scholarly journals Incidence and Prevalence of Crohn’s Disease and Ulerative Colitis (2013–2017) Based on the Latvian Nationwide Medicines Reimbursement Database

Author(s):  
Irēna Mirzajanova ◽  
Santa Purviņa ◽  
Juris Pokrotnieks

AbstractInflammatory bowel disease (IBD) is a chronic, relapsing–remitting, inflammatory condition of the gastrointestinal tract which consists of Crohn’s disease (CD), ulcerative colitis (UC) and undifferentiated IBD. Epidemiology of IBD is changing worldwide, but a significant gap remains in the description of the IBD population in Latvia. The aim of the study was to determine the incidence and prevalence rates of IBD in Latvia in the period between 2013 and 2017. Retrospective analysis of reimbursed medicines claims for IBD diagnoses from the Latvian National Health Service database (NHS) was conducted for the period of 2012 to 2017. From CD patients, 53.7% were female and the area of residency strongly favoured urban areas vs rural districts of Latvia, 59.1% vs 40.9%, respectively. A similar demographic pattern was observed in UC patients, where 56.2% were female and 55.1% of the total UC population lived in urban areas. The overall age- and sex-adjusted incidence rates for CD and UC were 16.45 (CI95% [14.68, 18.21]) and 70.53 (CI95% [66.88, 74.19]) per 100 000 population, respectively, for the entire 2013–2017 period. The prevalence of CD and UC in 2012 was 12.4 and 54.8 cases per 100 000 persons, respectively, compared to 15.5 and 79.5 cases per 100 000 persons in CD and UC in 2017, resulting in a 25% increase in prevalence of CD and 41% increase in UC over the 5-year period. For the first time temporal trends in IBD incidence and prevalence as well as differences across age groups and gender over a five-year period are reported for Latvia.

2020 ◽  
pp. injuryprev-2020-043714
Author(s):  
Miriam J Haviland ◽  
Ali Rowhani-Rahbar ◽  
Frederick P Rivara

BackgroundRates of firearm homicide and suicide have varied over time. These variations are due to a number of factors including temporal trends, age, birth year and gender. We sought to conduct an age–period–cohort analysis to understand the intersection of these factors with firearm homicide and suicide.MethodsWe used data on firearm homicide and suicide for the years 1983–2017 from the Centers for Disease Control and Prevention’s Web-based Injury Statistics Query and Reporting System for this analysis. We restricted our analysis on firearm homicide to persons aged 10–44 years and our analysis on firearm suicide to persons aged 50–84 years, as these age groups are most at risk of each outcome. We calculated annual incidence rates for both outcomes per 100 000 population, overall and by gender.ResultsAcross all age groups, rates of firearm homicide increased dramatically in the late 1980s and early 1990s. The peak age for firearm homicide varied across cohorts, although it was generally between ages 15 and 29 years. Rates of firearm homicide were substantially higher among men than women, regardless of age, period or cohort. Firearm suicide rates varied significantly by gender. Among men, older cohorts had higher firearm suicide rates, although the rate of firearm suicide increased with age across all cohorts. Among women, firearm suicide rates were also highest among older cohorts; however, firearm suicide rates decreased or remained relatively constant with age.ConclusionThere are important differences in rates of firearm homicide and suicide with respect to gender, age, period and cohort.


2017 ◽  
Vol 3 (1) ◽  
pp. 33-41 ◽  
Author(s):  
P.J. Anankware ◽  
E.A. Osekre ◽  
D. Obeng-Ofori ◽  
C.M. Khamala

This study evaluated the social and ecological factors that affect entomophagy in Ghana with a view to instigate the initiation of programmes for the use of insects for human and poultry nutrition in Africa. Two thousand questionnaires were administered to randomly selected respondents in all the ten regions of Ghana. With regards to social factors, entomophagy was found to be influenced by age, gender, education and occupation. Entomophagy is practiced across all age groups and gender in Ghana. Proportionally, 90, 78 and 74% of the aged (60+), middle aged (31-50) and the youth (18-30), respectively, were observed to consume various insect species. Ecologically, entomophagy was more pronounced in rural than urban areas. Over 87% of respondents who consume edible insects acquire them through harvesting/trapping. Four insect species were identified as feed for animals. The majority (81.6%) of the respondents consume insects as a source of protein, 9.6% for cultural reasons, 5.6% for medicinal values and 3.0 and 0.2%, respectively, for recreational and religious reasons. Gender has the least influence on entomophagy. Considering the economic, ecological and nutritional importance of edible insects in traditional Ghanaian foods, attention should be given to sustainable environmental harvesting practices.


Rheumatology ◽  
2018 ◽  
Vol 58 (5) ◽  
pp. 836-839 ◽  
Author(s):  
Kristian Zobbe ◽  
Daniel Prieto-Alhambra ◽  
René Cordtz ◽  
Pil Højgaard ◽  
Jens Skøt Hindrup ◽  
...  

Abstract Objective To investigate temporal trends in the incidence and prevalence of gout in the adult Danish population. Methods Using the nationwide Danish National Patient Registry, we calculated the number of incident gout patients (per 100 000 person-years) within each 1 year period from 1995 to 2015 and the prevalence of gout in 2000 and 2015. Further, we calculated age- and gender-specific incidence rates of gout from 1995 to 2015. Results We identified a total of 45 685 incident gout patients (72.9% males) with a mean age of 65 years (s.d. 16) at diagnosis. In both genders, an increase in age-standardized incidence rates was observed from 32.3/100 000 (95% CI 30.7, 33.9) in 1995 to 57.5/100 000 (95% CI 55.6, 59.5) in 2015 (P < 0.001). Similar trends were observed for 8950 cases diagnosed in rheumatology departments. We likewise observed an increase in the prevalence of gout from 0.29% (95% CI 0.29, 0.30) in 2000 to 0.68% (95% CI 0.68, 0.69) in 2015. Conclusions The annual incidence rate of gout increased by almost 80% in Denmark between 1995 and 2015. The prevalence increased by nearly 130% between 2000 and 2015. Reasons for this are unknown but may include an increase in risk factors (e.g. obesity, diabetes mellitus), longer life expectancy and increased awareness of the disease among patients and/or health professionals.


2001 ◽  
Vol 85 (03) ◽  
pp. 430-434 ◽  
Author(s):  
James Blanchard ◽  
Donald Houston ◽  
Andre Wajda ◽  
Charles Bernstein

Summary Background: There is an impression mostly from specialty clinics that patients with inflammatory bowel disease (IBD) have an increased risk of venous thromboembolic disorders. Our aim was to determine the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) from a population-based database of IBD patients and, to compare the incidence rates to that of an age, gender and geographically matched population control group. Methods: IBD patients identified from the administrative claims data of the universal provincial insurance plan of Manitoba were matched 1:10 to randomly selected members of the general population without IBD by year, age, gender, and postal area of residence using Manitoba Health’s population registry. The incidence of hospitalization for DVT and PE was calculated from hospital discharge abstracts using ICD-9-CM codes 451.1, 453.x for DVT and 415.1x for PE. Rates were calculated based on person-years of follow-up for 1984-1997. Comparisons to the population cohort yielded age-adjusted incidence rate ratios (IRR). Rates were calculated based on person-years of follow-up (Crohn’s disease = 21,340, ulcerative colitis = 19,665) for 1984-1997. Results: In Crohn’s disease the incidence rate of DVT was 31.4/10,000 person-years and of PE was 10.3/10,000 person-years. In ulcerative colitis the incidence rates were 30.0/10,000 person-years for DVT and 19.8/10,000 person-years for PE. The IRR was 4.7 (95% CI, 3.5-6.3) for DVT and 2.9 (1.8-4.7) for PE in Crohn’s disease and 2.8 (2.1-3.7) for DVT and 3.6 (2.5-5.2) for PE, in ulcerative colitis. There were no gender differences for IRR. The highest rates of DVT and PE were seen among patients over 60 years old; however the highest IRR for these events were among patients less than 40 years. Conclusion: IBD patients have a threefold increased risk of developing DVT or PE.


2017 ◽  
Vol 4 (2) ◽  
pp. 25
Author(s):  
Nicolas Garcia Papacosta ◽  
Gabriel Martins Nunes ◽  
Renato Jácomo Pacheco ◽  
Macaulay Viturino Cardoso ◽  
Virgílio Ribeiro Guedes

INTRODUÇÃO: A doença de Crohn é qualificada como uma doença inflamatória intestinal, de caráter crônico, recidivante, transmural e que pode afetar qualquer parte do trato digestivo, desde a boca até o ânus, mas, principalmente, o intestino delgado e o cólon. São de cunho multifatorial, com prevalência e incidência variando de acordo com a genética, meio ambiente, microbiota intestinal e até mesmo um possível agente entérico infeccioso. É uma doença que afeta pessoas de várias idades, sexos e raças, apesar de se verificar maior incidência em jovens do sexo feminino e em regiões urbanas. METODOLOGIA: Trata-se de um artigo de revisão no qual, a partir das palavras “doença de Crohn” e “doença inflamatórias intestinais”, foi realizado busca por periódicos nos bancos de dados: PubMed, Scielo, Portal Periódicos CAPES e Google acadêmico. CONCLUSÃO: A doença de Crohn apresenta uma importante taxa de morbimortalidade no mundo, principalmente em regiões em franca urbanização e industrialização. O diagnóstico é um procedimento extremamente complicado devido a sua clínica inespecífica e pelos vários aspetos em comum com outras patologias. Dessa forma, ainda se faz necessário uma melhor investigação científica na área, com intuito de se desenvolver melhores técnicas diagnosticas e condutas a serem tomadas no seguimento e cura dessa patologia.Palavras-chave: Doença de Crohn, Doença inflamatórias intestinais, Diarreia. ABSTRACT INTRODUCTION: Crohn's disease is described as an inflammatory, chronic, recurrent, transmural inflammatory disease that can affect any part of the digestive tract, from the mouth to the anus, but especially the small intestine and colon. They are multifactorial, with prevalence and incidence varying according to genetics, environment, intestinal microbiota and even a possible infectious enteric agent. It is a disease that affects people of various ages, sexes and races, although there is a greater incidence in young women and in urban areas. METHODOLOGY: This is a review article in which, from the words "Crohn's disease" and "inflammatory bowel disease", a search was made for journals in the databases: PubMed, Scielo, Portal Periódicos CAPES and Google academic. CONCLUSION: Crohn's disease presents an important morbidity and mortality rate in the world, especially in regions where there is rapid urbanization and industrialization. Diagnosis is an extremely complicated procedure due to its nonspecific clinical and various aspects in common with other pathologies. Thus, a better scientific investigation in the area is still necessary, in order to develop better diagnostic techniques and behaviors to be taken in the follow-up and cure of this pathology.                                              Keywords: Crohn's disease, Inflammatory bowel disease, Diarrhea.


2020 ◽  
Vol 14 (9) ◽  
pp. 1241-1247
Author(s):  
P W Jenkinson ◽  
N Plevris ◽  
S Siakavellas ◽  
M Lyons ◽  
I D Arnott ◽  
...  

Abstract Background The use of biologic therapy for Crohn’s disease [CD] continues to evolve, however, the effect of this on the requirement for surgery remains unclear. We assessed changes in biologic prescription and surgery over time in a population-based cohort. Methods We performed a retrospective cohort study of all 1753 patients diagnosed with CD in Lothian, Scotland, between January 1, 2000 and December 31, 2017, reviewing the electronic health record of each patient to identify all CD-related surgery and biologic prescription. Cumulative probability and hazard ratios for surgery and biologic prescription from diagnosis were calculated and compared using the log-rank test and Cox regression analysis stratified by year of diagnosis into cohorts. Results The 5-year cumulative risk of surgery was 20.4% in cohort 1 [2000–2004],18.3% in cohort 2 [2005–2008], 14.7% in cohort 3 [2009–2013], and 13.0% in cohort 4 [2014–2017] p &lt;0.001. The 5-year cumulative risk of biologic prescription was 5.7% in cohort 1, 12.2% in cohort 2, 22.0% in cohort 3, and 44.9% in cohort 4 p &lt;0.001. Conclusions The increased and earlier use of biologic therapy in CD patients corresponded with a decreasing requirement for surgery over time within our cohort. This could mean that adopting a top-down or accelerated step-up treatment strategy may be effective at reducing the requirement for surgery in newly diagnosed CD.


2020 ◽  
Vol 41 (8) ◽  
pp. 879-882
Author(s):  
Hana R. Winders ◽  
Julie Royer ◽  
Mariam Younas ◽  
Julie Ann Justo ◽  
P. Brandon Bookstaver ◽  
...  

AbstractObjective:To examine the temporal trends in ambulatory antibiotic prescription fill rates and to determine the influences of age, gender, and location.Design:Population-based cohort study.Setting:Ambulatory setting in South Carolina.Patients:Patients ≤64 years of age from January 2012 to December 2017.Methods:Aggregated pharmacy claims data for oral antibiotic prescriptions were utilized to estimate community antibiotic prescription rates. Poisson regression or Student t tests were used to examine overall temporal trend in antibiotic prescription rates, seasonal variation, and the trends across age group, gender, and rural versus urban location.Results:Overall antibiotic prescription rates decrease from 1,127 to 897 per 1,000 person years (P < .001). The decrease was more noticeable in persons aged <18 years (26%) and 18–39 years (20%) than in those aged 40–64 years (5%; P < .001 for all). Prescription rates were higher among females than males in all age groups, although this finding was the most pronounced in group aged 18–39 years (1,232 vs 585 per 1,000 person years; P < .0001). Annualized antibiotic prescription rates were higher during the winter months (December–March) than the rest of the year (1,145 vs 885 per 1,000 person years; P < .0001), and rates were higher in rural areas than in urban areas (1,032 vs 941 per 1,000 person years; P < .0001).Conclusions:The decline in ambulatory antibiotic prescription rates is encouraging. Ongoing ambulatory antibiotic stewardship efforts across South Carolina should focus on older adults, rural areas, and during the winter season when antibiotic prescriptions peak.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S254-S255
Author(s):  
U Coskun ◽  
K Kelly ◽  
T Hunter ◽  
L Newton ◽  
T Symonds ◽  
...  

Abstract Background Crohn’s disease (CD) is a type of inflammatory bowel disease that can occur at any age. CD symptoms can have a significant impact on health-related quality of life (HRQL). Although key symptoms and impacts of CD in adults are well-known, they have not been well explored or documented in children and adolescents. The objective of this study was to explore the similarities and differences in CD symptoms and impacts across various age groups (children and adolescents) and develop a list of most common symptoms and impacts for these populations. Methods Children (ages 5–11 years) and adolescents (ages 12–17 years) with CD and parents/caregivers of children with CD (ages 2–11 years) were recruited from US medical practices. Qualitative semi-structured interview guides were developed, informed by published literature. Face-to-face and telephone concept elicitation interviews were conducted, audio-recorded, and transcribed. Transcripts were analysed using thematic methods facilitated by NVivo. Results A total of 49 individuals participated in this study (child n = 11, adolescents n = 20, parents/caregivers n = 18). Preliminary results showed that there was a high level of qualitative agreement between CD symptoms in children and adolescents. The ranking of the top 15 symptoms was nearly identical between the two cohorts. The most frequently discussed symptoms (discussed by ≥75% of the participants in each cohort) were feeling gassy, abdominal pain, diarrhoea, incomplete evacuation, tiredness, and urgency. The second most frequently discussed symptoms (discussed by ≥50% of the participants in each cohort) were cramping, constipation, blood in stool, and frequent bowel movement. While abdominal cramping and blood in stool were discussed by ≥75% of the adolescents, 63% and 50% of the children discussed them respectively. Similarly, while bloating and nausea were discussed by ≥50% of adolescents, 38% and 25% of children discussed them, respectively. Finally, while vomiting was discussed by 50% of the children, 33% of the adolescents discussed it. Impacts due to CD were also regularly discussed across both cohorts but less so by the children. School and low mood/sadness were discussed by ≥50% of the participants in each cohort. Exercise/sport, play/leisure activities, annoyance/frustration, and eating/drinking limitations were discussed by ≥50% of the adolescents but &lt;50% of the children. Conclusion The results from the CE interviews show the clear burden of CD and that this is mostly similar across children and adolescents allowing for a future unified disease model to be developed.


Author(s):  
Vincent F. Biank ◽  
Frauke Friedrichs ◽  
Umesh Babusukumar ◽  
Tao Wang ◽  
Monika Stoll ◽  
...  

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3773-3773
Author(s):  
Adam Mendizabal ◽  
Paul H Levine

Abstract Abstract 3773 Background: Age at diagnosis of CML varies by race in the United States with median occurring around ages 54 and 63 among Black and White patients, respectively. The treatment paradigm shifted when Imatinib was approved in 2001 for treatment of CML. More recently, second generation tyrosine kinase inhibitors (TKI) have also been used for treatment of CML. Differences in outcomes by race have been previously reported prior to the TKI treatment period. We aimed to assess whether the earlier age at diagnosis resulted in differential trends in age-adjusted incidence rates and survival outcomes by race in the post-Imatinib treatment period. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) 18 Registries were extracted for diagnoses between 2002 and 2009 based on the assumption that cases diagnosed after 2002 would be treated with TKI's. CML was defined according to the International Classification of Diseases for Oncology 3rd edition code 9863 (CML-NOS) and 9875 (CML-Philadelphia Chromosome Positive). Cases diagnosed by autopsy or death certificate only were excluded. Incidence rates are expressed per 100,000 person-years and age-adjusted to the 2000 US Standard Population. Black/White incidence rate ratios (IRRBW) are shown with corresponding 95% confidence intervals (CI). Kaplan-Meier estimates of CML-specific survival (CPS) and overall survival (OS) were estimated at 5-years post-diagnosis with the event being time to CML-specific death or any death, respectively. Stratified Cox proportional hazards models were constructed to assess the impact of age and race on the risk of death expressed as a hazard ratio (HR). Results: Since 2002, 6,632 patients diagnosed with CML were reported to the SEER 18 registries including 5,829 White patients (87.9%) and 803 Black patients (12.1%) with 57% being male. The age-adjusted incidence rate for Blacks was 1.18 (95% CI, 1.10–1.27) per 100,000 and 1.12 (95% CI, 1.09–1.27) per 100,000 for Whites. The corresponding IRRBW was 1.06 (95% CI, 0.98– 1.14). When considering 20-year age-groups, Blacks had higher incidence rates in the 20–39 and 40–59 age groups; IRRBW of 1.26 (95% CI, 1.06–1.49; p=0.0073) and 1.23 (95% CI, 1.09–1.39; p=0.0007), respectively. No statistically significant differences in IRRBW were seen within the 0–19, 60–79 and 80+ age-groupings although Whites have higher non-significant incidence rates in the latter 2 age-groups. Differences in IRRBW prompted an assessment of survival to determine if the excess incidence observed in the younger age groups corresponded with a worse survival. CPS at 5-years was 85.5% (95% CI, 84.3–86.6). In univariate analysis, age was an important predictor of outcome (p<0.0001) with patients diagnosed after age 80 having the worse outcomes (OS: 58.3%), followed by patients diagnosed between 60 and 79 years (OS 84.7%), 0–19 years (OS: 87.1%), 40–59 years (OS: 90.2%), and 20–39 years (OS: 92.6%). When considering all age-groups, race was not a significant predictor of death (HR 0.91; 95% CI, 0.72–1.15). However, in a stratified analysis with 20-year age groups, Blacks had an increased risk of death as compared to Whites (Figure 1) in the 20–39 age group (HR: 2.94; 95% CI, 1.72–5.26; p<0.0001) and the 40–59 age group (HR: 1.67; 95% CI, 1.22–2.27; p=0.0069) while no differences were seen within the 0–19, 60–79 and 80+ age groups. Conclusions from OS models were similar to that of the CPS models. Conclusions: Through this analysis of population-based cancer registry data collected in the US between 2002 and 2009, we show that Blacks have a younger age at diagnosis with higher incidence rates observed in the 20–39 and 40–59 age-groups as compared to Whites. Both CPS and OS outcomes differed by race and age. Similar to the differences observed with the incidence rates, survival was worse in Blacks diagnosed within the 20–39 and 40–59 age-groups as compared to Whites. Although outcomes have globally improved in patients with CML since the advent of tyrosine kinase inhibitors, the persistence of incidence heterogeneity and poorer survival among Blacks warrants further attention. Access to care may be a possible reason for the differences observed but further studies are warranted to rule out biological differences which may be causing an earlier age at onset and poorer survival. Disclosures: No relevant conflicts of interest to declare.


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