Descriptive Epidemiology of Pediatric Inflammatory Bowel Disease in Oceania: A Systematic Review and Meta-Analysis

Abstract

Objectives: Pediatric inflammatory bowel diseases (IBDs) are chronic, idiopathic illnesses of the digestive tract, which can impact adversely on children’s quality of life and burden health systems. International studies have shown these diseases are increasing. The aim was to describe pediatric IBD epidemiology across Oceania by conducting a systematic review and meta-analysis of incidence and prevalence. Methods: Medline, EMBASE and Web of Science databases were searched in October 2022 for studies reporting rates of IBD, Crohn disease (CD), or ulcerative colitis (UC) in children (≤19 years). Several data collection methodologies were included and pooled estimates of incidence and prevalence were calculated using a random effects model with I 2 measures of heterogeneity. Results: Nineteen articles provided 15 incidence and 7 prevalence studies. Fourteen studies were from Australia, 8 studies from New Zealand, and no studies were found from the Pacific Islands. Study dates ranged from 1950 to 2020 with 11 studies using population-based designs. Pooled estimates for annual incidence were IBD 4.1 (3.4–4.8, I 2 = 98.7), CD 2.3 (1.9–2.7, I 2 = 98.6), and UC 0.9 (0.6–1.1, I 2 = 96.8) per 100,000 person-years. Prevalence rates were IBD 36.0 (23.5–48.5, I 2 = 98.4), CD 23.2 (6.6–39.8, I 2 = 97.8), and UC 7.6 (2.7–12.5, I 2 = 99.6) per 100,000 persons. Conclusions: Pediatric IBD is prevalent in Oceania with high incidence rates, particularly for CD. Low rates of IBD were observed in indigenous Australian, Māori, and New Zealand Pacific children and there were no studies from the Pacific Islands highlighting this as an area in need of further research.