Masoud M Malekzadeh1, Homayoon Vahedi1, Kimiya Gohari2, Parinaz Mehdipour3, Sadaf G Sepanlou1, Nasser Ebrahimi Daryani4, Mohammad-Reza Zali5, Fariborz Mansour-Ghanaei6, Alireza Safaripour7, Rahim Aghazadeh5, Hassan Vossoughinia8, Hafez Fakheri9, Mohammad H Somi10, Iradj Maleki9, Vahid Hoseini9, Mohammad-Reza Ghadir11, Hamed Daghaghzadeh12, Payman Adibi12, Hamid Tavakoli12, Alireza Taghavi7, Mohammad-Javad Zahedi13, Taghi Amiriani14, Masoud Tabib15, Zainab Alipour15, Hossein Nobakht16, Abbas Yazdanbod17, Masoud Sadreddini18, Alireza Bakhshipour19, Ahmad Khosravi8, Pejman Khosravi20, Siavosh Nasseri-Moghaddam1, Shahin Merat1, Rasoul Sotoudehmanesh1, Farhad Barazandeh21, Peyman Arab22, Nadieh Baniasadi23, Seyyed-Javad Pournaghi20, Mahboubeh Parsaeian24, Farshad Farzadfar3, Reza Malekzadeh25. 1. Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2. Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 3. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 4. Department of Gastroenterology, Imam Khomeini Hospital Tehran University of Medical Sciences, Tehran, Iran. 5. Gastrointestinal and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 6. Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences (GUMS), Rasht, Iran. 7. Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 8. Department of Gastroenterology and Hepatology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. 9. Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran. 10. Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 11. Department of Gastroenterology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran. 12. Gastroenterology Section, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 13. Digestive Research Center, Kerman University of Medical Sciences, Kerman, Iran. 14. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran. 15. Department of Internal Medicine, Bushehr University of Medical Science, Bushehr, Iran. 16. Department of Internal Medicine, Semnan University of Medical Science, Semnan, Iran. 17. Department of Medicine, Ardabil University of Medical Science, Ardabil, Iran. 18. Department of Internal Medicine, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran. 19. Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. 20. Department of Medicine, Dezful University of Medical Science, Dezful, Iran. 21. Department of Internal Medicine, North Khorasan University of Medical Sciences, Bojnourd, North Khorasan, Iran. 22. Department of Gastroenterology and Hepatology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran. 23. Department of Medicine, Kerman University of Medical Sciences, Kerman, Iran. 24. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 25. Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. malek@tums.ac.ir.
Abstract
BACKGROUND: The burden of inflammatory bowel disease (IBD) hasn't been reported in Iran. We aimed to estimate the prevalence and incidence of IBD and its trend in Iran at national and subnational level from 1990 to 2012. METHODS: We conducted a systematic review of English and Persian databases about the epidemiology of IBD. We also collected outpatient data from 17 provinces of Iran using almost all public and private referral gastroenterology clinics. Prevalence and incidence rate was calculated at national and subnational levels. The Kriging method was used to extrapolate provinces with missing data and GPR model to calculate time trends of rates at subnational level. RESULTS: We found 16 case series, two population-based studies, and two review articles. We collected 11,000 IBD cases from outpatient databases. Among them, 9,269 (84.26%) had ulcerative colitis (UC), 1,646 (14.96%) had Crohn's disease (CD), and 85 had intermediate colitis (IC). A total of 5,452 (49.56%) patients were male. Mean age at diagnosis was 32.80 years (CI: 13 - 61) for UC and 29.98 years (CI: 11 - 58) for CD. Annual incidences of IBD, UC, and CD in 2012 were 3.11, 2.70, and 0.41 per 100,000 subjects respectively. Prevalence of IBD, UC, and CD in 2012 were 40.67, 35.52, and 5.03 per 100,000 subjects respectively. The incidence of UC and CD showed a significant increase during the study period (P for trend < 0.05). CONCLUSIONS: The incidence and prevalence of IBD are increasing in Iran. Establishing a national IBD registry seems necessary for comprehensive care of IBD patients in Iran.
BACKGROUND: The burden of inflammatory bowel disease (IBD) hasn't been reported in Iran. We aimed to estimate the prevalence and incidence of IBD and its trend in Iran at national and subnational level from 1990 to 2012. METHODS: We conducted a systematic review of English and Persian databases about the epidemiology of IBD. We also collected outpatient data from 17 provinces of Iran using almost all public and private referral gastroenterology clinics. Prevalence and incidence rate was calculated at national and subnational levels. The Kriging method was used to extrapolate provinces with missing data and GPR model to calculate time trends of rates at subnational level. RESULTS: We found 16 case series, two population-based studies, and two review articles. We collected 11,000 IBD cases from outpatient databases. Among them, 9,269 (84.26%) had ulcerative colitis (UC), 1,646 (14.96%) had Crohn's disease (CD), and 85 had intermediate colitis (IC). A total of 5,452 (49.56%) patients were male. Mean age at diagnosis was 32.80 years (CI: 13 - 61) for UC and 29.98 years (CI: 11 - 58) for CD. Annual incidences of IBD, UC, and CD in 2012 were 3.11, 2.70, and 0.41 per 100,000 subjects respectively. Prevalence of IBD, UC, and CD in 2012 were 40.67, 35.52, and 5.03 per 100,000 subjects respectively. The incidence of UC and CD showed a significant increase during the study period (P for trend < 0.05). CONCLUSIONS: The incidence and prevalence of IBD are increasing in Iran. Establishing a national IBD registry seems necessary for comprehensive care of IBD patients in Iran.