BACKGROUND & AIMS The incidence of inflammatory bowel diseases (IBD) is increasing in Latin America. We performed a systematic review to identify clinical and epidemiologic features of IBD in Latin America (including Mexico, Central America, and South America) and the Caribbean. METHODS We searched MEDLINE, EMBASE, and SciELO databases for clinical or epidemiologic studies of Crohn's disease (CD) or ulcerative colitis (UC) from Latin American and Caribbean countries and territories that reported incidence, prevalence, ratio of UC:CD, IBD phenotype, and treatment, through September 12, 2018. Data were extracted from 61 articles for analysis. RESULTS The incidence and prevalence of IBD have been steadily increasing in Latin America and the Caribbean. The incidence of CD in Brazil increased from 0.08 per 100,000 person-years in 1988 to 0.68 per 100,000 person-years in 1991-1995 to 5.5 per 100,000 person-years in 2015. The highest reported prevalence of IBD was in Argentina, in 2007, at 15 and 82 per 100,000 person-years for CD and UC, respectively. The ratio of UC:CD exceeded 1 in all regions throughout Latin America and the Caribbean with the exception of Brazil. Treatment with tumor necrosis factor antagonists increased steadily for patients with CD (43.4% of all patients in Brazil were treated in 2014) but less so for patients with UC (4.5% of all patients were treated in 2014). Surgery for IBD decreased with time. In Chile, surgeries were performed on 57.0% of patients with CD and 18.0% of patients with UC during the period of 1990-2002; these values decreased to 38.0% and 5.0%, respectively, during the period of 2012-2015. In Peru, 6.9% of patients with UC received colectomies in the period of 2001-2003 and 6.2% in 2004-2014. CONCLUSIONS In a systematic review, we found the incidence of IBD to be increasing throughout Latin America and the Caribbean. Population-based epidemiology studies are needed to evaluate the increase in IBD in these regions, which differ from other global regions in climate, culture, demographics, diet, healthcare delivery and infrastructure, and socioeconomic status.

中文翻译：

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整个拉丁美洲和加勒比地区炎症性肠病的进展：系统评价。

背景和目的 在拉丁美洲，炎症性肠病 (IBD) 的发病率正在增加。我们进行了一项系统评价，以确定拉丁美洲（包括墨西哥、中美洲和南美洲）和加勒比地区 IBD 的临床和流行病学特征。方法 我们在 MEDLINE、EMBASE 和 SciELO 数据库中搜索了来自拉丁美洲和加勒比国家和地区的克罗恩病 (CD) 或溃疡性结肠炎 (UC) 的临床或流行病学研究，这些研究报告了发生率、患病率、UC:CD 的比率、IBD 表型、和治疗，截止到 2018 年 9 月 12 日。从 61 篇文章中提取数据进行分析。结果 在拉丁美洲和加勒比地区，IBD 的发病率和流行率一直在稳步上升。巴西的 CD 发病率从 1988 年的每 100,000 人年 0.08 增加到 0。1991-1995 年为每 100,000 人年 68 例，2015 年为每 100,000 人年 5.5 例。 报告的 IBD 患病率最高的是阿根廷，2007 年，CD 和 UC 分别为每 100,000 人年 15 例和 82 例。UC:CD 的比率在整个拉丁美洲和加勒比地区的所有地区都超过了 1，但巴西除外。CD 患者使用肿瘤坏死因子拮抗剂的治疗稳步增加（2014 年巴西所有患者中有 43.4% 接受了治疗），但 UC 患者的治疗率较低（2014 年所有患者中有 4.5% 接受了治疗）。IBD 的手术次数随着时间的推移而减少。在智利，1990-2002 年间，57.0% 的 CD 患者和 18.0% 的 UC 患者接受了手术；在 2012-2015 年期间，这些值分别下降到 38.0% 和 5.0%。在秘鲁，6。9% 的 UC 患者在 2001-2003 年期间接受了结肠切除术，2004-2014 年期间为 6.2%。结论 在一项系统评价中，我们发现整个拉丁美洲和加勒比地区的 IBD 发病率正在增加。需要基于人群的流行病学研究来评估这些地区 IBD 的增加，这些地区在气候、文化、人口统计、饮食、医疗保健和基础设施以及社会经济地位方面与其他全球地区不同。