Published online Nov 21, 2020. doi: 10.3748/wjg.v26.i43.6891
Peer-review started: June 19, 2020
First decision: August 22, 2020
Revised: September 4, 2020
Accepted: October 20, 2020
Article in press: October 20, 2020
Published online: November 21, 2020
While Crohn’s disease has been studied extensively in high-income countries, its epidemiology and care in low and lower-middle income countries (LLMICs) is not well established due to a lack of disease registries and diagnostic capacity.
To describe the published burden, diagnostic/treatment capacity, service utilization, challenges/barriers to individuals with Crohn’s in LLMICs and their providers.
We conducted a scoping review utilizing a full search strategy was developed and conducted in PubMed, Embase and World Health Organization Global Index Medicus. Two independent reviewers screened the titles and abstracts of all of the publications found in this search, reviewed selected publications, and extracted relevant data, which underwent descriptive review and was analyzed in Excel.
The database search yielded 4486 publications, 216 of which were determined to be relevant to the research questions. Of all 79 LLMICs, only 21 (26.6%) have publications describing individuals with Crohn’s. Overall, the highest number of studies came from India, followed by Tunisia, and Egypt. The mean number of Crohn’s patients reported per study is 57.84 and the median is 22, with a wide range from one to 980.
This scoping review has shown that, although there is a severe lack of population-based data about Crohn’s in LLMICs, there is a signal of Crohn’s in these settings around the world.
Core Tip: This scoping review demonstrates the lack of epidemiologic data on Crohn’s disease in low and lower-middle income countries, but that it does exist in these settings and presents unique challenges. There is a need for population-based research to fully understand the its burden among the world’s poorest people.