Epidemiology, Natural History, and Treatment of Inflammatory Bowel Disease in Africa: A Scoping Review

Inflammatory bowel diseases (IBD), Crohn's disease and ulcerative colitis, are global diseases. There is a paucity of knowledge about the burden and epidemiology of IBD in Africa. We performed a scoping review of the published literature on IBD in Africa to identify burden, risk factors, and outcomes as well as knowledge gaps.

A comprehensive search was conducted in MEDLINE, Embase, Web of Science, AIM, Africa Wide, Cochrane, and ClinicalTrials.gov in November 2024. Studies were screened and selected based on predefined inclusion criteria. Data extraction was conducted using Covidence. Literature was summarized focusing on the incidence and prevalence, environmental factors, diagnosis, outcomes, and management of IBD.

Of 6896 references identified, a total of 268 studies met inclusion criteria. This included data from 21,089 patients with IBD (10,426 Crohn's disease; 7956 ulcerative colitis; 329 unspecified IBD; 2378 uncategorized IBD). There were few studies examining temporal incidence of IBD; in the sparse available data, a similar increase was notable as seen in the West. Studies of genetics and environment revealed many shared findings from known associations from Western cohorts (such as environmental hygiene) but highlight some differences as well. Use of biologic or advanced therapy was sparse.

We identified a paucity of publications regarding the risk factors, burden, and outcomes of IBD in Africa. There were few prospective studies and regional variations in representation. There is a need for more prospective data to inform our knowledge and management strategies accurately.