Roro Guda M, Annose Rodas T, Gilja Odd H
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Addis Ababa University, College of Health Science, Addis Ababa 9086, Ethiopia.
Department of Clinical Medicine, University of Bergen 5020, Norway.
World J Gastrointest Endosc. 2025 May 16;17(5):106690. doi: 10.4253/wjge.v17.i5.106690.
Relative changes in the prevalence of gastrointestinal (GI) diseases have been reported worldwide over the past decades. However, data on changing trends of upper GI diseases remain scarce in sub-Saharan Africa. This study examines the shifting patterns of upper GI endoscopic findings over 35 years in Ethiopia.
To analyze trends in upper GI endoscopic findings over two distinct time periods, 35 years apart, in Ethiopia.
We extracted findings from 8412 upper GI endoscopies performed between 2016 and 2024 at a tertiary referral center in Addis Ababa, Ethiopia. Patient characteristics, indications, and endoscopic findings were analyzed using descriptive statistics and presented in tables, map and graphs. These findings were compared to 10000 procedures conducted between 1979 and 1994. Key endoscopic findings were identified, and percentage changes in disease prevalence were calculated.
Between the two study periods, the male-to-female ratio of patients undergoing upper GI endoscopy shifted from 2:1 to 1.4:1, while the median patient age increased from 36 to 40 years. The proportion of patients older than 50 years doubled (14.6% to 30.2%), and referrals from outside Addis Ababa increased from 33% to 57%. The prevalence of peptic ulcer disease and its complications decreased from 46.2% to 9.5%. Conversely, gastroesophageal varices increased from 9.5% to 21.8%, and upper GI malignancies rose from 3.6% to 18.8%.
This study sheds light on critical epidemiological shifts in upper GI diseases in Ethiopia, with a decline in peptic ulcer disease and a rise in portal hypertensive lesions and malignancies which have important public health implications. These findings underscore the need for increased awareness, improved clinical practices, enhanced resource allocation, and expanded access to early diagnosis and treatment of prevailing conditions. Preventive strategies targeting immunization and treatment of viral hepatitis, schistosomiasis, and infection are urgently needed.
在过去几十年中，全球范围内已报道了胃肠道（GI）疾病患病率的相对变化。然而，撒哈拉以南非洲地区关于上消化道疾病变化趋势的数据仍然很少。本研究调查了埃塞俄比亚35年来上消化道内镜检查结果的变化模式。
分析埃塞俄比亚两个相隔35年的不同时间段内上消化道内镜检查结果的趋势。
我们从2016年至2024年在埃塞俄比亚亚的斯亚贝巴的一家三级转诊中心进行的8412例上消化道内镜检查中提取了检查结果。使用描述性统计分析患者特征、检查指征和内镜检查结果，并以表格、地图和图表形式呈现。将这些结果与1979年至1994年进行的10000例检查进行比较。确定关键的内镜检查结果，并计算疾病患病率的百分比变化。
在两个研究时间段之间，接受上消化道内镜检查的患者的男女比例从2:1变为1.4:1，而患者的中位年龄从36岁增加到40岁。50岁以上患者的比例翻了一番（从14.6%增至30.2%），来自亚的斯亚贝巴以外地区的转诊患者从33%增至57%。消化性溃疡疾病及其并发症的患病率从46.2%降至9.5%。相反，食管胃静脉曲张从9.5%增至21.8%，上消化道恶性肿瘤从3.6%增至18.8%。
本研究揭示了埃塞俄比亚上消化道疾病的关键流行病学变化，消化性溃疡疾病减少，门静脉高压性病变和恶性肿瘤增加，这具有重要的公共卫生意义。这些发现强调需要提高认识、改进临床实践、加强资源分配，并扩大对当前疾病的早期诊断和治疗的可及性。迫切需要针对病毒性肝炎、血吸虫病和感染的免疫接种和治疗的预防策略。
