Epidemiologic profile of inflammatory bowel disease in Eastern Mediterranean Region (EMRO) countries: a systematic review and meta-analysis

Abstract

Background: Inflammatory bowel disease (IBD) consists of two main types: Crohn's disease (CD) and ulcerative colitis (UC). The epidemiology of IBD patients has not been comprehensively studied in EMRO countries; therefore, we conducted this meta-analysis to study the epidemiology of this disease in these countries.

Methods: We searched four international databases, namely Scopus, Web of Knowledge (ISI), Medline/PubMed, and ProQuest, from inception up to the end of May 2023. The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guideline was used to carry out this systematic review and meta-analysis investigation. Using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist, the quality of the selected papers was assessed.

Results: Based on the results of this study, the incidence of UC in EMRO countries was 2.65 per 100,000 (95% CI: 1.39-3.90), and the incidence of CD was 1.16 per 100,000 (95% CI: 0.73-1.59). The most commonly involved intestinal segment in CD was the terminal ileum (44.7%, 95% CI: 34.7-55.2), followed by the ileum (29.8%, 95% CI: 22.2-38.6), and colon (18.7%, 95% CI: 10.8-30.4). However, in UC patients, extensive colitis was the most common finding (32.3%, 95% CI: 26.4-38.8), followed by proctosigmoiditis (27.9%, 95% CI: 21.1-35.8), left-sided colitis (27.4%, 95% CI: 22.7-32.7), and proctitis (22.6%, 95% CI: 17.5-28.5).

Conclusion: As a result, we were able to establish the traits of IBD patients in EMRO nations. UC patients had a higher incidence than CD patients. The most common regions of involvement in CD and UC patients, respectively, were the colon and pancolitis. Compared to UC patients, CD patients had a higher history of appendectomy.

Keywords: Crohn’s disease; Inflammatory bowel disease; Meta-analysis; Systematic review; Ulcerative colitis.

Fig. 1

Flowchart of the included eligible studies in systematic review

Fig. 2

A Incidence of UC in EMRO countries, B Incidence of UC in EMRO countries, C Prevalence of Ulcerative Colitis among men, D Prevalence of Crohn Disease among men, E Mean Age at diagnosis for Ulcerative Colitis, F Mean Age at diagnosis for Crohn Disease, G Terminal ileum involvement in CD, H Ileal involvement in CD, I Colon involvement in CD

Fig. 3

A Extensive colitis involvement in UC, B Proctosigmoiditis involvement in UC, C Left sided colitis involvement in UC patients, D Proctitis involvement in UC, E Prevalence of smoking in CD patients, F Prevalence of smoking in UC patients, G Prevalence of positive family history in UC patients, H Prevalence of positive family history in CD patients, I (Upper figure): History of appendectomy in CD patients, J (Lower figure): History of appendectomy in UC patients