Inflammatory bowel disease in the Bedouin Arabs of southern Israel: rarity of diagnosis and clinical features.

Abstract

A prospective epidemiological and clinical study of ulcerative colitis and Crohn's disease was undertaken in the Bedouin Arabs of southern Israel between 1981 and 1990. There were six patients with ulcerative colitis and the prevalence rate in 1990 was calculated to be 9-8/105 (95% confidence intervals 3.6-17.4) in the total population, or 6-2/105 (0.8-22.5) in men and 13.7/105 (3.7-35.0) in women. Two cases of Crohn's disease occurred, both in women; the prevalence rate was 3 2/10 (0 4-11-8) Results are shown as mean (SD). The prevalence rates are expressed per 105 population, and the prevalence date was 30 June 1990. Confidence intervals (CI) are calculated at the 95% limit." Statistical comparison between the prevalence rates in Arabs and the rates previously documented in Jews5 was performed using age adjustment of rates to the world standard population and the odds ratio. 12 13 Results There were 61299 Bedouin Arabs living in southern Israel in 1990. The male to female ratio was 1 1. In men, 56-4% were aged 0-14 years, 30 4% were 15-34 years, 10-1% were 35-54 years, and 3-1% were 55+ years. In women the respective percentages were 57 6%, 28-6%, 10-5%, and 3-3%. About 80% of the population was rural but most lived within short distances from the large towns.Altogether eight patients with inflammatory bowel disease were diagnosed during the study period (no cases were diagnosed before 1981).There were two men and six women, ratio 0 33. These patients were aged mean (SD) 34-0 (16-4) years at a time of diagnosis, and the time interval between onset of symptoms and diagnosis was not more than one year. All the patients were alive on the prevalence date.Six of the patients had ulcerative colitis -two men and four women (Table I)

Ulcerative Colitis in Oman

“…There was no significant difference in the occurrence of the disease between the Omani and expatriate population. A similar low rate was reported in Bedouin Arabs in southern Israel (prevalence 9.8/100,000) and also in the province of Granada, Spain (incidence 2/100.000/year) [3,15]. In the present study we did not find any significant change in the incidence of UC over the 8-year study period.…”

Ulcerative Colitis in Kuwait: A Review of 90 Cases

“…In the Arab population, a growing number of publications have noted an increasing trend [5, 6, 7, 8, 9, 10, 11, 12, 13, 14]. Few reports have been published from the Persian Gulf area [9, 10, 11].…”

“…Several reports from Indian immigrants in Leicestershire, England [4], Israel [5, 6, 7, 8], Oman [9], Iran [10], Kuwait [11], Turkey [12, 13], Lebanon [14], and South Africa [15]all suggest an increasing incidence. However, UC seems to be uncommon in Singapore [16].…”

The Role of Psychological Stress in Inflammatory Bowel Disease

“…It was proposed that it was the stress of relocation which caused the increased risk of developing IBD. However, studies on the same population since have suggested that in fact exposure to new environmental factors such as hygiene or food may be more important [12] . Li et al [13] used retrospective population data to examine whether a stressful life event could predispose to IBD.…”