Inflammatory Bowel Disease in Latin America: A Systematic Review. 2018

María Calderón, and Nicole Minckas, and Solange Nuñez, and Agustín Ciapponi
Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina; London School of Hygiene and Tropical Medicine, London, UK. Electronic address: mcalderon@iecs.org.ar.

BACKGROUND Inflammatory bowel disease (IBD) is the name given to two inflammatory diseases of the colon and/or small intestine: Crohn disease (CD) and ulcerative colitis (UC). There is no information summarizing the complete body of evidence about IBD in developing regions, including Latin America. OBJECTIVE To estimate the burden of IBD in Latin America. METHODS We conducted a systematic review searching published and unpublished studies on major international and regional databases from January 2000 to September 2015. Outcomes considered were incidence, prevalence, mortality, hospitalization attributable, treatment patterns, comparative effectiveness, patient-reported outcomes, and adherence to treatment. Pairs of reviewers independently selected, extracted, and assessed the risk of bias of the studies. Discrepancies were solved by consensus. RESULTS We retrieved 3445 references, finally including 25 studies. Only 19% of the observational studies had a low risk of bias for participant selection and 60% were based on registries. The incidence ranged from 0.74 to 6.76/100,000 person-years for UC and from 0.24 to 3.5/100,000 person-years for CD. The prevalence rate ranged from 0.99 to 44.3/100,000 inhabitants for UC and 0.24 to 16.7/100,000 inhabitants for CD. Mortality rates ranged from 0.60 to 1.02 for UC and from 0.23 to 0.40 for CD. Patient-reported outcomes showed a decrease in quality of life associated with depression and anxiety and correlated with the time of diagnosis. The most frequently used medication in the studies was mesalazine. CONCLUSIONS The burden of IBD in Latin America seems to be important, but there is a considerable gap of high-quality evidence in the region.

UI MeSH Term Description Entries
D007843 Latin America The geographic area of Mexico, Central America, continent of South America and the islands of the Caribbean where Spanish or other Romance language is spoken.
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D003906 Developing Countries Countries in the process of change with economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. LMICs,Less-Developed Countries,Low Income Countries,Low and Middle Income Countries,Lower-Middle-Income Country,Middle Income Countries,Third-World Countries,Under-Developed Countries,Developing Nations,Least Developed Countries,Less-Developed Nations,Third-World Nations,Under-Developed Nations,Countries, Middle Income,Countries, Third-World,Country, Least Developed,Country, Less-Developed,Country, Low Income,Country, Lower-Middle-Income,Country, Middle Income,Country, Third-World,Country, Under-Developed,Developed Country, Least,Developing Country,Developing Nation,Least Developed Country,Less Developed Countries,Less Developed Nations,Less-Developed Country,Less-Developed Nation,Low Income Country,Lower Middle Income Country,Lower-Middle-Income Countries,Middle Income Country,Nation, Less-Developed,Nation, Third-World,Nation, Under-Developed,Third World Countries,Third World Nations,Third-World Country,Third-World Nation,Under Developed Countries,Under Developed Nations,Under-Developed Country,Under-Developed Nation
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015212 Inflammatory Bowel Diseases Chronic, non-specific inflammation of the GASTROINTESTINAL TRACT. Etiology may be genetic or environmental. This term includes CROHN DISEASE and ULCERATIVE COLITIS. Bowel Diseases, Inflammatory,Inflammatory Bowel Disease
D015994 Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases in the population at a given time. Attack Rate,Cumulative Incidence,Incidence Proportion,Incidence Rate,Person-time Rate,Secondary Attack Rate,Attack Rate, Secondary,Attack Rates,Cumulative Incidences,Incidence Proportions,Incidence Rates,Incidence, Cumulative,Incidences,Person time Rate,Person-time Rates,Proportion, Incidence,Rate, Attack,Rate, Incidence,Rate, Person-time,Rate, Secondary Attack,Secondary Attack Rates
D017281 Cost of Illness The personal cost of disease which may be economic, social, or psychological. The cost of illness may be reflected in absenteeism, productivity, response to treatment, peace of mind, or QUALITY OF LIFE. It differs from HEALTH CARE COSTS, the societal cost of providing services related to the delivery of health care. Burden Of Disease,Burden of Illness,Disease Burden,Disease Costs,Cost of Disease,Cost of Sickness,Costs of Disease,Disease Cost,Economic Burden of Disease,Sickness Cost,Burden Of Diseases,Burden, Disease,Cost, Disease,Disease Burdens,Illness Burden,Illness Burdens,Illness Cost,Illness Costs,Sickness Costs
D019804 Mesalamine An anti-inflammatory agent, structurally related to the SALICYLATES, which is active in INFLAMMATORY BOWEL DISEASE. It is considered to be the active moiety of SULPHASALAZINE. (From Martindale, The Extra Pharmacopoeia, 30th ed) 5-Aminosalicylate,Mesalazine,5-Aminosalicylic Acid,Asacol,Asacolon,Ascolitin,Canasa,Claversal,Fivasa,Lixacol,Mesalamine Hydrochloride,Mesalamine Monosodium Salt,Mesasal,Novo-5 ASA,Pentasa,Rowasa,Salofalk,m-Aminosalicylic Acid,meta-Aminosalicylic Acid,5 Aminosalicylate,5 Aminosalicylic Acid,Hydrochloride, Mesalamine,Monosodium Salt, Mesalamine,Novo 5 ASA,m Aminosalicylic Acid,meta Aminosalicylic Acid

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