Clinico-Epidemiological Characteristics of Patients With Inflammatory Bowel Disease in Egypt: A Nationwide Multicenter Study

Mohamed Elbadry; Mohamed O Nour; Mohamed Hussien; Elsayed Awad Ghoneem; Mohammed A Medhat; Hany Shehab; Sherif Galal; Mohamed Eltabbakh; Fathiya El-Raey; Mohamed Negm; Shimaa Afify; Walaa Abdelhamed; Ahmed Sherief; Ahmed Abdelaziz; Mohamed Abo Elkasem; Aya Mahrous; Ghada Kamal; Maha Maher; Omar Abdel-Hameed; Abubakr Elbasuny; Islam El-Zayyadi; Ahmed Bassiony; Abdelmajeed Moussa; Essam Bedewy; Asem Elfert; Mohamed El Kassas

doi:10.3389/fmed.2022.867293

Clinico-Epidemiological Characteristics of Patients With Inflammatory Bowel Disease in Egypt: A Nationwide Multicenter Study

Front Med (Lausanne). 2022 Apr 19:9:867293. doi: 10.3389/fmed.2022.867293. eCollection 2022.

Authors

Mohamed Elbadry¹, Mohamed O Nour^{2

3}, Mohamed Hussien⁴, Elsayed Awad Ghoneem⁵, Mohammed A Medhat⁶, Hany Shehab⁷, Sherif Galal⁸, Mohamed Eltabbakh⁹, Fathiya El-Raey¹⁰, Mohamed Negm⁷, Shimaa Afify¹¹, Walaa Abdelhamed¹², Ahmed Sherief⁹, Ahmed Abdelaziz¹⁰, Mohamed Abo Elkasem¹¹, Aya Mahrous⁴, Ghada Kamal⁶, Maha Maher⁵, Omar Abdel-Hameed⁵, Abubakr Elbasuny¹³, Islam El-Zayyadi⁵, Ahmed Bassiony⁹, Abdelmajeed Moussa¹⁴, Essam Bedewy¹⁵, Asem Elfert¹⁶, Mohamed El Kassas¹

Affiliations

¹ Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt.
² Department of Public Health and Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
³ Faculty of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia.
⁴ Department of Gastroenterology, Hepatology and Infectious Diseases, Kafrelsheikh University, Kafrelsheikh, Egypt.
⁵ Department of Hepatology and Gastroenterology, Mansoura University, Mansoura, Egypt.
⁶ Department of Tropical Medicine and Gastroenterology, Assiut University, Assiut, Egypt.
⁷ Integrated Clinical and Research Center for Intestinal Disorders (ICRID), Department and Endemic Medicine, Cairo University, Cairo, Egypt.
⁸ Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
⁹ Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
¹⁰ Department of Hepatogastroenterology and Infectious Diseases, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
¹¹ Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
¹² Department Tropical Medicine and Gastroenterology, Sohag University, Sohag, Egypt.
¹³ Department of Hepatology and Gastroenterology, Talkha Central Hospital, Talkha, Egypt.
¹⁴ Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Aswan University, Aswan, Egypt.
¹⁵ Department of Tropical Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
¹⁶ Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine Tanta University, Tanta, Egypt.

Abstract

Background and aims: Ulcerative colitis (UC) and Crohn's disease (CD) are the most common types of Inflammatory bowel disease (IBD), with variable responses to traditional therapies and unpredicted prognosis. In Egypt and most developing countries, the lack of recent epidemiological and prognostic data adversely affects management strategies. We collected and analyzed data of patients with IBD from multiple centers across Egypt to evaluate patients' clinical and epidemiological characteristics.

Methods: This retrospective multicenter study included patients diagnosed with IBD between May 2018 and August 2021, at 14 tertiary gastroenterology units across Egypt. Record analysis addressed a combination of clinico-epidemiological characteristics, biochemical tests, stool markers, endoscopic features, histological information, and different lines for IBD treatment.

Results: We identified 1104 patients with an established diagnosis of IBD; 81% of them had UC, and 19% showed CD. The mean age of onset was 35.1 ± 12.5 years ranging from 5 to 88 years, the mean duration of illness at inclusion was 13.6 ± 16.7 years, gender distribution was almost equal with a significant male dominance (60.4%, p = 0.003) among patients with CD, 57% were living in rural areas, and 70.5% were from Delta and Coastal areas. Two hundred nineteen patients (19.8%) displayed comorbid conditions, primarily associated with CD. The most frequent complaints were diarrhea (73.2%), rectal bleeding (54.6%) that was significantly higher among patients with UC (64%, p < 0.001), and 46.8% with abdominal pain (more often with CD: 71%, p < 0.001). Conventional therapy was effective in treating 94.7% of patients. The main lesion in patients with CD was ileal (47.8%); patients with UC mainly exhibited proctosigmoiditis (28.4%). Dysplasia was detected in 7.2% of patients, mainly subjects with UC.

Conclusions: To our knowledge, our effort is the first and largest cohort of Egyptian patients with IBD to describe clinical and epidemiological characteristics, and diagnostic and management approaches. More extensive prospective studies are still needed to fully characterize disease distribution, environmental factors, and pathological features of the disease.

Keywords: Crohn's disease; Egypt; inflammatory bowel disease; multicenter study; ulcerative colitis.

Copyright © 2022 Elbadry, Nour, Hussien, Ghoneem, Medhat, Shehab, Galal, Eltabbakh, El-Raey, Negm, Afify, Abdelhamed, Sherief, Abdelaziz, Abo Elkasem, Mahrous, Kamal, Maher, Abdel-Hameed, Elbasuny, El-Zayyadi, Bassiony, Moussa, Bedewy, Elfert and El Kassas.