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

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          Abstract

          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. The UC/CD prevalence ratio in Mexico and Colombia was 1.50:1 and 4.5:1 respectively. In Mexico, the female/male prevalence ratio for UC was 1.50:1 and 1.28:1 for CD, while in Colombia this ratio was 0.68:1 for UC and 0.8:1 for CD. In Mexico the relapse rate for UC was 63.3% and 72.5% for CD, while those rates in Colombia were 58.2% for UC and 58.3% for CD.

          Conclusions

          The estimated burden of disease of IBD in Mexico and Colombia is not negligible. Although these findings need to be confirmed by population-based studies, they are useful for decision-makers, practitioners and patients with this condition.

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          Most cited references56

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          Inflammatory bowel disease.

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            Comparative quantification of health risks: Conceptual framework and methodological issues

            Reliable and comparable analysis of risks to health is key for preventing disease and injury. Causal attribution of morbidity and mortality to risk factors has traditionally been conducted in the context of methodological traditions of individual risk factors, often in a limited number of settings, restricting comparability. In this paper, we discuss the conceptual and methodological issues for quantifying the population health effects of individual or groups of risk factors in various levels of causality using knowledge from different scientific disciplines. The issues include: comparing the burden of disease due to the observed exposure distribution in a population with the burden from a hypothetical distribution or series of distributions, rather than a single reference level such as non-exposed; considering the multiple stages in the causal network of interactions among risk factor(s) and disease outcome to allow making inferences about some combinations of risk factors for which epidemiological studies have not been conducted, including the joint effects of multiple risk factors; calculating the health loss due to risk factor(s) as a time-indexed "stream" of disease burden due to a time-indexed "stream" of exposure, including consideration of discounting; and the sources of uncertainty.
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              Systematic review with meta-analysis: the declining risk of colorectal cancer in ulcerative colitis.

              Patients with ulcerative colitis (UC) have an increased risk of developing colorectal cancer (CRC); however, the magnitude of this effect is open to debate.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: Methodology
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: SoftwareRole: Validation
                Role: Data curationRole: Formal analysis
                Role: Investigation
                Role: Investigation
                Role: InvestigationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                27 January 2020
                2020
                : 15
                : 1
                : e0228256
                Affiliations
                [1 ] Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
                [2 ] Hospital Dr. Bernardo Sepúlveda, Mexico DF, Mexico
                [3 ] Fundación Universitaria Sánitas, Bogotá, Colombia
                [4 ] Janssen-Cilag Farmacêutica Ltda, São Paulo, Brazil
                [5 ] Janssen-Cilag Farmacêutica Ltda, Bogotá, Colombia
                [6 ] Janssen-Cilag Farmacêutica Ltda, Buenos Aires, Argentina
                [7 ] Hospital Italiano de Buenos Aires (HIBA), Buenos Aires, Argentina
                Center for Primary Care and Public Health, SWITZERLAND
                Author notes

                Competing Interests: This work was funded by Janssen-Cilag Pharmaceutical. This does not alter our adherence to PLOS ONE policies on sharing data and materials. In the synthesis of the main results of the study as well as in the development of the writing of the manuscript did not interfere any interest. In addition to this, the present study is of the epidemiological type, where the main results are related to the estimation of prevalence and incidence of the disease, so we consider that it is still difficult for them to be influenced by interests outside those of the main researchers. There are no patents, products in development or marketed products evaluated in this research to declare.

                Author information
                http://orcid.org/0000-0001-9000-6294
                Article
                PONE-D-19-19547
                10.1371/journal.pone.0228256
                6984728
                31986191
                94e12386-6860-44dc-bc80-93a69a6af836
                © 2020 Ciapponi et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 11 July 2019
                : 12 January 2020
                Page count
                Figures: 0, Tables: 6, Pages: 17
                Funding
                This work was funded by Janssen-Cilag Pharmaceutical. Authors BS, AMBP, GM, and LA received funding in the form of salaries from Janssen-Cilag Pharmaceutical. The specific roles of these authors are articulated in the ‘author contributions’ section. The funders had no role in study design, data collection and analysis or decision to publish.
                Categories
                Research Article
                Medicine and Health Sciences
                Gastroenterology and Hepatology
                Inflammatory Bowel Disease
                Colitis
                Ulcerative Colitis
                People and places
                Geographical locations
                North America
                Mexico
                People and places
                Geographical locations
                South America
                Colombia
                Medicine and Health Sciences
                Gastroenterology and Hepatology
                Inflammatory Bowel Disease
                People and places
                Population groupings
                Ethnicities
                Latin American people
                Mexican People
                Medicine and Health Sciences
                Clinical Medicine
                Clinical Immunology
                Autoimmune Diseases
                Crohn's Disease
                Biology and Life Sciences
                Immunology
                Clinical Immunology
                Autoimmune Diseases
                Crohn's Disease
                Medicine and Health Sciences
                Immunology
                Clinical Immunology
                Autoimmune Diseases
                Crohn's Disease
                Medicine and Health Sciences
                Gastroenterology and Hepatology
                Inflammatory Bowel Disease
                Crohn's Disease
                Medicine and Health Sciences
                Public and Occupational Health
                Global Health
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Custom metadata
                All relevant data are within the manuscript and its Supporting Information files.

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                Uncategorized

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