Crohn’s disease in one mixed-race population in Brazil

Santana, Genoile Oliveira; Lyra, Luiz Guilherme Costa; Santana, Tamara Celi Almeida; Reis, Lidiane Bianca dos; Guedes, Jorge Carvalho; Toralles, Maria Betânia Pereira; Lyra, André Castro

doi:10.3748/wjg.v13.i33.4489

Cited by 14 publications

(14 citation statements)

References 18 publications

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“…4 Several studies suggested a modest association between nonwhite race and higher rates of hospitalization for IBD, but these studies tended to be small and not nationally representative. 9,16,35,41 African American subjects were 34% more likely to leave against medical advice in a study using the Nationwide Inpatient Sample. 40 However, SES appeared to be a stronger predictor of inpatient utilization than race, as patients with Medicaid healthcare coverage were 4.5 times more likely to leave against medical advice.…”

Section: Study Results and Interpretationmentioning

confidence: 97%

“…7,8,8-16 Seven of the nine studies comparing medical therapy across race groups identified race-based differences in medical therapy received by patients. In six of seven studies, whites were more often treated with immunomodulators and infliximab, suggesting disparities in access to, and/or utilization of, potentially disease-modifying therapy.…”

Section: Study Results and Interpretationmentioning

confidence: 99%

“…Fourteen studies evaluated the impact of race and SES on healthcare access and utilization (table 6). 4,8,9,13,15,16,20,22,35,40-44 Three of four studies of race and ambulatory care found race-based differences, with discordant findings; all were single-center studies. 8,13,20,44 The largest study of 951 subjects found that African American men with Crohn's disease had 67% more ambulatory gastroenterology visits than white men with Crohn's disease; there were no race-based differences for women.…”

Section: Study Results and Interpretationmentioning

confidence: 99%

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Systematic Review

Sewell

Velayos

2013

Inflammatory Bowel Diseases

101

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Introduction Race and socioeconomic status (SES) significantly affect the content and delivery of healthcare for multiple chronic disease states. Inflammatory bowel disease (IBD) is a set of complex, chronic diseases with the potential for significant morbidity if the content or delivery of healthcare is suboptimal. However, the literature related to race, SES, and IBD remains fragmented. Methods Using guidelines published by the Centre for Reviews and Dissemination, we performed a systematic review of the world's literature to identify studies related to: (1) IBD, (2) race/ethnicity, (3) SES, (4) healthcare delivery, and (5) healthcare effectiveness. Results We identified 40 studies that met inclusion criteria. Twenty-four studies (60%) assessed the role of SES, and 21 (53%) evaluated race. Topics addressed by these studies included: (1) Utilization of Medical and Surgical Therapy; (2) Adherence to Medical Therapy; (3) Clinical Outcomes; (4) Healthcare Access and Utilization; (5) Disease Perception and Knowledge; and (6) Employment/Insurance. We identified race- and SES-based disparities in the content of medical and surgical healthcare, utilization of inpatient and ambulatory medical care, adherence to medical therapy, and disease perceptions and knowledge. Several studies also identified race- and SES-based disparities in outcomes for IBD, including in-hospital mortality rates and health-related quality of life. Discussion Race- and SES-based disparities in the delivery and effectiveness of healthcare for patients with IBD exist in numerous domains, yet studies remain limited in their scope and breadth. Concerted, prospective, multicenter efforts are needed to address underlying causes for disparities and to identify methods of reducing and eliminating disparities.

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Section: Study Results and Interpretationmentioning

confidence: 97%

Section: Study Results and Interpretationmentioning

confidence: 99%

Section: Study Results and Interpretationmentioning

confidence: 99%

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Systematic Review

Sewell

Velayos

2013

Inflammatory Bowel Diseases

101

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“…[50]One study found a higher prevalence of left-sided colitis, higher mortality, and higher usage of biological agents in Mexican population than in Mexican-American population, supporting the role of environmental factors on clinical characteristics of IBD. [24] The larger case-series in LAC Countries are from 1946 to date are from Argentina [14,51,52], Barbados [13], Brazil [14,[53][54][55][56][57][58][59][60][61][62][63][64][65], Chile [66][67][68], Cuba [69], Peru [70,71], Puerto Rico [72][73][74][75] and Uruguay. [76][77][78] Most CD localizations were ileal-colonic and CD behavior was mostly inflammatory, followed by penetrant or stenotic.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of inflammatory bowel disease in Mexico and Colombia: Analysis of health databases, mathematical modelling and a case-series study

et al. 2020

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Background and aims Ulcerative Colitis (UC) and Crohn's Disease (CD) have a major impact on quality of life and medical costs. The aim of the study was to estimate the prevalence, incidence and clinical phenotypes of Inflammatory Bowel Disease (IBD) cases in Mexico and Colombia. Methods We analyzed official administrative and health databases, used mathematical modelling to estimate the incidence and complete prevalence, and performed a case-series of IBD patients at a referral center both in Mexico and Colombia. Results The age-adjusted complete prevalence of UC per 100,000 inhabitants for 2015/2016 ranged from 15.65 to 71.19 in Mexico and from 27.40 to 69.97 in Colombia depending on the model considered. The prevalence of CD per 100,000 inhabitants in Mexico ranged from 15.45 to 18.08 and from 16.75 to 18.43 in Colombia. In Mexico, the age-adjusted incidence of UC per 100,000 inhabitants per year ranged from 0.90 to 2.30, and from 0.55 to 2.33 in Colombia. The incidence for CD in Mexico ranged from 0.35 to 0.66 whereas in Colombia, the age-adjusted incidence of CD ranged from 0.30 to 0.57. The case-series included 200 IBD patients from Mexico and 204 patients from Colombia.

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“…The concordance rate of the incidence in monozygotic twins is 50% at most , and immigrants from low‐incidence to high‐incidence areas quite rapidly acquire the incidence of the current area of residence. Furthermore, economic development in recent years has led to westernized lifestyle changes and industrialization in developing countries, such as in Asia and Eastern Europe, and a higher incidence of IBDs . Environmental factors must therefore be considered.…”

Section: Introductionmentioning

confidence: 99%