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

Sudabeh Alatab(Tehran University of Medical Sciences), Sadaf G Sepanlou(Digestive Disease Research Institute), Kevin S Ikuta(Tehran University of Medical Sciences), Homayoon Vahedi(Institute for Health Metrics and Evaluation), Catherine Bisignano(Digestive Disease Research Institute), Saeid Safiri(University of Washington), Anahita Sadeghı(Digestive Disease Research Institute), Molly R Nixon(Institute for Health Metrics and Evaluation), Amir Abdoli(Tehran University of Medical Sciences), Hassan Abolhassani(Digestive Disease Research Institute), Vahid Alipour(University of Washington), Majid A. Almadi(Digestive Disease Research Institute), Amir Almasi‐Hashiani(University of Washington), Amir Anushiravani(Tehran University of Medical Sciences), Jalal Arabloo(Digestive Disease Research Institute), Suleman Atique(Institute for Health Metrics and Evaluation), Ashish Awasthi(Tehran University of Medical Sciences), Alaa Badawi(Institute for Health Metrics and Evaluation), Atif Amin Baig(Digestive Disease Research Institute), Neeraj Bhala(Digestive Disease Research Institute), Ali Bijani(Institute for Health Metrics and Evaluation), Antonio Biondi(University of Washington), Antonio Maria Borzì(Institute for Health Metrics and Evaluation), Kristin E. Burke(Tehran University of Medical Sciences), Félix Carvalho(Tehran University of Medical Sciences), Ahmad Daryani(Digestive Disease Research Institute), Manisha Dubey(Digestive Disease Research Institute), Aziz Eftekhari(Digestive Disease Research Institute), Eduarda Fernandes(University of Washington), João Carlos Fernandes(Institute for Health Metrics and Evaluation), Florian Fischer(Digestive Disease Research Institute), Arvin Haj‐Mirzaian(Tehran University of Medical Sciences), Arya Haj‐Mirzaian(Tehran University of Medical Sciences), Amir Hasanzadeh(Tehran University of Medical Sciences), Maryam Hashemian(University of Washington), Simon I Hay(Tehran University of Medical Sciences), Chi Linh Hoang(Institute for Health Metrics and Evaluation), Mowafa Househ(Tehran University of Medical Sciences), Olayinka Stephen Ilesanmi(Institute for Health Metrics and Evaluation), Nader Jafari Balalami(Digestive Disease Research Institute), Spencer L James(University of Washington), André Pascal Kengne(University of Washington), Masoud Malekzadeh(Institute for Health Metrics and Evaluation), Shahin Merat(Tehran University of Medical Sciences), Tuomo J Meretoja(Tehran University of Medical Sciences), Tomislav Meštrović(Institute for Health Metrics and Evaluation), Erkin М Мirrakhimov(Institute for Health Metrics and Evaluation), Hamid Reza Mirzaei(Institute for Health Metrics and Evaluation), Karzan Abdulmuhsin Mohammad(Institute for Health Metrics and Evaluation), Ali H. Mokdad(University of Washington), Lorenzo Monasta(Institute for Health Metrics and Evaluation), Ionuţ Negoi(Institute for Health Metrics and Evaluation), Trang Huyen Nguyen(University of Washington), Cuong Tat Nguyen(University of Washington), Akram Pourshams(University of Washington), Hossein Poustchi(Institute for Health Metrics and Evaluation), Mohammad Rabiee(University of Washington), Navid Rabiee(Tehran University of Medical Sciences), Kiana Ramezanzadeh(Digestive Disease Research Institute), David Laith Rawaf(Institute for Health Metrics and Evaluation), Salman Rawaf(Digestive Disease Research Institute), Nima Rezaei(University of Washington), Stephen R. Robinson(University of Washington), Luca Ronfani(Tehran University of Medical Sciences), Sonia Saxena(Digestive Disease Research Institute), Masood Sepehrimanesh(Institute for Health Metrics and Evaluation), Masood Ali Shaikh(Institute for Health Metrics and Evaluation), Zeinab Sharafi(Institute for Health Metrics and Evaluation), Mehdi Sharif(Institute for Health Metrics and Evaluation), Soraya Siabani(Digestive Disease Research Institute), Ali Reza Sima(Tehran University of Medical Sciences), Jasvinder A. Singh(Digestive Disease Research Institute), Amin Soheili(Digestive Disease Research Institute), Rasoul Sotoudehmanesh(Institute for Health Metrics and Evaluation), Hafiz Ansar Rasul Suleria(Institute for Health Metrics and Evaluation), Berhe Etsay Tesfay(Digestive Disease Research Institute), Bach Xuan Tran(Institute for Health Metrics and Evaluation), Derrick Tsoi(University of Washington), Marco Vacante(Digestive Disease Research Institute), Adam Wondmieneh(Tehran University of Medical Sciences), Afshin Zarghi(Digestive Disease Research Institute), Zhi-Jiang Zhang(Digestive Disease Research Institute), Mae Dirac(Institute for Health Metrics and Evaluation), Reza Malekzadeh(Institute for Health Metrics and Evaluation), Mohsen Naghavi(Tehran University of Medical Sciences)
˜The œLancet. Gastroenterology & hepatology
October 21, 2019
10.1016/s2468-1253(19)30333-4
Cited by 2,241Open Access
Full Text

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.

Related Papers

No related papers found

Powered by citation graph analysis