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Meta-Analysis
. 2024 Apr;183(4):1723-1732.
doi: 10.1007/s00431-024-05428-3. Epub 2024 Jan 17.

A systematic review and meta-regression on international trends in the incidence of ulcerative colitis in children and adolescents associated with socioeconomic and geographic factors

Jens Weidner  1 , Ivana Kern  2 , Ines Reinecke  3 , Franziska Bathelt  4 , Ulf Manuwald  5 , Elisa Henke  3 , Michele Zoch  3 , Ulrike Rothe  6 , Joachim Kugler  2
Affiliations
Meta-Analysis

A systematic review and meta-regression on international trends in the incidence of ulcerative colitis in children and adolescents associated with socioeconomic and geographic factors

Jens Weidner et al. Eur J Pediatr. 2024 Apr.

Abstract

The incidence of ulcerative colitis (UC) among children and adolescents is rising globally, albeit with notable discrepancies across countries. This systematic review and meta-analysis aims to provide a comprehensive overview of the incidence rates of pediatric UC in various countries and explore potential influencing factors. A systematic literature search was conducted in PubMed and EMBASE (via OVID) for studies published between January 1, 1970, and December 31, 2019. Additionally, a manual search was performed to identify relevant systematic reviews. Meta-analyses and meta-regressions were employed to determine the overall incidence rate and examine potential factors that may influence it. A total of 66 studies were included in the qualitative analysis, while 65 studies were included in the meta-analysis and 50 studies were meta-regression. The study reports a rising incidence of pediatric UC in several countries but significant differences across geographic regions, with no discernible global temporal trend. In addition, our meta-regression analysis showed that geographic location and socioeconomic factors significantly influenced the incidence of UC.

Conclusion: Our findings indicate a rising incidence of pediatric UC in numerous countries since 1970, but with significant geographical variation, potentially presenting challenges for respective healthcare systems. We have identified geographic and socioeconomic factors that contribute to the observed heterogeneity in incidence rates. These findings provide a foundation for future research and health policies, aiming to tackle the growing burden of UC among children and adolescents.

What is known: • The incidence of ulcerative colitis in childhood and adolescence appears to be increasing worldwide and varies internationally. • Environmental and lifestyle factors are suspected as potential causes.

What is new: • Our results highlight that the heterogeneity in incidence rates can be attributed to geographic and socio-economic factors.

Keywords: Epidemiology; Incidence; Inflammatory bowel disease; Pediatric; Ulcerative colitis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Dimensions of the factors for the meta-regressions
Fig. 2
Fig. 2
Meta-regression: time as moderator, ME model (k = 65, estimator: REML): test of moderators F-test = 5.25 P = .02, I2 = 97.07%, variance explanation via R2 = 7.06%
Fig. 3
Fig. 3
Geographical distribution of ulcerative colitis incidence (raw data)
Fig. 4
Fig. 4
Meta-regression: increasing incidence with increasing distance from the equator; (k = 50, estimator: REML): test of moderators F-test = 11.81 P < .001, I2 = 97.31%, variance explanation via R2 = 20.76%
Fig. 5
Fig. 5
Meta-regression. A Increasing incidence with increasing Human Development Index (HDI); (k = 50, estimator: REML): test of moderators F-test = 16.83 P < .0001, I2 = 96.94%, variance explanation via R2 = 29.73%. B Increasing incidence with increasing health expenditure (CHE-GDP%); (k = 50, estimator: REML): test of moderators F-test = 33.28 P < .0001, I2 = 96.1%, variance explanation via R2= 45.85%. C Increasing incidence with increasing UHC service coverage index SDG 3.8.1 (UHC); (k = 50, estimator: REML): test of moderators F-test = 4.19, P < .001, I2= 97.56%, variance explanation via R2= 8.56%
See this image and copyright information in PMC

References

    1. Lynch WD, Hsu R (2023) Ulcerative colitis. In: StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL) [cited 2023 Nov 30]. Available from http://www.ncbi.nlm.nih.gov/books/NBK459282/
    1. Gisbert JP, Chaparro M (2019) Clinical usefulness of proteomics in inflammatory bowel disease: a comprehensive review. J Crohns Colitis [Internet] [cited 2023 Apr 28] 13(3):374–384. Available from 10.1093/ecco-jcc/jjy158 - PubMed
    1. Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol EI et al (2017) Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet [Internet] 390(10114):2769–2778. Available from http://www.journals.elsevier.com/the-lancet/ - PubMed
    1. Buderus S, Scholz D, Behrens R, Classen M, De Laffolie J, Keller KM et al (2015) Inflammatory bowel disease in pediatric patients: characteristics of newly diagnosed patients from the CEDATA-GPGE Registry. Dtsch Arztebl Int [Internet] 112(8):121–127. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4361801/pdf/Dtsch_Arztebl_I... - PMC - PubMed
    1. Kern I, Schoffer O, Kiess W, Henker J, Laaß MW, Winkler U, et al. Incidence trends of pediatric onset inflammatory bowel disease in the years 2000–2009 in Saxony, Germany-first results of the Saxon Pediatric IBD Registry. PLoS ONE. 2021;16(1):e0243774. doi: 10.1371/journal.pone.0243774. - DOI - PMC - PubMed

Supplementary concepts