Inflammatory bowel disease (IBD) is generally considered a disease of high-income countries and is regarded as rare in sub-Saharan Africa. However, this assumption is almost certainly an underestimate, and the high burden of communicable diseases makes IBD in sub-Saharan Africa difficult to detect. Furthermore, some gastrointestinal infections can closely mimic IBD, contributing to delays in diagnosis and complicating therapeutic decision making. Constraints in endoscopic capacity alongside a scarcity of qualified diagnostic pathologists add to the difficulties. Implementing evidence-based guidelines recommended by international societies is challenging, mostly due to high costs and unavailability of medication. However, cost-effective approaches can still be implemented to manage IBD in sub-Saharan Africa as the predominant disease phenotype is mild-to-moderate ulcerative colitis, which often responds to treatment with basic medication. In this Series paper, we summarise the current management of IBD in sub-Saharan Africa and propose how it can be tailored to suit the epidemiological and socioeconomic specificities of the region. We also discuss measures required to address existing challenges, such as educating health-care workers about the diagnosis and management of IBD or improving endoscopic capacity.

炎症性肠病 (IBD) 通常被认为是高收入国家的一种疾病，在撒哈拉以南非洲地区被认为是罕见的。然而，这种假设几乎可以肯定是低估了，传染病的高负担使得撒哈拉以南非洲的 IBD 难以被发现。此外，一些胃肠道感染可以与 IBD 非常相似，导致诊断延迟和治疗决策复杂化。内窥镜能力的限制以及缺乏合格的诊断病理学家增加了困难。实施国际社会推荐的循证指南具有挑战性，主要是由于成本高和药物不可用。然而，在撒哈拉以南非洲，仍然可以实施具有成本效益的方法来管理 IBD，因为主要的疾病表型是轻度至中度溃疡性结肠炎，通常对基本药物治疗有反应。在本系列论文中，我们总结了撒哈拉以南非洲目前的 IBD 管理，并提出了如何对其进行调整以适应该地区的流行病学和社会经济特点。我们还讨论了应对现有挑战所需的措施，例如对卫生保健工作者进行有关 IBD 诊断和管理的教育或提高内窥镜检查能力。我们总结了撒哈拉以南非洲目前对 IBD 的管理，并提出了如何对其进行调整以适应该地区的流行病学和社会经济特点。我们还讨论了应对现有挑战所需的措施，例如对卫生保健工作者进行有关 IBD 诊断和管理的教育或提高内窥镜检查能力。我们总结了撒哈拉以南非洲目前对 IBD 的管理，并提出了如何对其进行调整以适应该地区的流行病学和社会经济特点。我们还讨论了应对现有挑战所需的措施，例如对卫生保健工作者进行有关 IBD 诊断和管理的教育或提高内窥镜检查能力。