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Pediatric Crohn's Disease in Bahrain
Hasan M Isa1, Afaf M Mohamed2, Halima E Al-Jowder1
1Pediatric Department, Salmaniya Medical Complex, Arabian Gulf University, Manama, Bahrain.
Insights
Pediatric Crohn's disease (CD) incidence is rising in Bahrain, with clinical features similar to global trends. This study details CD epidemiology, presentation, and management in Bahraini children.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Epidemiology
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) with increasing global prevalence.
- Understanding the epidemiology and clinical characteristics of pediatric CD is crucial for effective management.
Purpose of the Study:
- To investigate the epidemiology, clinical presentations, diagnostic and therapeutic strategies, and outcomes of pediatric Crohn's disease in Bahrain.
- To establish baseline data for pediatric CD in the region.
Main Methods:
- Retrospective review of medical records of pediatric patients diagnosed with CD from 1984 to 2017.
- Analysis of demographic data, clinical features, diagnostic findings, treatments, and patient outcomes.
- Calculation of annual incidence and cumulative prevalence rates.
Main Results:
- Out of 108 pediatric IBD cases, 51 (47.2%) were diagnosed with CD.
- Annual incidence showed a significant rise over three decades (p=0.0001), with a prevalence of 9.32 per 100,000 children.
- Common symptoms included abdominal pain and weight loss; terminal ileum and colon were frequently involved.
Conclusions:
- Pediatric Crohn's disease in Bahrain exhibits clinical characteristics comparable to international and regional data.
- The study highlights a concerning increase in pediatric CD incidence over time in Bahrain.
Objectives:
Our study aimed to report the epidemiology, clinical presentations, diagnostic and therapeutic approaches, and outcomes of Crohn's disease (CD) in pediatric patients in Bahrain.
Methods:
We conducted a retrospective review of the medical records of patients with CD diagnosed in the pediatric department, Salmaniya Medical Complex, Bahrain, between 1984 and 2017. We used the data to calculate the annual incidence and cumulative prevalence. Data about gender, nationality, clinical presentation, age at presentation and diagnosis, duration of illness, consanguinity, family history, contact with smokers, and comorbidities were gathered. Results of hematological, biochemical, and serological tests were also collected. All radiological, endoscopic, and histopathological findings were reviewed. Data about medical therapy, relapse episodes, hospital admissions, complications, and outcomes were collected.
Results:
Of 108 pediatric patients diagnosed with inflammatory bowel disease (IBD), 51 (47.2%) patients had CD. The annual incidence was 1 in 100 000 per year (range = 0-5 patients/year) with significant rise on comparing the three decades (p = 0.0001). Prevalence was 9.32 patients per 100 000 pediatric populations. Thirty-four patients (66.7%) were males, and the median age was 18.5 years (range = 6.4-35.0). Common clinical presentations were recurrent abdominal pain and weight loss. Family history of IBD was found in 10 patients. One patient had positive antineutrophil cytoplasmic antibody. The terminal ileum was involved in 68.1%, colon in 63.8%, and perianal area in 17.0% patients. Biological therapy was used in five patients. Surgical intervention was required in six patients. The mean follow-up period was 9.2±5.6 years.
Conclusions:
The clinical characteristics of our population are comparable to that reported in neighboring countries and worldwide.