Niriella Madunil Anuk, Martinus Charith Kanishka, Withanage Madhuri Yasodha, Darshika Selani, Illangasinghe Maljini, Perera Hayashini Ruvindri, Ediriweera Dileepa Senajith, Janaka de Silva Hithanadura
Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
Health Data Science Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
Heliyon. 2025 Jan 11;11(3):e41840. doi: 10.1016/j.heliyon.2025.e41840. eCollection 2025 Feb 15.
Inflammatory bowel disease (IBD) is an emerging disease in the South Asia. We conducted a systematic review to determine the characteristics and overall prevalence of IBD among South Asian adults.
We searched the PubMed database and included descriptive, epidemiological studies with satisfactory methodological quality, reporting the epidemiology of IBD with histological confirmation. The quality of the studies was assessed using Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Two authors screened and extracted data independently. A random-effects meta-analysis of characteristics and overall prevalence of IBD was performed.
This review analysed data from over 9000 IBD patients from 21 studies across multiple South Asian countries. It found a higher prevalence of ulcerative colitis (UC) compared to Crohn's disease (CD) (2:1). There was a male predominance and modest familial aggregation of IBD cases. Left-sided colitis was the most common disease extent for UC. Colonic involvement was more frequent than ileal involvement for CD. The non-stricturing, non-penetrating behaviour was dominant in CD cases. Joint manifestations were commonly reported in both UC and CD. Immunomodulators, such as azathioprine, were used in a significant proportion of patients, particularly for CD. The use of biological agents like infliximab was relatively low. Surgical intervention rates were lower than in Western cohorts but higher in CD compared to UC.
This study provides an epidemiological overview of adult IBD characteristics, phenotypes, and treatment patterns in the South Asian region. There were epidemiological, clinical, phenotypic and treatment differences compared to western IBD.
炎症性肠病（IBD）在南亚地区是一种新兴疾病。我们进行了一项系统综述，以确定南亚成年人IBD的特征和总体患病率。
我们检索了PubMed数据库，纳入了方法学质量令人满意的描述性、流行病学研究，报告了经组织学证实的IBD流行病学情况。使用乔安娜·布里格斯研究所患病率研究关键评估清单对研究质量进行评估。两位作者独立筛选和提取数据。对IBD的特征和总体患病率进行随机效应荟萃分析。
本综述分析了来自多个南亚国家21项研究的9000多名IBD患者的数据。研究发现，溃疡性结肠炎（UC）的患病率高于克罗恩病（CD）（2:1）。IBD病例存在男性主导和适度的家族聚集现象。左侧结肠炎是UC最常见的病变范围。CD患者结肠受累比回肠受累更常见。非狭窄、非穿透性病变在CD病例中占主导地位。UC和CD患者均普遍报告有关节表现。相当一部分患者使用了免疫调节剂，如硫唑嘌呤，尤其是CD患者。英夫利昔单抗等生物制剂的使用相对较少。手术干预率低于西方队列，但CD患者高于UC患者。
本研究提供了南亚地区成人IBD特征、表型和治疗模式的流行病学概述。与西方IBD相比，存在流行病学、临床、表型和治疗方面的差异。
