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The Global, Regional, and National Burden of Inflammatory Bowel Disease in 195 Countries and Territories, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017 Publisher Pubmed



Alatab S5 ; Sepanlou SG5, 8 ; Ikuta K11, 12 ; Vahedi H5 ; Bisignano C12 ; Safiri S13, 14 ; Sadeghi A5 ; Nixon MR12 ; Abdoli A16 ; Abolhassani H6, 17 ; Alipour V19, 20 ; Almadi MAH22, 23 ; Almasihashiani A18 ; Anushiravani A4 Show All Authors
Authors
  1. Alatab S5
  2. Sepanlou SG5, 8
  3. Ikuta K11, 12
  4. Vahedi H5
  5. Bisignano C12
  6. Safiri S13, 14
  7. Sadeghi A5
  8. Nixon MR12
  9. Abdoli A16
  10. Abolhassani H6, 17
  11. Alipour V19, 20
  12. Almadi MAH22, 23
  13. Almasihashiani A18
  14. Anushiravani A4
  15. Arabloo J21
  16. Atique S24, 25
  17. Awasthi A26, 27
  18. Badawi A28, 29
  19. Baig AAA30, 31
  20. Bhala N32, 33
  21. Bijani A34
  22. Biondi A35
  23. Borzi AM36
  24. Burke KE37
  25. Carvalho F38, 39
  26. Daryani A40
  27. Dubey M41
  28. Eftekhari A15, 43
  29. Fernandes E45
  30. Fernandes JC44
  31. Fischer F46
  32. Hajmirzaian A3, 49
  33. Hajmirzaian A3, 49
  34. Hasanzadeh A2, 42
  35. Hashemian M51, 52
  36. Hay SI12
  37. Hoang CL53
  38. Househ M54, 55
  39. Ilesanmi OS56
  40. Balalami NJ57
  41. James SL12
  42. Kengne AP58, 59
  43. Malekzadeh MM5
  44. Merat S5
  45. Meretoja TJ60, 61
  46. Mestrovic T62, 63
  47. Mirrakhimov EM64, 65
  48. Mirzaei H1, 66
  49. Mohammad KA67, 68
  50. Mokdad AH10, 12
  51. Monasta L69
  52. Negoi I70, 71
  53. Nguyen TH53
  54. Nguyen CT72
  55. Pourshams A5
  56. Poustchi H5
  57. Rabiee M73
  58. Rabiee N74
  59. Ramezanzadeh K48
  60. Rawaf DL77, 78
  61. Rawaf S75, 79
  62. Rezaei N6, 80
  63. Robinson SR81
  64. Ronfani L69
  65. Saxena S76
  66. Sepehrimanesh M82, 83
  67. Shaikh MA84
  68. Sharafi Z85
  69. Sharif M86, 87
  70. Siabani S88, 89
  71. Sima AR5, 7
  72. Singh JA90
  73. Soheili A91, 92
  74. Sotoudehmanesh R5
  75. Suleria HAR93
  76. Tesfay BE94
  77. Tran B95
  78. Tsoi D12
  79. Vacante M35
  80. Wondmieneh AB96, 97
  81. Zarghi A47
  82. Zhang ZJ98
  83. Dirac M12
  84. Malekzadeh R5, 9
  85. Naghavi M10, 12
Show Affiliations
Authors Affiliations
  1. 1. Department of Medical Immunology, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  9. 9. Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  10. 10. Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
  11. 11. Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, United States
  12. 12. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
  13. 13. Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
  14. 14. Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  15. 15. Department of Pharmacology and Toxicology, Tabriz University of Medical Sciences, Tabriz, Iran
  16. 16. Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
  17. 17. LABMED, Karolinska University Hospital, Stockholm, Sweden
  18. 18. Department of Epidemiology, Tehran, Iran
  19. 19. Health Management and Economics Research Center, Tehran, Iran
  20. 20. Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
  21. 21. Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
  22. 22. College of Medicine, King Saud University, Riyadh, Saudi Arabia
  23. 23. Division of Gastroenterology & Hepatology, McGill University, Montreal, QB, Canada
  24. 24. University Institute of Public Health, The University of Lahore, Lahore, Pakistan
  25. 25. College of Public Health, University of Hail, Hail, Saudi Arabia
  26. 26. Indian Institute of Public Health, Gandhinagar, India
  27. 27. Public Health Foundation of India, Gurugram, India
  28. 28. Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, ON, Canada
  29. 29. Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
  30. 30. Biomedicine Department, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
  31. 31. Unit of Biochemistry, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
  32. 32. Institutes of Applied Health Research and Translational Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
  33. 33. IAHR/ITM, University of Birmingham, Birmingham, United Kingdom
  34. 34. Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
  35. 35. Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
  36. 36. General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
  37. 37. Division Gastroenterology, Massachusetts General Hospital, Boston, MA, United States
  38. 38. Applied Molecular Biosciences Unit, University of Porto, Porto, Portugal
  39. 39. Institute of Public Health, University of Porto, Porto, Portugal
  40. 40. Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  41. 41. United Nations World Food Programme, United Nations World Food Programme, New Delhi, India
  42. 42. Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran
  43. 43. Pharmacology and Toxicology Department, Maragheh University of Medical Sciences, Maragheh, Iran
  44. 44. Center for Biotechnology and Fine Chemistry, Catholic University of Portugal, Porto, Portugal
  45. 45. REQUIMTE/LAQV, University of Porto, Porto, Portugal
  46. 46. School of Public Health Medicine, Bielefeld University, Bielefeld, Germany
  47. 47. Department of Medicinal and Pharmaceutical Chemistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  48. 48. Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  49. 49. Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  50. 50. Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
  51. 51. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
  52. 52. Department of Biology, Utica College, Utica, NY, United States
  53. 53. Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam
  54. 54. Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
  55. 55. Qatar Foundation for Education, Science, and Community Development, Doha, Qatar
  56. 56. Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
  57. 57. Department of Psychosis, Babol Noshirvani University of Technology, Babol, Iran
  58. 58. Non-Communicable Diseases Research Unit, Medical Research Council South Africa, Cape Town, South Africa
  59. 59. Department of Medicine, University of Cape Town, Cape Town, South Africa
  60. 60. Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
  61. 61. University of Helsinki, Helsinki, Finland
  62. 62. Clinical Microbiology and Parasitology Unit, Zora Profozic Polyclinic, Zagreb, Croatia
  63. 63. University Centre Varazdin, University North, Varazdin, Croatia
  64. 64. Faculty of General Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
  65. 65. Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
  66. 66. Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
  67. 67. Department of Biology, Salahaddin University, Erbil, Iraq
  68. 68. ISHIK University, Erbil, Iraq
  69. 69. Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
  70. 70. Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  71. 71. General Surgery Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  72. 72. Institute for Global Health Innovations, Duy Tan University, Hanoi, Viet Nam
  73. 73. Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
  74. 74. Department of Chemistry, Sharif University of Technology, Tehran, Iran
  75. 75. Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
  76. 76. School of Public Health, Imperial College London, London, United Kingdom
  77. 77. WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, United Kingdom
  78. 78. University College London Hospitals, London, United Kingdom
  79. 79. Academic Public Health, Public Health England, London, United Kingdom
  80. 80. Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  81. 81. Department of Psychology, Royal Melbourne Institute of Technology University, Bundoora, VIC, Australia
  82. 82. New Iberia Research Center, University of Louisiana at Lafayette, Lafayette, LA, United States
  83. 83. Guilan University of Medical Sciences, Rasht, Iran
  84. 84. Independent Consultant, Karachi, Pakistan
  85. 85. Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
  86. 86. Department of Basic Sciences, Islamic Azad University, Sari, Iran
  87. 87. Department of Laboratory Sciences, Islamic Azad University, Sari, Iran
  88. 88. Imam Ali Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  89. 89. School of Health, University of Technology Sydney, Sydney, NSW, Australia
  90. 90. Rheumatology/Medicine Department, University of Alabama at Birmingham, Birmingham, AL, United States
  91. 91. Medical Surgical Nursing Department, Urmia University of Medical Science, Urmia, Iran
  92. 92. Emergency Nursing Department, Zanjan University of Medical Sciences, Iran
  93. 93. Department of Agriculture and Food Systems, University of Melbourne, Melbourne, VC, Australia
  94. 94. Department of Public Health, Adigrat University, Adigrat, Ethiopia
  95. 95. Department of Health Economics, Hanoi Medical University, Hanoi, Viet Nam
  96. 96. Nursing Department, Wollo University, Dessie, Ethiopia
  97. 97. Addis Ababa University, Addis Ababa, Ethiopia
  98. 98. Department of Preventive Medicine, Wuhan University, Wuhan, China

Source: The Lancet Gastroenterology and Hepatology Published:2020


Abstract

Background: The burden of inflammatory bowel disease (IBD) is rising globally, with substantial variation in levels and trends of disease in different countries and regions. Understanding these geographical differences is crucial for formulating effective strategies for preventing and treating IBD. We report the prevalence, mortality, and overall burden of IBD in 195 countries and territories between 1990 and 2017, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. Methods: We modelled mortality due to IBD using a standard Cause of Death Ensemble model including data mainly from vital registrations. To estimate the non-fatal burden, we used data presented in primary studies, hospital discharges, and claims data, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to ensure consistency between measures. Mortality, prevalence, years of life lost (YLLs) due to premature death, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were estimated. All of the estimates were reported as numbers and rates per 100 000 population, with 95% uncertainty intervals (UI). Findings: In 2017, there were 6·8 million (95% UI 6·4–7·3) cases of IBD globally. The age-standardised prevalence rate increased from 79·5 (75·9–83·5) per 100 000 population in 1990 to 84·3 (79·2–89·9) per 100 000 population in 2017. The age-standardised death rate decreased from 0·61 (0·55–0·69) per 100 000 population in 1990 to 0·51 (0·42–0·54) per 100 000 population in 2017. At the GBD regional level, the highest age-standardised prevalence rate in 2017 occurred in high-income North America (422·0 [398·7–446·1] per 100 000) and the lowest age-standardised prevalence rates were observed in the Caribbean (6·7 [6·3–7·2] per 100 000 population). High Socio-demographic Index (SDI) locations had the highest age-standardised prevalence rate, while low SDI regions had the lowest age-standardised prevalence rate. At the national level, the USA had the highest age-standardised prevalence rate (464·5 [438·6–490·9] per 100 000 population), followed by the UK (449·6 [420·6–481·6] per 100 000). Vanuatu had the highest age-standardised death rate in 2017 (1·8 [0·8–3·2] per 100 000 population) and Singapore had the lowest (0·08 [0·06–0·14] per 100 000 population). The total YLDs attributed to IBD almost doubled over the study period, from 0·56 million (0·39–0·77) in 1990 to 1·02 million (0·71–1·38) in 2017. The age-standardised rate of DALYs decreased from 26·5 (21·0–33·0) per 100 000 population in 1990 to 23·2 (19·1–27·8) per 100 000 population in 2017. Interpretation: The prevalence of IBD increased substantially in many regions from 1990 to 2017, which might pose a substantial social and economic burden on governments and health systems in the coming years. Our findings can be useful for policy makers developing strategies to tackle IBD, including the education of specialised personnel to address the burden of this complex disease. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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