Rajbhandari Ruma, Blakemore Samantha, Gupta Neil, Adler Alma J, Noble Christopher Allen, Mannan Sara, Nikolli Klejda, Yih Alison, Joshi Sameer, Bukhman Gene
Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States.
World J Gastroenterol. 2020 Nov 21;26(43):6891-6908. doi: 10.3748/wjg.v26.i43.6891.
While Crohn's disease has been studied extensively in high-income countries, its epidemiology and care in low and lower-middle income countries (LLMICs) is not well established due to a lack of disease registries and diagnostic capacity.
To describe the published burden, diagnostic/treatment capacity, service utilization, challenges/barriers to individuals with Crohn's in LLMICs and their providers.
We conducted a scoping review utilizing a full search strategy was developed and conducted in PubMed, Embase and World Health Organization Global Index Medicus. Two independent reviewers screened the titles and abstracts of all of the publications found in this search, reviewed selected publications, and extracted relevant data, which underwent descriptive review and was analyzed in Excel.
The database search yielded 4486 publications, 216 of which were determined to be relevant to the research questions. Of all 79 LLMICs, only 21 (26.6%) have publications describing individuals with Crohn's. Overall, the highest number of studies came from India, followed by Tunisia, and Egypt. The mean number of Crohn's patients reported per study is 57.84 and the median is 22, with a wide range from one to 980.
This scoping review has shown that, although there is a severe lack of population-based data about Crohn's in LLMICs, there is a signal of Crohn's in these settings around the world.
虽然克罗恩病在高收入国家已得到广泛研究，但由于缺乏疾病登记和诊断能力，其在低收入和中低收入国家（LLMICs）的流行病学和医疗情况尚未明确。
描述已发表的关于LLMICs中克罗恩病患者及其医疗服务提供者的疾病负担、诊断/治疗能力、服务利用情况、挑战/障碍。
我们采用全面检索策略进行了一项范围综述，检索了PubMed、Embase和世界卫生组织全球医学索引。两名独立评审员筛选了该检索中找到的所有出版物的标题和摘要，审查了选定的出版物，并提取了相关数据，这些数据经过描述性综述并在Excel中进行分析。
数据库检索产生了4486篇出版物，其中216篇被确定与研究问题相关。在所有79个LLMICs中，只有21个（26.6%）有描述克罗恩病患者的出版物。总体而言，研究数量最多的来自印度，其次是突尼斯和埃及。每项研究报告的克罗恩病患者平均数量为57.84，中位数为22，范围从1到980不等。
这项范围综述表明，尽管LLMICs严重缺乏基于人群的克罗恩病数据，但全球这些地区存在克罗恩病的迹象。
