Inflammatory Bowel Disease in Accra: WhatNewTrends?

Abstract

Background: Inflammatory bowel disease (IBD) has been more common in Western Europe and North America. Initially IBD had been thought to be low in incidence among Sub- Saharan Africans. However, it is now being increasingly recognised in patients of African descent.
Objective: A comparative assessment of the patterns of IBD in Accra from 1997 to 2011.
Methods: This study used a retrospective design to access clinical details of follow-up patients attending the Gastroenterology Unit of the Korle-Bu Teaching Hospital, Accra between February, 1997 and May, 2011. It was a comparative seven-year review of clinical presentations of IBD between April, 2004 – August, 2011 (t2) and February, 1997 – March, 2004 (t1) for changing patterns of disease in tertiary care.
Results: Twenty-eight (28) new IBD patients were seen in the Gastroenterology Clinic, KBTH with IBD during 2004 – 2011 (t2) in comparison to 17 patients over1997 – 2004 (t1). Presentations of severe diarrhoea were 70.4% and 55.6% in (t1) and (t2) respectively. Eighty-two percent (82%) of patients with IBD in (t2) had a severely inflamed colon on the index colonoscopy. Most patients (70–80%) responded to medical therapy (steroids, sulfasalazine) with no colon resections for steroid-refractory colitis.
Conclusion: Although relatively uncommon, IBD recorded a 65% rise in incidence over the study periods with a male preponderance. Most patients with IBD were presenting late with severe clinical and endoscopic features of disease yet medically responsive. Non-specific (indeterminate) colitis gained prominence in (t2).

Keywords: Inflammatory, bowel, trends, Accra, Ghana, Africans, non-specific colitis.