Abstract
Background: The burden of inflammatory bowel disease (IBD) is rising globally, with substantial variation in levels and trends of disease in different countries and regions. Understanding these geographical differences is crucial for formulating effective strategies for preventing and treating IBD. We report the prevalence, mortality, and overall burden of IBD in 195 countries and territories between 1990 and 2017, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. Methods: We modelled mortality due to IBD using a standard Cause of Death Ensemble model including data mainly from vital registrations. To estimate the non-fatal burden, we used data presented in primary studies, hospital discharges, and claims data, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to ensure consistency between measures. Mortality, prevalence, years of life lost (YLLs) due to premature death, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were estimated. All of the estimates were reported as numbers and rates per 100 000 population, with 95% uncertainty intervals (UI). Findings: In 2017, there were 6·8 million (95% UI 6·4–7·3) cases of IBD globally. The age-standardised prevalence rate increased from 79·5 (75·9–83·5) per 100 000 population in 1990 to 84·3 (79·2–89·9) per 100 000 population in 2017. The age-standardised death rate decreased from 0·61 (0·55–0·69) per 100 000 population in 1990 to 0·51 (0·42–0·54) per 100 000 population in 2017. At the GBD regional level, the highest age-standardised prevalence rate in 2017 occurred in high-income North America (422·0 [398·7–446·1] per 100 000) and the lowest age-standardised prevalence rates were observed in the Caribbean (6·7 [6·3–7·2] per 100 000 population). High Socio-demographic Index (SDI) locations had the highest age-standardised prevalence rate, while low SDI regions had the lowest age-standardised prevalence rate. At the national level, the USA had the highest age-standardised prevalence rate (464·5 [438·6–490·9] per 100 000 population), followed by the UK (449·6 [420·6–481·6] per 100 000). Vanuatu had the highest age-standardised death rate in 2017 (1·8 [0·8–3·2] per 100 000 population) and Singapore had the lowest (0·08 [0·06–0·14] per 100 000 population). The total YLDs attributed to IBD almost doubled over the study period, from 0·56 million (0·39–0·77) in 1990 to 1·02 million (0·71–1·38) in 2017. The age-standardised rate of DALYs decreased from 26·5 (21·0–33·0) per 100 000 population in 1990 to 23·2 (19·1–27·8) per 100 000 population in 2017. Interpretation: The prevalence of IBD increased substantially in many regions from 1990 to 2017, which might pose a substantial social and economic burden on governments and health systems in the coming years. Our findings can be useful for policy makers developing strategies to tackle IBD, including the education of specialised personnel to address the burden of this complex disease. Funding: Bill & Melinda Gates Foundation.
Original language | English |
---|---|
Pages (from-to) | 17-30 |
Number of pages | 14 |
Journal | The Lancet Gastroenterology and Hepatology |
Volume | 5 |
Issue number | 1 |
DOIs | |
Publication status | Published - Jan 1 2020 |
ASJC Scopus subject areas
- Hepatology
- Gastroenterology
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The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017. / GBD 2017 Inflammatory Bowel Disease Collaborators.
In: The Lancet Gastroenterology and Hepatology, Vol. 5, No. 1, 01.01.2020, p. 17-30.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990–2017
T2 - a systematic analysis for the Global Burden of Disease Study 2017
AU - GBD 2017 Inflammatory Bowel Disease Collaborators
AU - Alatab, Sudabeh
AU - Sepanlou, Sadaf G.
AU - Ikuta, Kevin
AU - Vahedi, Homayoon
AU - Bisignano, Catherine
AU - Safiri, Saeid
AU - Sadeghi, Anahita
AU - Nixon, Molly R.
AU - Abdoli, Amir
AU - Abolhassani, Hassan
AU - Alipour, Vahid
AU - Almadi, Majid A.H.
AU - Almasi-Hashiani, Amir
AU - Anushiravani, Amir
AU - Arabloo, Jalal
AU - Atique, Suleman
AU - Awasthi, Ashish
AU - Badawi, Alaa
AU - Baig, Atif A.A.
AU - Bhala, Neeraj
AU - Bijani, Ali
AU - Biondi, Antonio
AU - Borzì, Antonio M.
AU - Burke, Kristin E.
AU - Carvalho, Félix
AU - Daryani, Ahmad
AU - Dubey, Manisha
AU - Eftekhari, Aziz
AU - Fernandes, Eduarda
AU - Fernandes, João C.
AU - Fischer, Florian
AU - Haj-Mirzaian, Arvin
AU - Haj-Mirzaian, Arya
AU - Hasanzadeh, Amir
AU - Hashemian, Maryam
AU - Hay, Simon I.
AU - Hoang, Chi L.
AU - Househ, Mowafa
AU - Ilesanmi, Olayinka S.
AU - Balalami, Nader Jafari
AU - James, Spencer L.
AU - Kengne, Andre P.
AU - Malekzadeh, Masoud M.
AU - Merat, Shahin
AU - Meretoja, Tuomo J.
AU - Mestrovic, Tomislav
AU - Mirrakhimov, Erkin M.
AU - Mirzaei, Hamed
AU - Monasta, Lorenzo
AU - Ronfani, Luca
N1 - Funding Information: Department of Medical Immunology (H Mirzaei PhD), Department of Microbiology (A Hasanzadeh PhD), Department of Pharmacology (A Haj-Mirzaian MD, A Haj-Mirzaian MD), Digestive Disease Research Institute (A Anushiravani MD), Digestive Diseases Research Institute (S Alatab PhD, S G Sepanlou MD, H Vahedi MD, A Sadeghi MD, M M Malekzadeh MD, Prof S Merat MD, Prof A Pourshams MD, H Poustchi PhD, A Sima MD, Prof R Sotoudehmanesh BHlthSci, Prof R Malekzadeh MD), Research Center for Immunodeficiencies (Prof N Rezaei PhD), Research center for Immunodeficiencies (H Abolhassani PhD), Shariati Hospital (A Sima MD), Tehran University of Medical Sciences, Tehran, Iran; Non-Communicable Diseases Research Center (S G Sepanlou MD), Non-communicable Diseases Research Center (Prof R Malekzadeh MD), Shiraz University of Medical Sciences, Shiraz, Iran; Department of Health Metrics Sciences, School of Medicine (Prof S I Hay FMedSci, Prof A H Mokdad PhD, Prof M Naghavi MD), Division of Allergy and Infectious Diseases (K Ikuta MD), Institute for Health Metrics and Evaluation (K Ikuta MD, C Bisignano MPH, Prof S I Hay FMedSci, S L James MD, Prof A H Mokdad PhD, M R Nixon PhD, D Tsoi BS, M Dirac MD, Prof M Naghavi MD), University of Washington, Seattle, WA, USA; Aging Research Institute (S Safiri PhD), Department of Community Medicine (S Safiri PhD), Department of Pharmacology and Toxicology (A Eftekhari PhD), Tabriz University of Medical Sciences, Tabriz, Iran; Department of Parasitology and Mycology (A Abdoli PhD), Jahrom University of Medical Sciences, Jahrom, Iran; LABMED (H Abolhassani PhD), Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology (A Almasi-Hashiani PhD), Health Management and Economics Research Center (V Alipour PhD), Tehran, Iran; Health Economics Department (V Alipour PhD), Health Management and Economics Research Center (J Arabloo PhD), Iran University of Medical Sciences, Tehran, Iran; College of Medicine (M A H Almadi FRCPC), King Saud University, Riyadh, Saudi Arabia; Division of Gastroenterology & Hepatology (M A H Almadi FRCPC), McGill University, Montreal, QB, Canada; University Institute of Public Health (S Atique PhD), The University of Lahore, Lahore, Pakistan; College of Public Health (S Atique PhD), University of Hail, Hail, Saudi Arabia; Indian Institute of Public Health, Gandhinagar, India (A Awasthi PhD); Public Health Foundation of India, Gurugram, India (A Awasthi PhD); Public Health Risk Sciences Division (A Badawi PhD), Public Health Agency of Canada, Toronto, ON, Canada; Department of Nutritional Sciences (A Badawi PhD), University of Toronto, Toronto, ON, Canada; Biomedicine Department (A A A Baig PhD), Unit of Biochemistry, Faculty of Medicine (A A A Baig PhD), Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia; Institutes of Applied Health Research and Translational Medicine (N Bhala DPhil), Queen Elizabeth Hospital Birmingham, Birmingham, UK; IAHR/ITM (N Bhala DPhil), University of Birmingham, Birmingham, UK; Social Determinants of Health Research Center (A Bijani PhD), Babol University of Medical Sciences, Babol, Iran; Department of General Surgery and Medical-Surgical Specialties (Prof A Biondi PhD, M Vacante PhD), General Surgery and Medical-Surgical Specialties (A M Borzì MD), University of Catania, Catania, Italy; Division Gastroenterology (K E Burke MD), Massachusetts General Hospital, Boston, MA, USA; Applied Molecular Biosciences Unit (Prof F Carvalho PhD), Institute of Public Health (Prof F Carvalho PhD), University of Porto, Porto, Portugal; Toxoplasmosis Research Center (Prof A Daryani PhD), Mazandaran University of Medical Sciences, Sari, Iran; United Nations World Food Programme (M Dubey PhD), United Nations World Food Programme, New Delhi, India; Department of Microbiology (A Hasanzadeh PhD), Pharmacology and Toxicology Department (A Eftekhari PhD), Maragheh University of Medical Sciences, Maragheh, Iran; Center for Biotechnology and Fine Chemistry (J C Fernandes PhD), Catholic University of Portugal, Porto, Portugal; REQUIMTE/LAQV (Prof E Fernandes PhD), University of Porto, Porto, Portugal; School of Public Health Medicine (F Fischer PhD), Bielefeld University, Bielefeld, Germany; Department of Medicinal and Pharmaceutical Chemistry (Prof A Zarghi PhD), Department of Pharmacology (K Ramezanzadeh PharmD), Obesity Research Center (A Haj-Mirzaian MD), Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Radiology (A Haj-Mirzaian MD), Johns Hopkins University, Baltimore, MD, USA; Division of Cancer Epidemiology and Genetics (M Hashemian PhD), National Cancer Institute, Rockville, MD, USA; Department of Biology (M Hashemian PhD), Utica College, Utica, NY, USA; Center of Excellence in Behavioral Medicine (C L Hoang BMedSci, T H Nguyen BMedSci), Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam; Division of Information and Computing Technology, College of Science and Engineering (Prof M Househ PhD), Hamad Bin Khalifa University, Doha, Qatar; Qatar Foundation for Education, Science, and Community Development, Doha, Qatar (Prof M Househ PhD); Department of Community Medicine (O S Ilesanmi PhD), University of Ibadan, Ibadan, Nigeria; Department of Psychosis (N Jafari Balalami PhD), Babol Noshirvani University of Technology, Babol, Iran; Non-Communicable Diseases Research Unit (Prof A P Kengne PhD), Medical Research Council South Africa, Cape Town, South Africa; Department of Medicine (Prof A P Kengne PhD), University of Cape Town, Cape Town, South Africa; Breast Surgery Unit (T J Meretoja MD), Helsinki University Hospital, Helsinki, Finland; University of Helsinki, Helsinki, Finland (T J Meretoja MD); Clinical Microbiology and Parasitology Unit (T Mestrovic PhD), Zora Profozic Polyclinic, Zagreb, Croatia; University Centre Varazdin (T Mestrovic PhD), University North, Varazdin, Croatia; Faculty of General Medicine (Prof E M Mirrakhimov MD), Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan; Department of Atherosclerosis and Coronary Heart Disease (Prof E M Mirrakhimov MD), National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan; Research Center for Biochemistry and Nutrition in Metabolic Diseases (H Mirzaei PhD), Kashan University of Medical Sciences, Kashan, Iran; Department of Biology (K A Mohammad PhD), Salahaddin University, Erbil, Iraq; ISHIK University, Erbil, Iraq (K A Mohammad PhD); Clinical Epidemiology and Public Health Research Unit (L Monasta DSc, L Ronfani PhD), Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy; Emergency Hospital of Bucharest (I Negoi PhD), General Surgery Department (I Negoi PhD), Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Institute for Global Health Innovations (C T Nguyen MPH), Duy Tan University, Hanoi, Vietnam; Biomedical Engineering Department (Prof M Rabiee PhD), Amirkabir University of Technology, Tehran, Iran; Department of Chemistry (N Rabiee PhD), Sharif University of Technology, Tehran, Iran; Department of Primary Care and Public Health (Prof S Rawaf MD), School of Public Health (Prof S Saxena MD), WHO Collaborating Centre for Public Health Education and Training (D L Rawaf MD), Imperial College London, London, UK; University College London Hospitals, London, UK (D L Rawaf MD); Academic Public Health (Prof S Rawaf MD), Public Health England, London, UK; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA) (Prof N Rezaei PhD), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Psychology (Prof S R Robinson PhD), Royal Melbourne Institute of Technology University, Bundoora, VIC, Australia; New Iberia Research Center (M Sepehrimanesh PhD), University of Louisiana at Lafayette, Lafayette, LA, USA; Guilan University of Medical Sciences, Rasht, Iran (M Sepehrimanesh PhD); Independent Consultant, Karachi, Pakistan (M A Shaikh MD); Razi Herbal Medicines Research Center (Z Sharafi PhD), Lorestan University of Medical Sciences, Khorramabad, Iran; Department of Basic Sciences (Prof M Sharif PhD), Department of Laboratory Sciences (Prof M Sharif PhD), Islamic Azad University, Sari, Iran; Imam Ali Cardiovascular Research Center (S Siabani PhD), Kermanshah University of Medical Sciences, Kermanshah, Iran; School of Health (S Siabani PhD), University of Technology Sydney, Sydney, NSW, Australia; Rheumatology/Medicine Department (J A Singh MD), University of Alabama at Birmingham, Birmingham, AL, United States; Medical Surgical Nursing Department (A Soheili PhD), Urmia University of Medical Science, Urmia, Iran; Emergency Nursing Department (A Soheili PhD), Zanjan University of Medical Sciences, Iran; Department of Agriculture and Food Systems (H Suleria PhD), University of Melbourne, Melbourne, VC, Australia; Department of Public Health (B E Tesfay MPH), Adigrat University, Adigrat, Ethiopia; Department of Health Economics (B Tran PhD), Hanoi Medical University, Hanoi, Vietnam; Nursing Department (A B Wondmieneh MSc), Wollo University, Dessie, Ethiopia; Addis Ababa University, Addis Ababa, Ethiopia (A B Wondmieneh MSc); and Department of Preventive Medicine (Z Zhang PhD), Wuhan University, Wuhan, China. Funding Information: SLJ reports grants from Sanofi Pasteur, outside the submitted work. JS reports personal fees for consulting work from Crealta/Horizon, Medisys, Fidia, UBM LLC, Medscape, WebMD, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Spherix, The National Institutes of Health, and The American College of Rheumatology, outside the submitted work; and reports owning stock options in Amarin Pharmaceuticals and Viking Pharmaceuticals, outside the submitted work. All other authors declare no competing interests. Funding Information: This study is funded by the Bill & Melinda Gates Foundation. AA is supported by the Department of Science and Technology, Government of India, New Delhi through INSPIRE Faculty programme. AB and JF acknowledge support with funding from Fundacao para a Ciencia e a Tecnologia/Ministerio da Ciencia, Tecnologia e Ensino Superior (FCT/MCTES) through Portuguese national funds, though UID/MULTI/04378/2019 (AB), UID/QUI/50006/2019 (AB), and UID/Multi/50016/2019 (JF) grants. AD would like to thank the College of Science and Engineering, Hamad Bin Khalifa University, Qatar, for providing him with the time and support to work on this important publication. Publisher Copyright: © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: The burden of inflammatory bowel disease (IBD) is rising globally, with substantial variation in levels and trends of disease in different countries and regions. Understanding these geographical differences is crucial for formulating effective strategies for preventing and treating IBD. We report the prevalence, mortality, and overall burden of IBD in 195 countries and territories between 1990 and 2017, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. Methods: We modelled mortality due to IBD using a standard Cause of Death Ensemble model including data mainly from vital registrations. To estimate the non-fatal burden, we used data presented in primary studies, hospital discharges, and claims data, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to ensure consistency between measures. Mortality, prevalence, years of life lost (YLLs) due to premature death, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were estimated. All of the estimates were reported as numbers and rates per 100 000 population, with 95% uncertainty intervals (UI). Findings: In 2017, there were 6·8 million (95% UI 6·4–7·3) cases of IBD globally. The age-standardised prevalence rate increased from 79·5 (75·9–83·5) per 100 000 population in 1990 to 84·3 (79·2–89·9) per 100 000 population in 2017. The age-standardised death rate decreased from 0·61 (0·55–0·69) per 100 000 population in 1990 to 0·51 (0·42–0·54) per 100 000 population in 2017. At the GBD regional level, the highest age-standardised prevalence rate in 2017 occurred in high-income North America (422·0 [398·7–446·1] per 100 000) and the lowest age-standardised prevalence rates were observed in the Caribbean (6·7 [6·3–7·2] per 100 000 population). High Socio-demographic Index (SDI) locations had the highest age-standardised prevalence rate, while low SDI regions had the lowest age-standardised prevalence rate. At the national level, the USA had the highest age-standardised prevalence rate (464·5 [438·6–490·9] per 100 000 population), followed by the UK (449·6 [420·6–481·6] per 100 000). Vanuatu had the highest age-standardised death rate in 2017 (1·8 [0·8–3·2] per 100 000 population) and Singapore had the lowest (0·08 [0·06–0·14] per 100 000 population). The total YLDs attributed to IBD almost doubled over the study period, from 0·56 million (0·39–0·77) in 1990 to 1·02 million (0·71–1·38) in 2017. The age-standardised rate of DALYs decreased from 26·5 (21·0–33·0) per 100 000 population in 1990 to 23·2 (19·1–27·8) per 100 000 population in 2017. Interpretation: The prevalence of IBD increased substantially in many regions from 1990 to 2017, which might pose a substantial social and economic burden on governments and health systems in the coming years. Our findings can be useful for policy makers developing strategies to tackle IBD, including the education of specialised personnel to address the burden of this complex disease. Funding: Bill & Melinda Gates Foundation.
AB - Background: The burden of inflammatory bowel disease (IBD) is rising globally, with substantial variation in levels and trends of disease in different countries and regions. Understanding these geographical differences is crucial for formulating effective strategies for preventing and treating IBD. We report the prevalence, mortality, and overall burden of IBD in 195 countries and territories between 1990 and 2017, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. Methods: We modelled mortality due to IBD using a standard Cause of Death Ensemble model including data mainly from vital registrations. To estimate the non-fatal burden, we used data presented in primary studies, hospital discharges, and claims data, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to ensure consistency between measures. Mortality, prevalence, years of life lost (YLLs) due to premature death, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were estimated. All of the estimates were reported as numbers and rates per 100 000 population, with 95% uncertainty intervals (UI). Findings: In 2017, there were 6·8 million (95% UI 6·4–7·3) cases of IBD globally. The age-standardised prevalence rate increased from 79·5 (75·9–83·5) per 100 000 population in 1990 to 84·3 (79·2–89·9) per 100 000 population in 2017. The age-standardised death rate decreased from 0·61 (0·55–0·69) per 100 000 population in 1990 to 0·51 (0·42–0·54) per 100 000 population in 2017. At the GBD regional level, the highest age-standardised prevalence rate in 2017 occurred in high-income North America (422·0 [398·7–446·1] per 100 000) and the lowest age-standardised prevalence rates were observed in the Caribbean (6·7 [6·3–7·2] per 100 000 population). High Socio-demographic Index (SDI) locations had the highest age-standardised prevalence rate, while low SDI regions had the lowest age-standardised prevalence rate. At the national level, the USA had the highest age-standardised prevalence rate (464·5 [438·6–490·9] per 100 000 population), followed by the UK (449·6 [420·6–481·6] per 100 000). Vanuatu had the highest age-standardised death rate in 2017 (1·8 [0·8–3·2] per 100 000 population) and Singapore had the lowest (0·08 [0·06–0·14] per 100 000 population). The total YLDs attributed to IBD almost doubled over the study period, from 0·56 million (0·39–0·77) in 1990 to 1·02 million (0·71–1·38) in 2017. The age-standardised rate of DALYs decreased from 26·5 (21·0–33·0) per 100 000 population in 1990 to 23·2 (19·1–27·8) per 100 000 population in 2017. Interpretation: The prevalence of IBD increased substantially in many regions from 1990 to 2017, which might pose a substantial social and economic burden on governments and health systems in the coming years. Our findings can be useful for policy makers developing strategies to tackle IBD, including the education of specialised personnel to address the burden of this complex disease. Funding: Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85075968413&partnerID=8YFLogxK
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U2 - 10.1016/S2468-1253(19)30333-4
DO - 10.1016/S2468-1253(19)30333-4
M3 - Article
C2 - 31648971
AN - SCOPUS:85075968413
VL - 5
SP - 17
EP - 30
JO - The Lancet Gastroenterology and Hepatology
JF - The Lancet Gastroenterology and Hepatology
SN - 2468-1253
IS - 1
ER -