Review for 10.1186/1471-230X-10-32 (2010)

Reviewer's report
Title:Prevalence of inflammatory bowel disease in two districts of Sri Lanka: a
hospital based survey
Version: 1Date:8 November 2009
Reviewer: JOHN Triantafillidis
Reviewer's report:
Reviewer's report
Title: Prevalence of inflammatory bowel disease in two districts of Sri Lanka: a
hospital based survey
Version: 1. November 8, 2009
Reviewer: John K. Triantafillidis
The manuscript by Niriella MA et al antitled: “Prevalence of inflammatory bowel
disease in two districts of Sri Lanka: a hospital based survey” is an interesting
epidemiological study as it describes the epidemiology and some clical details of
patients with inflammatory bowel disease in an Asian country (Sri Lanka). The
results of the study are in accordance with the general opinion concerning the
low incidence of IBD in Asia compared to USA and the developed European
countries. Certainly we need these data as the epidemiological features from
these countries emphasize the central role of genetic background and the
environment as well.
The question of the authors is adequate and the methods employed are the
currently used.
Minor Essential Revisions have to be done by the authors before publication.
These are listed below:
• Table 1. The number of UC and CD patients must be noticed in the “ethnicity”
part, as it was happened in the “extent of disease” and “severity of disease” part.
• Page 6, line 13: CD instead of C.
• Location of disease in CD patients: The authors did not mention anything about
concurrent location of CD in the small and large bowel. Were they such data? If
not the authors must comment on that.
• I wonder how the authors reached the conclusion (first and second line in the
discussion section, page 7) according of which “… IBD is increasingly diagnosed
in Sri Lanka” in the absence of previous epidemiological data. This statement
must be deleted as it is not supported by the data presented.
• Were they data concerning the clinical character of CD (non-stricturing
non-penetrating disease, structuring disease, and penetrating disease) as well as
data of patients with perianal disease? If yes, the authors must comment on that.
• References: in the reference number 8 the year of publication must be in the
correct position. Reference number 9: Year of publication?
• One concern is related to the number and origin of references included in the
paper. Most of them are quite old. However, there are some recently published
papers that could facilitate the authors to improve the discussion section by
mentioning data provided by these references. For example the authors must
comment on the possible co-existence of infectious colitis aggravating the course
of the underlying IBD. Some of these references are listed below.
• Hilmi I, Singh R, Ganesananthan S, Yatim I, Radzi M, Chua AB, Tan HJ, Huang
S, Chin KS, Menon J, Goh KL. Demography and clinical course of ulcerative
colitis in a multiracial Asian population: a nationwide study from Malaysia. J Dig
Dis. 2009;10:15-20.
• Goh K, Xiao SD. Inflammatory bowel disease: a survey of the epidemiology in
Asia. J Dig Dis. 2009;10:1-6.
• Banerjee D, Deb R, Dar L, Mirdha BR, Pati SK, Thareja S, Falodia S, Ahuja V.
High frequency of parasitic and viral stool pathogens in patients with active
ulcerative colitis: report from a tropical country. Scand J Gastroenterol.
2009;44:325-31.
• Soylu A, Dolapcioglu C, Alis H, Dolay K, Yasar N, Boduroglu O, Cildas A,
Bolukbas FF, Bolukbas C. Prevalence and importance of amebic infestation in
patients with ulcerative colitis in two regions in Turkey. Dig Dis Sci.
2009;54:1292-6.
• Thia KT, Loftus EV Jr, Sandborn WJ, Yang SK. An update on the epidemiology
of inflammatory bowel disease in Asia. Am J Gastroenterol. 2008;103:3167-82.
• Yang SK, Yun S, Kim JH, Park JY, Kim HY, Kim YH, Chang DK, Kim JS, Song
IS, Park JB, Park ER, Kim KJ, Moon G, Yang SH. Epidemiology of inflammatory
bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005: a
KASID study. Inflamm Bowel Dis. 2008;14:542-9.
• Sood A, Midha V. Epidemiology of inflammatory bowel disease in Asia. Indian J
Gastroenterol. 2007;26:285-9.
• Rerknimitr R, Chalapipat O, Kongkam P, Mb PK. Clinical characteristics of
inflammatory bowel disease in Thailand: a 16 years review. J Med Assoc Thai.
2005;88 Suppl 4:S129-33.
Statistical review: The manuscript could be seen by a statistician, although to my
opinion the method used by the authors is correct.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
'I declare that I have no competing interests'