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Incidence of pediatric inflammatory bowel disease in Saudi Arabia: a multicenter national study
Mohammad I El Mouzan1, Omar Saadah, Khalid Al-Saleem
11Department of Pediatrics, Division of Gastroenterology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia; 2Department of Pediatrics, Division of Gastroenterology, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia; 3Department of Pediatrics, Division of Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; 4Department of Pediatrics, Division of Gastroenterology, Dhahran Health Center, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia; 5Department of Pediatrics, Division of Gastroenterology, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia; 6Department of Pediatrics, Division of Gastroenterology, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 7Department of Pediatrics, Division of Gastroenterology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia; 8Department of Gastroenterology, Al-Mofarreh Polyclinic, Riyadh, Saudi Arabia; 9Division of Gastroenterology, King Fahad Medical City, Children's Hospital, Riyadh, Saudi Arabia; 10Department of Medicine, Division of Gastroenterology, King Fahd Hospital of the University, University of Dammam, Al Khobar, Saudi Arabia; 11Department of Pediatrics, Division of Gastroenterology, Al-Noor Specialist Hospital, Makkah, Saudi Arabia; 12Division of Gastroenterology, Maternity and Children's Hospital, Madinah, Saudi Arabia; 13Department of Pediatrics, Division of Gastroenterology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; 14Division of Gastroenterology, Maternity and Children's Hospital, Dammam, Saudi Arabia; 15Division of Gastroenterology, Makkah Maternity and Children's Hospital, Makkah, Saudi Arabia; and 16Department of Pediatrics, Division of Gastroenterology, Prince Sultan Military Medical City. Riyadh, Saudi Arabia.
Insights
The incidence of pediatric inflammatory bowel disease (IBD) in Saudi Arabia is rising, particularly in older children, though it remains lower than in Western countries. Further research is needed to understand risk factors.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Inflammatory Bowel Disease (IBD) Research
Background:
- Pediatric inflammatory bowel disease (IBD) recognition is growing in developing nations.
- Data on pediatric IBD incidence and trends in Saudi Arabia were previously unavailable.
Purpose of the Study:
- To determine the incidence and temporal trends of pediatric IBD in Saudi Arabia.
- To compare ulcerative colitis and Crohn's disease incidence across different age groups.
Main Methods:
- Retrospective analysis of 340 children diagnosed with IBD between 2003 and 2012 in Saudi Arabia.
- Data collection included demographics, diagnosis dates, and clinical, laboratory, imaging, endoscopic, and histopathological findings.
- Statistical analysis used descriptive statistics, chi-square tests, and Poisson distribution for incidence and trend analysis.
Main Results:
- The mean incidence rates per 100,000 were 0.2 for ulcerative colitis, 0.27 for Crohn's disease, and 0.47 for overall IBD.
- A significant increasing trend in pediatric IBD incidence was observed over time, except in the 0-4 year age group.
- Incidence rates were lower than those reported in Western literature.
Conclusions:
- Pediatric IBD incidence in Saudi Arabia shows a significant upward trend, despite being lower than Western rates.
- A decreasing incidence trend was noted in the youngest age group (0-4 years).
- Prospective studies are recommended to identify specific risk factors for pediatric IBD in various age demographics.
Background:
Pediatric inflammatory bowel disease (IBD) is increasingly recognized in developing countries; however, the incidence and trend over time have not been reported.
Methods:
This retrospective study included children diagnosed with IBD in gastroenterology centers in the Kingdom of Saudi Arabia between 2003 and 2012. The date of birth, date and age at diagnosis, gender, and final diagnosis were collected on special forms. Clinical, laboratory, imaging, endoscopy, and histopathology results were reviewed to confirm the final diagnosis. Descriptive statistics were used to compare ulcerative colitis and Crohn's disease in different age groups, and significance was assessed by the chi-square test. Incidence rates and trend over time were analyzed with the assumption of Poisson distribution. The incidence rate over time was compared in 2 periods (2003-2007 and 2008-2012). A P value of <0.05 and 95% confidence intervals were used to assess the significance and precision of the estimates.
Results:
A total of 340 Saudi Arabian children aged 0 to 14 years were diagnosed. The mean incidence rate per 100,000 individuals was 0.2, 0.27, and 0.47 for ulcerative colitis, Crohn's disease, and IBD, respectively. Except for the 0- to 4-year age group, there was a significant increase in incidence over time.
Conclusions:
Although the incidence of pediatric IBD in Saudi Arabian children is lower than suggested in the Western literature, there is a significantly increasing trend over time. However, decreased trend in the younger age group over time is identified. Prospective studies will be important to identify the risk factors for IBD in different age groups.
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