Epidemiologic trend of pediatric inflammatory bowel disease in Latin America: The Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) Working Group

INTRODUCTION AND AIMS

The primary aim was to explore the epidemiologic trend of pediatric inflammatory bowel disease in Latin America, and the secondary aims were to obtain an overview of the diagnostic/therapeutic focus of the members of the LASPGHAN and examine the relation of case frequency to year, during the study period.

MATERIALS AND METHODS

Latin American pediatric gastroenterologists participated in an online survey, conducted through the SurveyMonkey platform, that investigated the yearly frequency of new inflammatory bowel disease patients within the time frame of 2005-2016, their disease variety, the gastrointestinal segments affected, and the diagnostic and treatment methods utilized. The correlation of new case frequency with each study year was evaluated.

RESULTS

A total of 607 patients were studied. The diagnoses were ulcerative colitis in 475 (78.3%) cases, Crohn's disease in 104 (17.1%), and inflammatory bowel disease D unclassified in 28 (4.6%). The trend in ulcerative colitis was a lineal increase in the frequency of new cases related to each study year, with a significant correlation coefficient. Pancolitis was found in 67.6% of the patients. The diagnostic methods included clinical data, endoscopy, and biopsies in more than 99% of the cases, and imaging studies were indicated selectively. Drug regimens were limited to 5-aminosalicylic acid derivatives, azathioprine, 6-mercaptopurine, infliximab, and adalimumab.

CONCLUSIONS

Pediatric inflammatory bowel disease in Latin America appears to have increased during the years included in the study period, with a predominance of moderate or severe ulcerative colitis. That lineal trend suggests the predictive likelihood of a gradual increase in the coming years, with possible epidemiologic and clinical implications.

Epidemiologic trend of pediatric inflammatory bowel disease in Latin America: The Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) Working Group

INTRODUCTION AND OBJECTIVES

The primary aim was to explore the epidemiologic trend of pediatric inflammatory bowel disease in Latin America, and the secondary aims were to obtain an overview of the diagnostic/therapeutic focus of the members of the LASPGHAN and examine the relation of case frequency to year, during the study period.

MATERIALS AND METHODS

Latin American pediatric gastroenterologists participated in an online survey, conducted through the SurveyMonkey platform, that investigated the yearly frequency of new inflammatory bowel disease patients within the time frame of 2005 to 2016, their disease variety, the gastrointestinal segments affected, and the diagnostic and treatment methods utilized. The correlation of new case frequency with each study year was evaluated.

RESULTS

A total of 607 patients were studied. The diagnoses were ulcerative colitis in 475 (78.3%) cases, Crohn's disease in 104 (17.1%), and inflammatory bowel disease D unclassified in 28 (4.6%). The trend in ulcerative colitis was a lineal increase in the frequency of new cases related to each study year, with a significant correlation coefficient. Pancolitis was found in 67.6% of the patients. The diagnostic methods included clinical data, endoscopy, and biopsies in more than 99% of the cases, and imaging studies were indicated selectively. Drug regimens were limited to 5-aminosalicylic acid derivatives, azathioprine, 6-mercaptopurine, infliximab, and adalimumab.

CONCLUSIONS

Pediatric inflammatory bowel disease in Latin America appears to have increased during the years included in the study period, with a predominance of moderate or severe ulcerative colitis. That lineal trend suggests the predictive likelihood of a gradual increase in the coming years, with possible epidemiologic and clinical implications.

Prevalence of eosinophilic esophagitis: A multicenter study on a pediatric population evaluated at thirty-six Latin American gastroenterology centers

INTRODUCTION AND OBJECTIVE

Eosinophilic esophagitis is a chronic, immune-mediated disease described in case series and publications worldwide. Over the past twenty years, the authors of different studies have attempted to evaluate its incidence and prevalence. The objetive of the present study was to estimate the prevalence of eosinophilic esophagitis in a group of children seen at 36 pediatric gastroenterology centers in ten Latin American countries.

MATERIALS AND METHODS

A multicenter, observational, and cross-sectional study was conducted that estimated the period prevalence of eosinophilic esophagitis in children seen at outpatient consultation and that underwent diagnostic upper gastrointestinal endoscopy for any indication at 36 centers in 10 Latin American countries, within a 3-month time frame.

RESULTS

Between April and June 2016, 108 cases of eosinophilic esophagitis were evaluated. Likewise, an average of 29,253 outpatient consultations and 4,152 diagnostic upper gastrointestinal endoscopies were carried out at the 36 participating centers. The period prevalence of eosinophilic esophagitis in the population studied (n=29,253) was 3.69 cases×1,000 (95% CI: 3.04 to 4.44), and among the children that underwent routine upper gastrointestinal endoscopy (n=4,152), it was 26x1,000 (95% CI: 22.6 to 29.4).

CONCLUSIONS

The general period prevalence of eosinophilic esophagitis in a group of children evaluated at 36 Latin American pediatric gastroenterology centers was 3.69×1,000, and in the children that underwent endoscopy, it was 26×1,000. There was important prevalence variability between the participating countries and centers. The present analysis is the first study conducted on the prevalence of pediatric eosinophilic esophagitis in Latin America.

Prevalence of functional gastrointestinal disorders in school-aged children in El Salvador

BACKGROUND

We studied the epidemiology of functional gastrointestinal disorders (FGIDs) in school-aged Salvadoran children using standardized diagnostic criteria.

AIMS

To determine the prevalence of FGIDs in school-aged children in El Salvador.

MATERIAL AND METHODS

A total of 395 children participated in the study (one public school and one private school). School children completed the Spanish version of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III (QPGS-III), an age-appropriate and previously validated instrument for diagnosing FGIDs according to the Rome III criteria. Sociodemographic (age, sex, type of school) and familial (family structure and size, family history of gastrointestinal disorders) data were obtained.

RESULTS

The mean age of the sample was 11.8 years ± 1.6 SD (median 10, range 8-15) and 59% of the participants were female. Eighty-one children met the diagnostic criteria for a FGID (20%). Defecation disorders were the most common group of FGIDs. Functional constipation was diagnosed in 10% of the children and 9.25% were diagnosed with abdominal pain-related FGIDs (most commonly IBS, 3.75%). IBS overlapped with functional dyspepsia in 11% of the cases. Children with FGIDs frequently reported nausea. Children attending private school and older children had significantly more FGIDs than children in public school and younger children.

CONCLUSIONS

FGIDs are common in school-aged Salvadoran children.

Prevalence of functional gastrointestinal disorders in school-aged children in El Salvador

BACKGROUND

We studied the epidemiology of functional gastrointestinal disorders (FGIDs) in school-aged Salvadoran children using standardized diagnostic criteria.

AIMS

To determine the prevalence of FGIDs in school-aged children in El Salvador.

MATERIAL AND METHODS

A total of 395 children participated in the study (one public school and one private school). School children completed the Spanish version of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III (QPGS-III), an age-appropriate and previously validated instrument for diagnosing FGIDs according to the Rome III criteria. Sociodemographic (age, sex, type of school) and familial (family structure and size, family history of gastrointestinal disorders) data were obtained.

RESULTS

The mean age of the sample was 11.8 years ± 1.6 SD (median 10, range 8-15) and 59% of the participants were female. Eighty-one children met the diagnostic criteria for a FGID (20%). Defecation disorders were the most common group of FGIDs. Functional constipation was diagnosed in 10% of the children and 9.25% were diagnosed with abdominal pain-related FGIDs (most commonly IBS, 3.75%). IBS overlapped with functional dyspepsia in 11% of the cases. Children with FGIDs frequently reported nausea. Children attending private school and older children had significantly more FGIDs than children in public school and younger children.

CONCLUSIONS

FGIDs are common in school-aged Salvadoran children.