Epidemiology of inflammatory bowel disease in Mexico and Colombia: Analysis of health databases, mathematical modelling and a case-series study

Abstract

Background and aims Ulcerative Colitis (UC) and Crohn's Disease (CD) have a major impact on quality of life and medical costs. The aim of the study was to estimate the prevalence, incidence and clinical phenotypes of Inflammatory Bowel Disease (IBD) cases in Mexico and Colombia. Methods We analyzed official administrative and health databases, used mathematical modelling to estimate the incidence and complete prevalence, and performed a case-series of IBD patients at a referral center both in Mexico and Colombia. Results The age-adjusted complete prevalence of UC per 100,000 inhabitants for 2015/2016 ranged from 15.65 to 71.19 in Mexico and from 27.40 to 69.97 in Colombia depending on the model considered. The prevalence of CD per 100,000 inhabitants in Mexico ranged from 15.45 to 18.08 and from 16.75 to 18.43 in Colombia. In Mexico, the age-adjusted incidence of UC per 100,000 inhabitants per year ranged from 0.90 to 2.30, and from 0.55 to 2.33 in Colombia. The incidence for CD in Mexico ranged from 0.35 to 0.66 whereas in Colombia, the age-adjusted incidence of CD ranged from 0.30 to 0.57. The case-series included 200 IBD patients from Mexico and 204 patients from Colombia.

Clinical differentiation of inflammatory bowel disease (IBD) in Latin America and the Caribbean

“…Environmental factors, such as socioeconomic status, exposure to infections, abuse of antibiotics, and poor hygiene, might help explain the epidemiological differences between populations. [ 31 , 32 ]…”

“…These findings support the notion that IBD is a heterogeneous entity in both Latin America and the Caribbean. Environmental factors, such as socioeconomic status, exposure to infections, abuse of antibiotics, and poor hygiene, might help explain the epidemiological differences between populations [31,32] …”

Características de la enfermedad inflamatoria intestinal con respecto a otros centros nacionales de Colombia

“…Entender las diferencias de presentación de la EII entre las diversas regiones geográficas es importante debido al impacto en la carga que tiene la enfermedad en los sistemas de salud, así como para establecer las estrategias de prevención y tratamiento adecuadas. La incidencia y prevalencia en los países en desarrollo está aumentando constantemente y se ha atribuido a la rápida occidentalización de la población (5) . Colombia hace parte de los países latinoamericanos con un aumento significativo de la prevalencia e incidencia, en el contexto de los países en desarrollo (6) .…”

“…A pesar de esto, en las últimas dos décadas, los estudios epidemiológicos han demostrado un rápido aumento en la incidencia de EII en países del Medio Oriente, Asia y Suramérica (3) . Existen estudios que demuestran una disminución de EII en Norteamérica (4) , mientras que la incidencia de la EII ha aumentado significativamente en Latinoamérica en los últimos 21 años (5) .…”

Cost Effectiveness of Tofacitinib for the Treatment of Moderate to Severe Active Ulcerative Colitis in Colombia

“…One study in Colombia estimated a period of 9.2 months to establish a diagnosis of UC after the onset of symptoms [ 7 ]. According to observational studies in Colombia [ 6 , 8 , 9 ], the majority of UC patients receive 5-aminosalicylates, systemic or topical corticosteroids, azathioprine (immunosuppressants), and biological drugs such as antitumor necrosis factor (anti-TNF) agents (infliximab, adalimumab and golimumab). Anti-adhesion molecules (vedolizumab) are the most commonly used and surgery is considered in a few clinical scenarios [ 6 ].…”