Diagnostic delay of pediatric inflammatory bowel disease in Saudi Arabia

Mouzan, Mohammad I. El; AlSaleem, Badr; Hasosah, Mohammed; Al–Hussaini, Abdulrahman; Anazi, Aziz H Al; Saadah, Omar I.; Sarkhy, Ahmed Al; Mofarreh, Mohammad Al; Assiri, Asaad

doi:10.4103/sjg.sjg_457_18

Cited by 29 publications

(31 citation statements)

References 19 publications

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“…Our study shows that TD in pediatric IBD in Spain is longer for CD than for UC, as it has been observed in pediatric and adult series from other countries (3,5,(9)(10)(11)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). It has also been demonstrated that the majority of this delay is generated in the timespan from the first consultation with a physician, who is usually the PCP, to the referral to PG.…”

Section: Discussionsupporting

confidence: 78%

Spanish Pediatric Inflammatory Bowel Disease Diagnostic Delay Registry: SPIDER Study From Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica

et al. 2020

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Background and Aims: Diagnostic delay (DD) is especially relevant in children with inflammatory bowel disease, leading to potential complications. We examined the intervals and factors for DD in the pediatric population of Spain. Methods: We conducted a multicentric prospective study, including 149 pediatric inflammatory bowel disease patients, obtaining clinical, anthropometric, and biochemical data. Time to diagnosis (TD) was divided into several intervals to identify those where the Jiménez Treviño et al. Pediatric IBD Diagnostic Delay in Spain DD was longer and find the variables that prolonged those intervals. Missed opportunities for diagnosis (MODs) were also identified. Results: Overall TD was 4.4 months (interquartile range [IQR] 2.6-10.4), being significantly higher in Crohn's disease (CD) than in ulcerative colitis (UC) (6.3 [IQR 3.3-12.3] vs. 3 [IQR 1.6-5.6] months, p = 0.0001). Time from the visit to the first physician until referral to a pediatric gastroenterologist was the main contributor to TD (2.4 months [IQR 1.03-7.17] in CD vs. 0.83 months [IQR 0.30-2.50] in UC, p = 0.0001). One hundred and ten patients (78.3%) visited more than one physician (29.9% to 4 or more), and 16.3% visited the same physician more than six times before being assessed by the pediatric gastroenterologist. The number of MODs was significantly higher in CD than that in UC patients: 4 MODs (IQR 2-7) vs. 2 MODs ([IQR 1-5], p = 0.003). Referral by pediatricians from hospital care allowed earlier IBD diagnosis (odds ratio 3.2 [95% confidence interval 1.1-8.9], p = 0.025). Conclusions: TD and DD were significantly higher in CD than those in UC. IBD patients (especially those with CD) undergo a large number of medical visits until the final diagnosis.

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Section: Discussionsupporting

confidence: 78%

Spanish Pediatric Inflammatory Bowel Disease Diagnostic Delay Registry: SPIDER Study From Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica

et al. 2020

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“…Ileal disease (L1) was predictive of longer diagnostic delay ( > 50th percentile) in CD. 38 This is in sharp contrast to the EPIMAD study where diagnostic delay > 6 months were seen in only 27% and 30% patients respectively in VEOIBD and LO-PIBD. 32 The disproportionately longer delay in diagnosis could be attributable to poor physician awareness of pediatric IBD in India and high percentage of ileal (31.4%) disease in our study which is a known risk factor for diagnostic delay in pediatric CD.…”

Section: Discussionmentioning

confidence: 64%

Very early onset inflammatory bowel disease in a South Asian country where inflammatory bowel disease is emerging: a distinct clinical phenotype from later onset disease

et al. 2021

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cluding a severe and aggressive course of disease, predominant colonic involvement and a higher incidence of familial IBD compared to PIBD other than VEOIBD (6-17 years). 1 The incidence of PIBD is on the rise globally. 2 A complex interplay of genetic and changing environmental factors has been implicated for the rising incidence although specific factors are yet to be completely understood. 2-6 Most of the epidemiological data however are from the West including North America, Canada, and Europe. 3 A few recent studies from Asia also suggest a rising trend of PIBD. Interestingly the phenotype appears to be distinct from that of the West including a milder ulcerative colitis (UC) and a higher perianal

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“…Early diagnosis and management of IBD can reduce the severity of symptoms and the incidence of complications [7]. Nonethless, delayed diagnosis is well recognized in IBD and is associated with signi cant complications [8,9]. Diagnostic delay, which prolongs the disease duration, in addition affects the response to therapy.…”

Section: Introductionmentioning

confidence: 99%

A Regional Survey of Awareness of Inflammatory Bowel Disease among the Saudi Population

Meeralam¹,

Zanabgi²,

Mahmoud³

et al. 2020

Preprint

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Background: Inflammatory bowel disease (IBD) is common among different age groups worldwide, Including the gulf region. It is categorized into Crohn's disease and Ulcerative colitis. Early diagnosis and treatment of inflammatory bowel disease can improve patients' outcomes and reduce the incidence of complications. However, early diagnosis is highly dependent on patients' awareness of the disease to seek medical advice. This study aims to survey the awareness IBD in the general population of the western region of Saudi Arabia. Methods: A self-administered structured questionnaire was translated into Arabic and distributed to the general public above 16 years old. The questionnaire included questions about Crohn's disease and Ulcerative colitis and their treatment, in addition to the respondents' demographic data. Results: 1304 participants responded to this survey. 29% had not heard or read about Crohn's disease, while 19% of the responders had not heard or read about Ulcerative colitis. The mean awareness level score was 1.72±1.19, with a minimum score of 0 and a maximum score of 3. Females showed a significantly higher average score compared to males (p-value < 0.001). Also, the age group between 31 to 40 had the highest average score (p value=0.002). Moreover, responders, who had a Ph.D., showed significantly higher mean scores than the other educational degrees (p value<0.001). Responders who dealt with Crohn's disease patient or ulcerative colitis patients, showed significantly higher scores than their peers, with p values < 0.001 for bothConclusion: The general population in Saudi Arabia has an unacceptable level of awareness of inflammatory bowel disease. Males, young adults, highly educated individuals who dealt with patients previously had better awareness compared to the rest of the population. National acts are essential to improve public awareness towards the disease.

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Diagnostic delay of pediatric inflammatory bowel disease in Saudi Arabia

Cited by 29 publications

References 19 publications

Spanish Pediatric Inflammatory Bowel Disease Diagnostic Delay Registry: SPIDER Study From Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica

Spanish Pediatric Inflammatory Bowel Disease Diagnostic Delay Registry: SPIDER Study From Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica

Very early onset inflammatory bowel disease in a South Asian country where inflammatory bowel disease is emerging: a distinct clinical phenotype from later onset disease

A Regional Survey of Awareness of Inflammatory Bowel Disease among the Saudi Population

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