Roro GM, Annose RT, Gilja OH. Changing trends in upper gastrointestinal endoscopic findings in Ethiopia: A comparison of eighteen thousand exams across two periods. World J Gastrointest Endosc 2025; 17(5): 106690 [DOI: 10.4253/wjge.v17.i5.106690]
Corresponding Author of This Article
Rodas T Annose, MD, Assistant Professor, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Addis Ababa University, College of Health Science, Nifas Silk Lafto Street, Addis Ababa 9086, Ethiopia. rodas.temesgen97@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. May 16, 2025; 17(5): 106690 Published online May 16, 2025. doi: 10.4253/wjge.v17.i5.106690
Changing trends in upper gastrointestinal endoscopic findings in Ethiopia: A comparison of eighteen thousand exams across two periods
Guda M Roro, Rodas T Annose, Odd H Gilja
Guda M Roro, Rodas T Annose, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Addis Ababa University, College of Health Science, Addis Ababa 9086, Ethiopia
Odd H Gilja, Department of Clinical Medicine, University of Bergen 5020, Norway
Odd H Gilja, National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen 5020, Norway
Co-first authors: Guda M Roro and Rodas T Annose.
Author contributions: Roro GM developed initial concept, drafted the proposal; Annose RT prepared research proposal for approval; Roro GM and Annose RT, developed the study design and performed data analysis, they contributed equally to this article, they are the co-first authors of this manuscript; Roro GM, Annose RT and Gilja OH all participated in the interpretation of data, drafting the manuscript, and revising it for critical intellectual content; and all authors approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Addis Ababa University, approval No. 164/22.
Informed consent statement: Patient agreement to allow the use of data collected.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data is available with request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rodas T Annose, MD, Assistant Professor, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Addis Ababa University, College of Health Science, Nifas Silk Lafto Street, Addis Ababa 9086, Ethiopia. rodas.temesgen97@gmail.com
Received: March 12, 2025 Revised: April 2, 2025 Accepted: April 24, 2025 Published online: May 16, 2025 Processing time: 61 Days and 22.4 Hours
Abstract
BACKGROUND
Relative changes in the prevalence of gastrointestinal (GI) diseases have been reported worldwide over the past decades. However, data on changing trends of upper GI diseases remain scarce in sub-Saharan Africa. This study examines the shifting patterns of upper GI endoscopic findings over 35 years in Ethiopia.
AIM
To analyze trends in upper GI endoscopic findings over two distinct time periods, 35 years apart, in Ethiopia.
METHODS
We extracted findings from 8412 upper GI endoscopies performed between 2016 and 2024 at a tertiary referral center in Addis Ababa, Ethiopia. Patient characteristics, indications, and endoscopic findings were analyzed using descriptive statistics and presented in tables, map and graphs. These findings were compared to 10000 procedures conducted between 1979 and 1994. Key endoscopic findings were identified, and percentage changes in disease prevalence were calculated.
RESULTS
Between the two study periods, the male-to-female ratio of patients undergoing upper GI endoscopy shifted from 2:1 to 1.4:1, while the median patient age increased from 36 to 40 years. The proportion of patients older than 50 years doubled (14.6% to 30.2%), and referrals from outside Addis Ababa increased from 33% to 57%. The prevalence of peptic ulcer disease and its complications decreased from 46.2% to 9.5%. Conversely, gastroesophageal varices increased from 9.5% to 21.8%, and upper GI malignancies rose from 3.6% to 18.8%.
CONCLUSION
This study sheds light on critical epidemiological shifts in upper GI diseases in Ethiopia, with a decline in peptic ulcer disease and a rise in portal hypertensive lesions and malignancies which have important public health implications. These findings underscore the need for increased awareness, improved clinical practices, enhanced resource allocation, and expanded access to early diagnosis and treatment of prevailing conditions. Preventive strategies targeting immunization and treatment of viral hepatitis, schistosomiasis, and Helicobacter pylori infection are urgently needed.
Core Tip: This study analyzes changing trends in upper gastrointestinal endoscopic findings, comparing two distinct time periods over 35 years. We reviewed 18412 exams, focusing on varices, esophageal cancer, gastric cancer, and strictures. Our analysis highlights significant shifts in the prevalence and detection rates of these conditions, providing valuable insights into the evolution of gastrointestinal disease patterns and the impact of advancements in endoscopic technology.
