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A first study on the incidence and prevalence of IBD in Malaysia--results from the Kinta Valley IBD Epidemiology Study

Hilmi I, Jaya F, Chua A, Heng WC, Singh H, Goh KL

J Crohns Colitis, 2015 May;9(5):404-9.
PMID: 25744112 DOI: 10.1093/ecco-jcc/jjv039

Inflammatory bowel disease [IBD] is known to be rare in the Asia Pacific region but epidemiological studies are scarce.

Matched MeSH terms: Colitis, Ulcerative/ethnology*
Inflammatory bowel disease: a survey of the epidemiology in Asia

Goh K, Xiao SD

J Dig Dis, 2009 Feb;10(1):1-6.
PMID: 19236540 DOI: 10.1111/j.1751-2980.2008.00355.x

Inflammatory bowel disease (IBD) has long been considered a disease that affects predominantly a Western population. The incidence and prevalence rates from Asian populations are much lower in comparison. More recent data, however, have shown significantly higher rates in Asians and time trend studies have shown an increase in the incidence of ulcerative colitis (UC) and a similar but lower rise in Crohn's disease (CD). The epidemiological changes that are taking place mirror that of the Western experience seen 50 years previously and seem to occur in parallel with the rapid socioeconomic development taking place in Asia. It appears that certain racial groups are more prone than others to develop IBD. For instance, Indians in South-East Asia have higher rates compared to Chinese and Malays. While there is host genetic predisposition, environmental factor(s) may be responsible for this difference. Migrant studies of South Asians in the UK, where second-generation immigrants have assumed incidence rates as high as the indigenous whites and Asian Jews who develop high incidence rates comparable to Jews from Europe or North America in Israel point to the role of environmental factors. It is unclear which specific factors are responsible. Studies have suggested a change in diet to a more Westernized one may underlie this epidemiological change in the Asian population. It is likely that there are racial groups amongst Asians who are more susceptible to IBD and who will demonstrate a higher frequency of IBD when exposed to putative environmental factors.

Matched MeSH terms: Colitis, Ulcerative/ethnology
Racial differences in the prevalence of ulcerative colitis and Crohn's disease in Singapore

Lee YM, Fock K, See SJ, Ng TM, Khor C, Teo EK

J Gastroenterol Hepatol, 2000 Jun;15(6):622-5.
PMID: 10921415

BACKGROUND: The aim of this study was to determine the prevalence rates of inflammatory bowel disease in the different races in Singapore.
METHODS: The patients studied consisted of 58 people with an established diagnosis of ulcerative colitis (UC) and Crohn's disease (CD) as determined by a combination of clinical, radiological, endoscopic and histological criteria. The patients were residents of a well-defined geographical area in the northern part of Singapore and had been referred to the single regional hospital. Epidemiological data including sex, age, ethnicity, family history and disease type and extent were collected from case records and patient interviews.
RESULTS: There were 37 UC and 21 CD patients. Of the patients with UC, 67.5% were Chinese, 13.5% were Malay and 19% were Indian. The CD group consisted of 81% Chinese, 9.5% Malay and 9.5% Indian patients. The study population from which the patients were drawn was approximately 0.5 million in size.
CONCLUSIONS: The overall prevalence of UC was 6 per 100,000 and of CD was 3.6 per 100,000 in Singapore. There were disproportionately more Indians suffering from UC, with a prevalence of 16.2 per 100,000 in comparison with six per 100,000 for Chinese and seven per 100 000 for Malays. The relative risk of UC in Indians is 2.9-fold greater than for the Chinese (CI= 1.25-6.7) which was statistically significant. This trend was not seen for CD.

Matched MeSH terms: Colitis, Ulcerative/ethnology*
Ulcerative colitis in a multiracial Asian country: racial differences and clinical presentation among Malaysian patients

Tan YM, Goh KL

World J Gastroenterol, 2005 Oct 07;11(37):5859-62.
PMID: 16270398

AIM: Inflammatory bowel disease appears to be uncommon among Asians. This study was conducted to determine the prevalence of ulcerative colitis (UC) in Malaysian patients and to establish the spectrum of the disease seen in Malaysian patients. Three major Asian races: Malay, Chinese, and Indian co-exist in Malaysia and we sought to determine if there were any racial differences in the prevalence and presentation of disease. Racial differences for several other gastrointestinal diseases have previously been observed and found to be extremely interesting.
METHODS: Data were obtained retrospectively from a review of the medical records of in- and out-patients with a diagnosis of UC at the University Hospital, Kuala Lumpur between 1985 and 1998.
RESULTS: There were 45 confirmed cases of UC of which 3 were foreigners, who were excluded from analysis. Thirty new cases of UC were diagnosed during the study period. Their mean age at presentation was 33.0+/-10.0 years. The highest prevalence of UC was 17.9/100 000 hospital admissions in the Indians, followed by 11.2/100 000 hospital admissions in the Chinese. The lowest prevalence was 3.7/100 000 hospital admissions in the Malays. The prevalence of UC was significantly higher in the Indians and the Chinese when compared with the Malays with an OR of 4.89 (CI = 2.02-12.24; chi2 = 15.45, P<0.001) and 3.06 (CI = 1.24-7.78; chi2 = 6.30; P = 0.012) respectively. The extent of colonic disease was similar in the Malay and Indian patients. In contrast, distal or left-sided colitis predominated in the Chinese with an OR of 8.17 (95%CI = 1.31-64.87; chi2 = 5.53, P = 0.02). Extraintestinal manifestations were uncommon (11.9%).
CONCLUSION: UC is an uncommon disease in Malaysia, but racial differences exist. The Indians had the highest prevalence of UC with the Chinese demonstrating the least extensive disease.

Matched MeSH terms: Colitis, Ulcerative/ethnology*
Fulltext Ulcerative colitis in Malaysians: a review of 23 patients

Htut T, Kudva MV

Singapore Med J, 1989 Aug;30(4):385-7.
PMID: 2814543

Twenty-three patients with ulcerative colitis are reported from Kuala Lumpur, Malaysia. Sixteen were newly diagnosed over a six-year period between 1982 and 1987. The disease was commoner in men (16 men : 7 women). The peak age of onset was in the third decade. The ethnic distribution of the patients was 10 Malays, eight Indians and five Chinese making the disease relatively commoner amongst Indians. The extent of colonic involvement varied and six (26%) had a total colitis. Extra-intestinal manifestations were seen in seven patients. Diagnosis was delayed for over 10 years in four. Colorectal cancer was not seen. There was no mortality. Ulcerative colitis remains an uncommon disease amongst Malaysians. During the same period, only four male patients with Crohn's colitis were seen.

Matched MeSH terms: Colitis, Ulcerative/ethnology
Demography and clinical course of ulcerative colitis in a multiracial Asian population: a nationwide study from Malaysia

Hilmi I, Singh R, Ganesananthan S, Yatim I, Radzi M, Chua AB, et al.

J Dig Dis, 2009 Feb;10(1):15-20.
PMID: 19236542 DOI: 10.1111/j.1751-2980.2008.00357.x

To establish the clinical course of ulcerative colitis (UC) in the Malaysian population, comparing the three major ethnic groups: Malay, Chinese and Indian.

Matched MeSH terms: Colitis, Ulcerative/ethnology*