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Published on: February 1, 2012
Regional variation of pediatric inflammatory bowel disease in Saudi Arabia: Results from a multicenter study
Mohammad I El Mouzan1, Mohammed H AlEdreesi2, Mohammed Y Hasosah3
1Department of Pediatrics, Gastroenterology Unit, King Saud University, Riyadh11461, Saudi Arabia. drmouzan@gmail.com.
Insights
Pediatric inflammatory bowel disease (IBD) shows regional variations in Saudi Arabia. Children in the Eastern region present with more severe Crohn's disease (CD) and ulcerative colitis (UC) compared to other areas.
Area of Science:
- Gastroenterology and Hepatology
- Pediatric Medicine
- Epidemiology
Background:
- Inflammatory bowel disease (IBD) incidence and severity vary globally, particularly in Western populations.
- Limited data exist on regional IBD differences in non-Western countries.
- Understanding these variations is crucial for effective healthcare management.
Purpose of the Study:
- To investigate regional disparities in the clinical profiles of pediatric inflammatory bowel disease (IBD) patients within the Kingdom of Saudi Arabia.
- To compare the incidence, trends, and clinical presentations of Crohn's disease (CD) and ulcerative colitis (UC) across different regions.
Main Methods:
- Utilized data from a national multicenter IBD study.
- Analyzed incidence, time trends, and clinical presentation of CD and UC in Central, Western, and Eastern regions.
- Employed Poisson regression and Chi-square tests for statistical analysis.
Main Results:
- No significant regional differences in CD and UC incidence or time trends were observed.
- Children with CD in the Eastern region showed higher rates of abdominal pain, bloody stools, stricturing/penetrating disease, elevated inflammatory markers, anemia, and lower albumin.
- Pediatric UC patients in the Eastern region had higher anemia rates but lower rates of pancolitis.
Conclusions:
- The Eastern region of Saudi Arabia exhibits a more severe presentation of pediatric Crohn's disease.
- Regional variations in IBD severity warrant further investigation.
- Prospective studies are recommended to elucidate the underlying causes of these observed differences.
Background:
Incidence and severity variations of inflammatory bowel disease (IBD) have been reported from Western populations between continents and regions of the same countries. However, no data were available from other countries.
Aim:
To investigate the regional differences in the IBD profiles of pediatric patients from the Kingdom of Saudi Arabia.
Methods:
Data from a national multicenter IBD study were used. The incidence, time trend, and clinical presentation of Crohn's disease (CD) and ulcerative colitis (UC) in the Central region (CR), Western region (WR), and Eastern region (ER) were analyzed and compared. Statistical analysis included Poisson regression analysis for incidence variation and Chi-square test for demographic and clinical parameters. A P < 0.05 was considered significant.
Results:
The prevalence of positive family history was lower in children with CD from the ER than the CR or the WR. Consanguinity rate was higher in children with CD and UC from the CR and the ER, respectively. The incidences and time trends of CD and UC were not significantly different between regions. In the ER, a significantly higher percentage of children with CD presented with abdominal pain (P < 0.001), blood in stools (P = 0.048), stricturing or penetrating disease (P = 0.029), higher erythrocyte sedimentation rate (P < 0.001), higher C-reactive protein (P < 0.001), higher anemia (P = 0.017), and lower albumin level (P = 0.014). For children with UC from the ER, a significantly higher percentage presented with anemia (P = 0.006) and a lower percentage with pancolitis (P < 0.001).
Conclusion:
The most important finding is the identification of significantly more severe presentation of CD in the ER of the Kingdom of Saudi Arabia. Prospective studies are needed to explain such variations.
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