Childhood Inflammatory Bowel Disease in Libya: Epidemiological and Clinical features

Abstract

Background & aims: Inflammatory bowel disease is thought to be rare in Libya. The aim is to determine the prevalence of juvenile onset inflammatory bowel disease in Libya.

Setting: Al-Fateh childrens' hospital, Benghazi, Libya.

Methods: This is a retrospective study of all cases diagnosed over 10 years (1997-2006) with either ulcerative colitis, Crohn's disease or indeterminate colitis. Inclusion criteria were age <15 years at time of presentation who were resident in the eastern part of the country and who diagnosed with inflammatory bowel disease. Clinical features were outlined using a proforma.

Results: Sixteen cases were diagnosed with inflammatory bowel disease, of whom 11 were males (M:F ratio of 1.5:1). The prevalence and incidence rates in the year 2006 were 3.6 and 0.9 per 100,000 children, respectively. The incidence rate increased from 0.2 in 2002 to 0.9 in 2006 (Z score of 39.87, p= 0.00). The age at presentation ranged from 5 months to 14 years. Nine had Crohn's disease (6 males) and 6 had ulcerative colitis (4 males). One patient had indeterminate colitis. The most common clinical features were diarrhea in 10 (62.5%), abdominal pain, anorexia and weight loss in 9 (56.2%), anemia in 7 (43.75%) and vomiting in 6 (37%). Ileopancolitis was found in 3 patients whereas 6 patients had ileocecal disease.

Conclusions: Childhood inflammatory bowel disease in this population is not so rare and it is increasing. The clinical pattern is similar to that reported by others.

Keywords: Crohn's disease; Indeterminate colitis; Inflammatory bowel disease; Juvenile onset inflammatory bowel disease; Ulcerative colitis.