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. 2016 Oct 14;22(38):8615-8623.
doi: 10.3748/wjg.v22.i38.8615.

Incidence, clinical features and para-clinical findings of achalasia in Algeria: Experience of 25 years

Amar Tebaibia  1 , Mohammed Amine Boudjella  1 , Djamel Boutarene  1 , Farouk Benmediouni  1 , Hakim Brahimi  1 , Nadia Oumnia  1
Affiliations

Incidence, clinical features and para-clinical findings of achalasia in Algeria: Experience of 25 years

Amar Tebaibia et al. World J Gastroenterol. .

Abstract

Aim: To investigate the incidence of achalasia in Algeria and to determine its clinical and para-clinical profile. To evaluate the impact of continuing medical education (CME) on the incidence of this disease.

Methods: From 1990 to 2014, 1256 patients with achalasia were enrolled in this prospective study. A campaign of CME on diagnosis involving different regions of the country was conducted between 1999 and 2003. Annual incidence and prevalence were calculated by relating the number of diagnosed cases to 105 inhabitants. Each patient completed a standardized questionnaire, and underwent upper endoscopy, barium swallow and esophageal manometry. We systematically looked for Allgrove syndrome and familial achalasia.

Results: The mean annual incidence raised from 0.04 (95%CI: 0.028-0.052) during the 1990s to 0.27/105 inhabitants/year (95%CI: 0.215-0.321) during the 2000s. The incidence of the disease was two and half times higher in the north and the center compared to the south of the country. One-hundred-and-twenty-nine (10%) were children and 97 (7.7%) had Allgrove syndrome. Familial achalasia was noted in 18 different families. Patients had dysphagia (99%), regurgitation (83%), chest pain (51%), heartburn 24.5% and weight loss (70%). The lower esophageal sphincter was hypertensive in 53% and hypotensive in 0.6%.

Conclusion: The mean incidence of achalasia in Algeria is at least 0.27/105 inhabitants. A good impact on the incidence of CME was noted. A gradient of incidence between different regions of the country was found. This variability is probably related to genetic and environmental factors. The discovery of an infantile achalasia must lead to looking for Allgrove syndrome and similar cases in the family.

Keywords: Achalasia; Allgrove syndrome; Continuing medical education; Incidence; Manometry.

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Conflict of interest statement

Conflict-of-interest statement: None to declare.

Figures

Figure 1
Figure 1
Map of Algeria. R: Region.
Figure 2
Figure 2
Number of cases of achalasia diagnosed each year and continuing medical education campaign. CME: Continuing medical education.
Figure 3
Figure 3
Number of cases of achalasia in the different regions according to time.
See this image and copyright information in PMC

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