A revised HE scoring tool and step-by-step treatment pathway:
- Lactulose dosing
- Rifaximin use (where available)
- Nutrition guidance
6. Liver Cancer (HCC) Screening
- Mandatory 6-month ultrasound
- AFP testing (optional, based on resources)
- Referral pathways to specialist centers
Somalia-Adapted Clinical Algorithms
The guidelines introduce Somalia-Specific Management Pathways, including:
- Low-resource diagnostic options
- Primary-care-level management flowcharts
- Referral criteria to regional hepatology units
- Emergency management for rural facilities
These tools ensure uniform care even in resource-limited environments.
Training & CME Rollout
HSS will deliver the guidelines through:
- National CME workshops
- Online modules for rural clinicians
- Printed guideline booklets for hospitals
- Somali-language versions (coming soon)
More than 900 healthcare providers are expected to be trained in 2025.
Expert Commentary
Dr. [Name], Chair of the Clinical Guidelines Committee:
“These guidelines reflect the best available science while acknowledging the realities of Somalia’s healthcare system. They will save lives by standardizing care nationwide.”
HSS President:
“This release is a milestone in our mission to improve liver disease outcomes and support clinicians with clear, practical tools.”
Accessing the Guidelines
The full guideline document is available exclusively for HSS members via the official portal:
👉 SomaliaHepatology.org/Guidelines
Hospitals and medical institutions may request printed or digital copies through HSS.
Media & Professional Contact
Hepatology Society of Somalia (HSS)
📍 Mogadishu, Somalia
📧 Info@HSS.org
🌐 SomaliaHepatology.org
