Diverticular Disease in Urban Africans in South Africa

Abstract

At Baragwanath Hospital, Johannesburg, South Africa, during a 3-year period diverticular disease was diagnosed in 42 Black patients (16 men, 26 women), from an urban population approaching 1,5 million. Patients presented mainly with rectal bleeding, abdominal mass or pain. Of average age 62 years, all were among the more privileged. The persisting very low frequency of the disease, which is in consonance with low frequencies of other bowel diseases (appendicitis, ulcerative colitis, colon cancer), is deemed valid. The mean daily dietary fibre intake, 26.5 ± 8.5 g, was higher than that of local Whites, 22.4 ± 6.0 g, but significantly less than that of a sex-age matched urban Black control group, 32.5 ± 11.4 g. Although a measure of westernization of diet has obviously occurred, its extent, also the period of exposure, would seem to have been insufficient to have evoked significant rises in the occurrence of diverticular disease.

An investigation of diverticular disease among black patients undergoing colonoscopy at Dr George Mukhari Academic Hospital, Pretoria, South Africa

“…Prospective studies are recommended to investigate the natural clinical course of the disease in this population group. Segal and Walker, [7] 1982…”

“…These studies do not adequately reflect the socioeconomic and lifestyle changes that have occurred since the country attained democracy in 1994. [7,8] To determine the current prevalence and characteristics of diverticular disease in black South Africans, we retrospectively reviewed colonoscopy reports from the endoscopy suite at Dr George Mukhari Academic Hospital, Pretoria, SA from January to December 2015.…”

“…Segal and Walker [7] and Madiba and Mokoena. [8] Comparisons between age, gender and presenting symptoms are fairly consistent in the three studies.…”

“…These studies are summarised in Table 4. [6][7][8][9]11,12] Whether our findings can be attributed solely to changes in dietary habits and socioeconomic changes is unclear. An additional explanation for such an increased prevalence could be that black patients in SA currently have better access to appropriate, modern diagnostic modalities than before democracy was instituted in 1994.…”

Body Mass Index and Diverticular Disease: A 28-Year Follow-Up Study in Men

“…1 Even so, studies of symptomatic diverticular disease in Africa have shown a rising incidence in increasingly urbanized communities. [13][14][15] Generally, an ageing population and reduced fiber consumption have led to an increase of complicated diverticulitis during the past two decades. 6 However, it should be recognized that diverticular disease includes a wide spectrum of manifestations, from asymptomatic to a lifethreatening condition.…”