Jaundice in African Adults: Causes, Symptoms, and Treatment

Michelle B. Abebrese, MD. DLHA Volunteer and Freelance Health Writer. Medically reviewed by A. Odutola, MB BS, PhD, FRCSEd

Published: December 29, 2025.

 A black male doctor examining the eyes of a man with yellowish dicolouration of the eyes. AI image generated from ChatGPT

 

Highlights

• Jaundice is a symptom, not a disease—it may signal disorders that cause excess accumulation of a skin discolouration pigment, called bilirubin, in the bloodstream.

• The common causes of jaundice can be grouped under conditions occurring before the liver (pre-hepatic), in the liver (hepatic) and after the liver (post-hepatic).

• Key warning signs of jaundice include yellow eyes, dark urine, pale stool, fatigue, abdominal pain, nausea, and itchy skin.

• Diagnosis relies on history taking, physical examination, and some tests.

• Treatment is directed at the root cause.

• Prevention is possible through hepatitis B vaccination, malaria control, avoiding excessive alcohol, safe water, and proper food storage.

 

Introduction

Jaundice is a yellowing of the skin and eyes (icterus) and it is a visible sign of underlying liver or blood problems. 

Jaundice is not a disease by itself, but rather a visible indication that something is wrong in the body - particularly with the liver or blood. It happens when too much bilirubin, a yellow pigment, builds up in the blood. Normally, the liver processes and removes much of the bilirubin that occurs after breaking down old red blood cells.

The aim of this article is to explain what jaundice is, why it occurs, and how problems in the liver or blood lead to the buildup of bilirubin that causes the yellow discoloration of the skin and eyes. The article also seeks to help readers recognize jaundice as an important warning sign, and appreciate why timely medical evaluation is essential.

 

How does jaundice occur?

Jaundice occurs commonly when any of these events happen:

• Red blood cells are broken down rapidly or excessively
• The liver is damaged
• The bile duct (the tube that drains liver products into the first part of the small bowel) is blocked.

Image showing the liver, biliary tree and the common bile duct in the human body. Click on image to enlarge

 

What are the common causes of jaundice in African adults?

Info poster illustrating causes of jaundice by origin. Click on image to enlarge

 

In Africa, several preventable and treatable conditions can lead to jaundice. These can are grouped into prehepatic, hepatic and post hepatic. 

Prehepatic causes: 

• Severe malaria, caused mainly by Plasmodium falciparum, can destroy red blood cells, leading to hemolytic jaundice. This is why some malaria patients develop yellow eyes during severe infection.
• Genetic conditions like sickle cell disease, enzyme deficiency disease like G6PD  and other blood destroying disorders: Many Africans carry genes for sickle cell disease, which causes frequent red blood cell breakdown and, consequently, high bilirubin levels.
• Other acquired blood destroying conditions like autoimmune haemolytic anaemia, blood transfusion reaction, etc.

Hepatic causes:  

• Viral Hepatitis (A, B, and E): Hepatitis - especially hepatitis B and E - is a major cause of liver inflammation in Africa. Chronic hepatitis B infection can damage the liver to cause a chronic condition known as liver cirrhosis, or liver cancer, both of which often present with jaundice.
• Alcoholic and Non-Alcoholic Fatty Liver Disease: Urban lifestyles, poor diet, and alcohol misuse are rising across the continent. These contribute to fatty liver disease and alcohol-induced liver injury, both common triggers for jaundice as a result of liver cirrhosis.
• Liver Cancer: Primary liver cancer is common in parts of Africa due to chronic hepatitis B infection and exposure to aflatoxins - toxic substances found in moldy grains or groundnuts.

Aflatoxins are the by-product from a mold related fungus (germ) called Aspergillus spp. in crops in fields or storage. Mostly found in dried fruits, groundnuts, and maize. Aflatoxin is toxic and has been identified as a cause of cancer 

Post-hepatic:

Gallstones and Bile Duct Blockages: Gallstones or tumors can block bile flow, causing obstructive jaundice. This type often needs surgical treatment.

Studies on the common specific causes of jaundice in several African countries are limited, but one hospital based study in a tertiary hospital identified the following as common causes of jaundice in Togo:

• Liver cirrhosis (51.36%)
• Liver cancer or hepatocarcinoma (29.09%)
• Biliary lithiasis (stones) (5.45%)
• Malaria (3.64%)
• Acute hepatonephritis – infection of the liver and kidneys (3.18%)
• Liver metastases or secondary liver cancer (2.73%),
• HIV infection (1.82%)
• Pancreatic cancer (0.91%)

It is unclear if this burden reflects what applies in other African countries. More studies are needed for clarification.

 

How to recognise the symptoms of jaundice

Infographic showing key symptoms of jaundice — yellow eyes, dark urine, pale stool, fatigue. An AI generated image from DeeVid. Click on image to enlarge.

 

The most obvious symptom is yellowing of the skin and eyes, but other warning signs that may suggest the origin of the jaundice often appear, including:

• Dark or tea-colored urine
• Pale or clay-colored stool
• Fatigue and weakness
• Abdominal pain or swelling (especially on the right side)
• Nausea and vomiting
• Itchy skin

If symptoms like confusion, swelling of the legs, or vomiting blood occur, it may indicate liver failure, a medical emergency.

 

How is jaundice diagnosed?

Photo of a doctor explaining liver test results to a patient in a clinic.  AI image generated from ChatGPT. Click on image to enlarge.

 

The diagnosis of jaundice and identification of its cause should be left to your doctor.

To make a diagnosis, your doctor will start by asking for your complaints and detailed medical history. This is followed with a complete physical examination of your body and requests for blood tests to check your bilirubin levels in blood and liver function. Other tests may include:

• Ultrasound or CT scans to check for blockages or tumors
• Viral screening for hepatitis A, B, or E
• Blood counts to detect red blood cell destruction (hemolysis)

Early diagnosis is essential to identify the cause and start treatment before serious damage occurs.

Some laboratory tests that your doctor may request for include:

• Bilirubin
• Aspartate Aminotransferase (AST)
• Alanine Aminotransferase ( ALT)
• Alkaline Phosphatase (ALP)
• Gamma/Glutamyl Transferase (GGT)

These tests may help to locate the source of the cause of your jaundice.

Bilirubin comes in two forms:

• Direct (processed by the liver) and
• Indirect (not yet processed)

High indirect bilirubin points to blood breakdown problems, while high direct bilirubin suggests liver or bile duct issues.

AST & ALT are liver enzymes; ALT is more liver-specific. When these rise- especially ALT - it usually means the liver cells are inflamed or injured, like in hepatitis, alcohol damage, or fatty liver.

ALP & GGT rise when there is problem with bile flow. High ALP together with high GGT often means a blockage in the bile ducts (e.g., gallstones)

 

How is jaundice treated?

An info-poster showing treatment steps for jaundice. This commonly involves medications, including intravenous (IV) fluids, and liver-friendly foods. Click on image to enlarge.

 

There is no one-size-fits-all treatment for jaundice. Management depends on the underlying cause. Here are some considerations:

• Hepatitis-related jaundice: Antiviral therapy, rest, and hydration.
• Malaria-related jaundice: Prompt use of effective antimalarial drugs and symptomatic therapy.
• Gallstones or bile duct blockage: Surgery or endoscopic procedures may be needed.
• Sickle cell-related jaundice: Blood transfusions, hydration, and infection prevention.
• Alcoholic or fatty liver disease: Avoid alcohol, improve diet, and encourage lifestyle changes.

In advanced cases, hospitalization or referral to a liver specialist (hepatologist) may be required.

 

Jaundice prevention and community awareness raising

 Photo of female and male community health workers educating a group of African women in an outdoor shed on hepatitis and how to prevent jaundice. AI image generated from ChatGPT. Click on image to enarge.

 

Most causes of jaundice in African adults are preventable. Key prevention steps include:

• Vaccination against hepatitis B
• Drinking safe water and maintaining good hygiene
• Early malaria treatment and prevention (use of treated mosquito nets and mosquito repellent, citronella grass)
• Avoiding excessive alcohol consumption
• Proper food storage to prevent aflatoxin contamination

Public health education is critical. In many African countries, many people still associate jaundice with spiritual causes or traditional beliefs, which causes delay in seeking medical attention. 

 

 Conclusion

Photo of a smiling African doctor with a patient, symbolising professional support in aid of hope and recovery for the patient’s condition. AI image generated from ChatGPT. Click on iamge to enlarge.

 

Jaundice is a warning sign that should never be ignored. Whether it’s due to severe malaria, sickle cell disease, hepatitis, or blockage of the biliary pathways, early diagnosis and treatment are crucial.

In Africa, where infections and lifestyle diseases coexist, community education and preventive healthcare remain the best defense.

By getting educated about the common causes and early warning signs of jaundice, Africans will more likely seek medical help early. Doing so will help to reduce the effects of the causes of jaundice on general health in African communities.    

 

Resources:

1. Bagny A, Kogoe LR, Redah DV, Lawson ALM, Bouglouga O, El Hadji YR, Kaaga LY. Jaundice in tropical Africa: Epidemiological, clinical and diagnostic features. World Journal of Advanced Research and Reviews, 2020, 07(01), 174–177. Doi: 10.30574/wjarr.2020.7.1.0243. Available from here.

2. Paruk IM, Pirie FJ, Motala AA. Non-alcoholic fatty liver disease in Africa: a hidden danger. Glob Health Epidemiol Genom. 2019 Apr 12;4:e3. doi: 10.1017/gheg.2019.2. Available from here.  

3. National Cancer Institute (NIH). Aflatoxins. [Internet]. Last updated July 3, 2024. [Cited Dec. 18, 2025’]. Available from here.

4. Munghieng TN. Sickle cell disease: Essential information for Africans. Last updated Dec. 15, 2025. Datelinehealth Africa. [Cited Dec. 18, 2025] Available from here.

5, World Health Organization. Hepatitis [Internet. n.d.] WHO Regional Office for Africa. {Cited Dec 5, 2025]. Available from here.

 

 

Published: December 29, 2025

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