Abstract Background The evolving epidemiological trends suggest increasing IBD in the global south making it truly a global disease. To be prepared for the rapid increases in the lower and lower middle-income countries need country level data on diagnostic and therapeutic challenges. There is limited data on IBD in the Sub-Saharan region. We aimed to investigate diagnostic delay and treatment patterns in Ethiopia. Methods Data from 198 patients treated for IBD were collected from a predefined geographical area in Ethiopia. We included IBD patients from both private and public hospitals. Data was collected from paper and electronic medical records. Descriptive statistics were done using R Stats Version (R-4.4.2.tar.) Results The median age of patients included in the study were 26 years (21, 34). Crohn`s disease (CD) was more common than ulcerative colitis (UC) ((139/198(71%) CD, 58/198(29%) UC). The phenotype of IBD in this cohort is stated in Table 1. Thirteen percent (26/193) of patients had family history of IBD in first- or second-degree relatives. The median time to diagnosis was 35(14,105) weeks. The delay was mainly contributed by time from symptoms to gastroenterologist /internist review (34(8, 78 weeks), while there was no delay in performing a diagnostic test after review 1(1, 4) weeks. Following diagnosis there was no delay in initiation of the first treatment (median time to treatment 1 (1, 2) week). This was not different among patients with UC or CD (p-value = 0.08692). Majority of patients had steroids after diagnosis. 125/134(93%) of Crohn’s disease patients received steroids at diagnosis while 44/51(86%) of ulcerative colitis patients received the same. 170/191(86%) received immunomodulators at the first year from diagnosis with 164/170(96%) receiving azathioprine. None of the patients received biologics within one year of diagnosis. 16/198 (8%) of patients had surgery at diagnosis and 30/198 (15%) had surgery within 1 year after diagnosis. Conclusion Delay in diagnosis of IBD in Ethiopia is influenced by access to trained/specialized health care personnel and not access to diagnostic modalities (i.e Colonoscopy and CT). Treatment is heavily relying on steroids and immunomodulators. None of the patients in this cohort received biologics presumably related to lack of access. Conflict of interest: Dr. Teferra, Fasika Shimeles: No conflict of interest Ibrahim, Fadwa Adel Elshahat: No conflict of interest Yohannes, Binyam: No conflict of interest Mekonnen, Hailemichael Desalegn: No conflict of interest Tesfaye, Paulos Shume: No conflict of interest Fisseha, Henok: No conflict of interest Berhane, Kaleb Assefa: No conflict of interest Gebreselassie, Amanuel Getu: No conflict of interest Gebreyohannes, Shewit Atkilt: No conflict of interest Jira, Nuhamin Abebe: No conflict of interest Tsega, Kaleb Y: No conflict of interest Al-Dujaily, Hashem: No conflict of interest Sebastian, Shaji: Grant: Takeda, Tillots pharma, Biogen, Pfizer, Abbvie, Johnson & Johnson, Olympus -Odin Vision Personal Fees: Tillots, Johnson & Johnson, Olympus Odin Vision, AbbVie, Takeda, Merck, Pharmacosmos, Amgen, Eli Lilly, BMS, Odin Vision Non-financial Support: Tillots, Takeda, AbbVie, Celltrion, Johnson & Johnson, Eli Lilly, Alphasigma, Ferring Pharma
Teferra et al. (Thu,) studied this question.