Chronic inflammatory bowel diseases: epidemiological features in Ukraine
Background. The number of registered patients with inflammatory bowel diseases (IBD) that is characterized by systemic manifestations and polymorbidal course is increas- ing nowadays. IBD, which include ulcerative colitis (UC) and Crohn’s disease (CD), represent one of the most serious problems in modern gastroenterology and coloproctology. The purpose of our work was to examine the prevalence and incidence of UC and CD in chronic digestive diseases (CDD) structure, their dynam- ics for the last 2 years (2014-2015) in Ukraine and its individual regions. Materials and methods. The situation in epidemiology of UC and CD was analyzed using the data officially submitted to the medical statistic center of the Ministry of Health of Ukraine. To assess the epidemiological pattern, we used such indicators: prevalence (absolute and per 100 thousand of population) - the number of total registered diseases, and incidence - the number of first ill patients in current year. This study was conducted us- ing the data of appealing to the health care facilities for a 2-year period, from 2014 to 2015, to assess the epidemiological picture in children for a 3-year period. We used the rate of growth/re- duction to determine general trends and the nature of changes. Results were processed with the use of Statistics software pack- age, version 6.0, Microsoft Excel, version 7.0. Results. In Ukraine since 2013, in the official statistics for the group of CDD such nosological forms, as UC, CD and irritable bowel syndrome, were recorded separately. That made possible to analyze health indica- tors for these diseases in the whole Ukraine, and in some regions. However, the current government statistics do not allow obtain-ing detailed information on the characteristics of the prevalence and incidence of IBD, because does not contain information on the age and gender composition of patients, and, most impor- tantly, does not provide information on the effectiveness of the existing system of medical care. It was established that in 2015 bowel diseases accounted for 3.7 % in the structure of CDD. In 2014-2015, the growth of the prevalence and incidence of IBD was observed: in 2015 the absolute number of new cases was 179 (growth rate - 15.1 %). There were 79 patients with newly diagnosed UC (growth rate - 28.1 %). Newly diagnosed cases of CD and UC among children in this period decreased by 25.0 and 8.7 %, respectively. Conclusions. Bowel diseases accounted for3.7 % in the structure of CDD in 2015, with an advantage of UC over CD, with the ratio of 4.4 : 1. During 2014-2015, we recorded increasing prevalence and incidence of IBD, while the incidence of digestive diseases in Ukraine changed a little. We determined growth in the absolute number of IBD cases among the working- age population. The ratio of such incidence in urban and village population in Ukraine is 3 : 1. Cluster analysis carried out in rela- tion to regional characteristics of IBD prevalence made it possible to select area with their greatest spread (Vinnytsia, Khmelnytskyi, Volyn, Rivne, Ivano-Frankivsk, Chernihiv and Kyiv regions and the Kyiv). Among children and adolescents, the prevalence and incidence of IBD tends to decrease. Among children with UC, boys dominated, with UC - girls and boys were equal.