Inflammatory bowel disease epidemiology in São Paulo State, Brazil

Abstract

PurposeThis study aimed to estimate the incidence and prevalence of inflammatory bowel disease (IBD) in São Paulo, Brazil, for 2012–2015.Patients and methods:This observational, descriptive, and cross-sectional study included 22,638 IBD patients out of 43,046,555 inhabitants, who had initiated their treatment through the Governmental Program of the Brazilian Unified National Health System between the years of 2012 and 2015. The onset of the disease (used to determine incidence) was established as the date of the patient’s initial registration in the Governmental Program with a diagnosis for Crohn’s disease (CD) or ulcerative colitis (UC). Every patient registered in the system as of December 2015 was included in determining the prevalence. The demographic and clinical data, such as age and sex, were collected for each patient. Statistical analysis included mean and SD, absolute and percentage frequencies, and Pearson’s chi-squared test (c2). The incidence and prevalence rates were calculated based on the estimated annual population of the State of São Paulo.ResultsThe study population consisted of 10,451 (46.16%) CD patients and 12,187 (53.84%) UC patients. The mean age was 42.66 (SD±16.2) years for the CD group and 47.87 (SD±16.6) years for the UC group. There was a predominance of females corresponding to 59.70% of the study population (female:male =1.48:1.00; P<0.0001). The incidence of IBD was 13.30 new cases/100,000 inhabitants per year, while the overall prevalence was 52.6 cases/100,000 inhabitants.ConclusionThis population-based study demonstrated a stability in IBD incidence rates and an increase in IBD prevalence rates in São Paulo state between 2012 and 2015. The IBD incidence and prevalence rates were comparable to European countries, with a higher occurrence in the female participants.

Real-world disease activity and sociodemographic, clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil

“…Although UC is more prevalent than CD in most LA countries[ 28 ], including Brazil[ 10 , 12 , 13 , 29 ], we found a predominance of CD compared to UC, both overall and by region. Nevertheless, our findings are aligned with the CD and UC prevalence (24.1 and 14.1/100000, respectively) reported in a systematic review from LA[ 11 ] and those reported in a recent epidemiological characterization of 579 IBD patients from a Southeastern Brazilian tertiary care center, which found a CD prevalence of 56.1%[ 30 ].…”

“…In addition, the incidence of IBD in Brazil was estimated at 0.08 per 100000 inhabitants in 1988, but the CD incidence rose from 0.68 (1991-1995) to 3.5 (2001-2005), being observed a peak incidence of 5.5 per 100000 inhabitants in 2015[ 11 ]. The same trend can be observed at a regional level, with Sao Paulo State showing the highest IBD incidence when compared to other areas of Brazil[ 12 - 14 ].…”

“…Sao Paulo, which is located in the SE, is the most developed state in Brazil, with higher economic activity and greater opportunities for employment. Based on public health system records from 2012-2015, the state of Sao Paulo recorded the highest IBD incidence, namely, 6.14 and 7.16 per 100000 inhabitants/year for CD and UC, respectively[ 12 ].…”

Cholinergic immunomodulation in inflammatory bowel diseases

“…Since individuals with low levels of D vitamin show an increased risk of developing IBD, and D vitamin synthesis is consequent to UV-B exposure (which is highly sensitive to the scattering caused by air particulate and pollutants), this might justify the increased risk of IBD in individuals living in urban settings in highly industrialized countries ( Ananthakrishnan et al., 2012 ; Kimlin et al., 2007 ; MacLaughlin et al., 1982 ; Ng et al., 2019 ; Piovani et al., 2019 ). Accordingly, epidemiologic studies in Brazil reported that the most developed, higher economy activity state also presented the highest IBD incidence rate, comparable to European countries such as Portugal and Ireland ( Gasparini et al., 2018 ; Zaltman et al., 2021 ). Nevertheless, the incidence of IBD is increasing in several low income countries throughout Latin America and the Caribbean ( Kotze et al., 2020 ).…”

Retocolite ulcerativa e citocinas: uma revisão da literatura

“…A incidência de DIIs foi de 13,30 novos casos / 100.000 hab./ano, enquanto a prevalência geral foi de 52,6 casos / 100.000 hab. (Gasparini, Sassaki & Saad-Hossne, 2018). No Espírito Santo-ES foram avaliados pacientes com DII de 2012 a 2014 e observou-se a incidência de DII foi de 7,7/100.000 hab./ano (RCU: 5,3/100.000 hab./ano) e prevalência de 38,2/100.000 hab., com maior percentual de RCU (24,1/100.000 hab.)…”