Epidemiology, disease burden, and treatment challenges of ulcerative colitis in Africa and the Middle East

Abstract

Introduction: Ulcerative colitis is an idiopathic, chronic, inflammatory bowel disorder characterized by an unpredictable course of alternating cycles of relapse and remission. Traditionally viewed as a disease of Western countries, the prevalence of ulcerative colitis is reported to be increasing in the developing world. In these regions, there is the potential to further explore the etiology of the disease, mainly through genetic studies. With this in mind, we consider available data relating to the epidemiology, clinical manifestations, and disease course of ulcerative colitis in Africa and the Middle East. Current treatment approaches in these countries are also reviewed and discussed in the context of new, small molecule, orally administered therapies. Areas covered: Available data on the epidemiology, clinical manifestations, and risk factors of ulcerative colitis in Africa and the Middle East are reviewed using a PubMed database search. Expert commentary: Epidemiologic studies from African and Middle Eastern countries suggest disease trends similar to the West, and an important health and economic burden. The management of ulcerative colitis within these developing countries is challenging, with the need to improve early diagnosis, access to healthcare, and patient education, along with facilitation of access to treatment options and improvement of medication adherence. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.

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Keywords

Africa, Epidemiology, Inflammatory bowel disease, Middle east, Prevalence, Ulcerative colitis, Administration, oral, Adult, Age of onset, Aged, Aged, 80 and over, Anti-inflammatory agents, Colitis, ulcerative, Developing countries, Female, Gastrointestinal agents, Humans, Incidence, Male, Middle aged, Risk factors, Severity of illness index, Treatment outcome, Young adult, Adalimumab, Aminosalicylic acid, Corticosteroid, Infliximab, Multidrug resistance associated protein 1, Antiinflammatory agent, Gastrointestinal agent, Adverse outcome, Clinical feature, Disease burden, Disease classification, Disease course, Disease severity, Early diagnosis, Genetic risk, Health care access, Health care cost, Human, Ileal pouch-anal anastomosis, Mdr1 gene, Medication compliance, Onset age, Patient care, Patient education, Proctocolectomy, Remission, Review, Risk factor, Single nucleotide polymorphism, Smoking, Western diet, Developing country, Immunology, Oral drug administration, Very elderly

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