Over the past century, the incidence of inflammatory bowel disease (IBD) in high-income countries has shown a sharp rise that then plateaued, and a similar trend has been observed in newly industrialised countries. IBD has long been considered uncommon in sub-Saharan Africa, possibly reflecting low exposure to environmental risk factors described in high-income populations. Alternatively, individuals living in sub-Saharan Africa might have a different genetic disposition. However, some cases of IBD might remain undetected in sub-Saharan Africa because of a lack of awareness, deficiencies in diagnostic and clinical capacity, and a substantial rate of misdiagnosis due to the high burden of infectious diseases. There are few published data describing the natural history of IBD in sub-Saharan Africa, and the true burden of the disease remains largely unknown, although there is some evidence that the incidence of IBD is rising in this region. This Series paper summarises the present understanding of IBD and challenges facing clinicians when diagnosing this disease in sub-Saharan Africa.

在过去的一个世纪里，高收入国家的炎症性肠病（IBD）发病率急剧上升，然后趋于平稳，在新兴工业化国家也观察到了类似的趋势。长期以来，IBD 一直被认为在撒哈拉以南非洲不常见，这可能反映了高收入人群中描述的环境风险因素暴露程度低。或者，生活在撒哈拉以南非洲的个体可能具有不同的遗传倾向。然而，由于缺乏认识、诊断和临床能力不足，以及由于传染病的高负担而误诊率很高，撒哈拉以南非洲的一些 IBD 病例可能仍未被发现。很少有公开的数据描述撒哈拉以南非洲 IBD 的自然史，尽管有一些证据表明该地区 IBD 的发病率正在上升，但该疾病的真正负担仍然很大程度上未知。本系列文章总结了目前对 IBD 的理解以及临床医生在撒哈拉以南非洲地区诊断这种疾病时面临的挑战。