Global Epidemiology and Geographic Variations of Pediatric-Onset Inflammatory Bowel Disease: A Comprehensive Analysis of the Global Burden of Disease Study 1990 to 2019

Yichen Wang; Chun-Wei Pan; Yuting Huang; Xin Zheng; Si Li; Mingyue He; Jana G Hashash; Francis A Farraye; Adam C Ehrlich

doi:10.1093/ibd/izae093

Global Epidemiology and Geographic Variations of Pediatric-Onset Inflammatory Bowel Disease: A Comprehensive Analysis of the Global Burden of Disease Study 1990 to 2019

Inflamm Bowel Dis. 2024 Apr 27:izae093. doi: 10.1093/ibd/izae093. Online ahead of print.

Authors

Yichen Wang¹, Chun-Wei Pan², Yuting Huang³, Xin Zheng⁴, Si Li⁵, Mingyue He⁵, Jana G Hashash³, Francis A Farraye³, Adam C Ehrlich⁶

Affiliations

¹ Division of Hospital Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
² Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
³ Division of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, FL, USA.
⁴ Division of Gastroenterology and Hepatology, Loma Linda University Health, Loma Linda, CA, USA.
⁵ Department of Medicine, Temple University Hospital, Philadelphia, PA, USA.
⁶ Section of Gastroenterology and Hepatology, Temple University Hospital, Philadelphia, PA, USA.

PMID: 38676392
DOI: 10.1093/ibd/izae093

Abstract

Background: An increasing incidence of pediatric-onset inflammatory bowel disease (PIBD) has been reported in many countries. However, the global burden and distribution of this disease remain less understood. We aimed to examine the global epidemiology and trends of PIBD from 1990 to 2019.

Methods: Data from the 2019 Global Burden of Disease Study, covering 204 countries, were analyzed. We assessed key measures like incidence, prevalence, mortality, and disability-adjusted life years (DALYs) using linear regression to calculate annual percentage changes and assess trends.

Results: Between 1990 and 2019, the PIBD incidence rate increased and the DALY rate and mortality rate declined. The incidence rate was notably elevated in the high Socio-demographic Index (SDI) quintile, reaching 6.3 per 100 000 person-years, corresponding to 13 914 new cases in 2019. Incidence and prevalence of PIBD positively correlated with the SDI, while higher death and DALY burdens were observed in lower-SDI countries. In 2019, the top 5 countries with the highest PIBD incidence rates were Canada (19.9 per 100 000 population), Denmark (12.4 per 100 000 population), Hungary (8.5 per 100 000 population), Austria (8.1 per 100 000 population), and the United States (7.4 per 100 000 population). Several countries experienced significant increases in incidence rates from 1990 to 2019, led by Taiwan (annual percent change 4.2%), followed by China (2.8%), Japan (2.1%), Australia (1.8%), and Hungary (1.6%).

Discussion: PIBD incidence has significantly increased since 1990. High-SDI countries face higher incidence, while lower-SDI countries experience higher mortality and DALY burdens. The study underscores the need for ongoing monitoring and research to address this emerging public health issue.

Keywords: Socio-demographic Index; disease burden; global epidemiology; pediatric-onset inflammatory bowel disease.

Plain language summary

This study analyzed global pediatric-onset inflammatory bowel disease trends from 1990 to 2019. Findings show an increased incidence, especially in high Socio-demographic Index countries, highlighting a growing public health concern and the need for continued monitoring and investigation.

© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.