Epidemiology, disease burden, and treatment challenges of ulcerative colitis in Africa and the Middle East

ABSTRACT

Introduction: Ulcerative colitis is an idiopathic, chronic, inflammatory bowel disorder characterized by an unpredictable course of alternating cycles of relapse and remission. Traditionally viewed as a disease of Western countries, the prevalence of ulcerative colitis is reported to be increasing in the developing world. In these regions, there is the potential to further explore the etiology of the disease, mainly through genetic studies. With this in mind, we consider available data relating to the epidemiology, clinical manifestations, and disease course of ulcerative colitis in Africa and the Middle East. Current treatment approaches in these countries are also reviewed and discussed in the context of new, small molecule, orally administered therapies.

Areas covered: Available data on the epidemiology, clinical manifestations, and risk factors of ulcerative colitis in Africa and the Middle East are reviewed using a PubMed database search.

Expert commentary: Epidemiologic studies from African and Middle Eastern countries suggest disease trends similar to the West, and an important health and economic burden. The management of ulcerative colitis within these developing countries is challenging, with the need to improve early diagnosis, access to healthcare, and patient education, along with facilitation of access to treatment options and improvement of medication adherence.

KEYWORDS:

• Africa
• inflammatory bowel disease
• Middle East
• ulcerative colitis
• prevalence
• epidemiology

Acknowledgments

Medical writing support under the guidance of the authors was provided by Helen Findlow PhD at CMC Connect, a division of Complete Medical Communications Ltd, Manchester, UK and was funded by Pfizer Inc, New York, NY, USA in accordance with Good Publication Practice (GPP3) guidelines (Ann Intern Med 2015;163:461–464).

Declaration of interest

A.I. Sharara has received grant support from AbbVie, Janssen, and Takeda; has been an invited speaker for and received honoraria from AbbVie, Falk, Ferring, Janssen, Takeda, and Tillots; and has been an advisory board member for AbbVie, Janssen, Pfizer, and Takeda. O. Alharbi has received grant support from Janssen; has been an invited speaker for and received honoraria from AbbVie, AstraZeneca, Janssen, Takeda, and Tillotts; and has been an advisory board member for AbbVie, Janssen, Pfizer, and Takeda. M. Mosli has received grant support from Takeda; has been an invited speaker for and received honoraria from AbbVie, Janssen, and Takeda, and has been an advisory board member for AbbVie, Janssen, Pfizer, and Takeda. E. Singh, M. Mounir, L. Salese, N. Sunna, and N. Tarcha are employees of Pfizer and owns stocks options in the company.  S. Al Awadhi and H. Al Dhahab have no conflicts of interest to disclose. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

Pfizer Inc sponsored this review article. Both Pfizer and non-Pfizer authors have participated in the development of the associated manuscript. The views and opinions expressed within the manuscript are those of all authors and do not necessarily represent those of the funding organization.