EVOLVING BURDEN OF INFLAMMATORY BOWEL DISEASE IN WOMEN FROM 1990-2019: GLOBAL, REGIONAL, NATIONAL VARIATIONS, AGE DYNAMICS, AND IMPLICATIONS FOR GLOBAL HEALTH
Authors: Sojitra Vani , Naradasu Pranathi Royal , Patel Krina Manojbhai , Patel Rahul , Patel Sneh , Desai Hardik Dineshbhai 
Published: January 2024

Abstract

BACKGROUND
Inflammatory Bowel Disease (IBD), encompassing conditions such as Crohn's disease and ulcerative colitis, has been a growing concern globally. While its burden has been studied extensively, the specific impact on women, who face unique physiological and socio-cultural challenges, remains underexplored. Grasping the global, national, and regional implications of IBD in women across 204 countries and territories provides a comprehensive understanding to guide healthcare strategies and tailor patient management.

METHOD
Using data from the Global Burden of Disease tool, we estimated the prevalence, incidence, mortality, and Disability Adjusted Life Years (DALYs) associated with IBD in women by age, year, and location from 1990 to 2019 across 204 countries and territories. Non-fatal health parameters, such as incidence and prevalence, were calculated using the DisMod-MR 2.1 tool. Fatal health outcomes were discerned using the Cause of Death Ensemble Model (CODEm) framework. This comprehensive approach allowed for a detailed, standardized, and comparative analysis of the IBD burden on women at global, national, and regional levels, considering the variations by age and over time.

RESULTS
From 1990 to 2019, there was a notable rise in the annual percentage change (APC) of IBD metrics in women, with prevalence increasing by 43% (95%UI: 39-47), deaths by 73% (48-116), DALYs by 27% (11-55), and incidence by 36% (31-40). However, when examining age-standardized rates, there was a decrease in incidence by 20%, death rates by 18%, and DALYs by 27% over the same period. Regionally, Southeast Asia, East Asia, and Oceania saw the sharpest surge in incidence rates at 104%, trailed by the Middle socio-demographic index at 37% and North Africa and the Middle East at 26%. Mortality rates were most pronounced in the European Union with a 37% APC increase, followed by high-income countries at 22% and OECD countries at 20%. DALYs rates revealed the European Union leading with a 13% APC growth, while the Nordic Region saw a 4% increase. When dissected by age groups, those under 20 years exhibited the most significant rise in incidence rates at 7% per 100,000, closely followed by children under 5 at 5%.

CONCLUSIONS
The rising burden of IBD in women from 1990 to 2019, particularly in regions like Southeast Asia, East Asia, Oceania, and the European Union, underscores the pressing need for targeted healthcare strategies and interventions. The distinct variations observed across age groups, especially among the younger population, further highlight the importance of early detection and intervention. Given the significant socio-economic and health implications, it's imperative to prioritize women-centric IBD research and clinical care, ensuring that healthcare policies and practices are tailored to address these specific challenges.

Age-standardized Mortality rate (per 100,000 person years), Female, due to IBD in Global Burden of Disease Super region, from 1990-2019.

Age-wise distribution of incidence (per 100,000) Inflammatory Bowel Disease, Global, Female.