Inflammatory Bowel disease (IBD) do occur across populations but the prevalence and detail epidemiologic data for non-European population is lacking. Asian populations were once considered very low risk, but data points to an increasing incidence of IBD in Asian (South Asian in particular) populations who migrate to areas where IBD is more common. A recent study done in British Columbia (Canada) suggest that the incidence of IBD among South Asians children was 3 times more common compared with Caucasian children. The objective of this project is to (1) Among children (under 18 years), estimate the IBD burden among Asians compared with Caucasians and African Americans in Georgia (GA); (2) Compare the differences between South Asians and East Asians; (3) Compare the clinical outcome and the need for surgery among racial ethnic groups.Methods:
Demographics of Asian populations in Georgia were obtained from the United States 2010 census (factfinder.cencus.gov) along with data from other racial/ethnic groups. The data was then categorized as SA (Asian Indian, Bangladeshi, Pakistani, Sri Lankan, Bhutanese, Nepalese) Or EA (Cambodian, Chinese, Filipino, Hmong, Indonesian, Japanese, Korean, Laotian, Malaysian, Thai, Vietnamese, Mongolian). Electronic Medical Records (EMR) at Children's Healthcare of Atlanta (CHOA) was queried for ICD 9 and ICD 10 codes for Crohn's disease (CD) and Ulcerative colitis (UC)/Indeterminate colitis (IBDU). A total of 1284 pediatric subjects were identified as being IBD (either CD or UC/IBDU). Patients were then categorized by race (Caucasians, African American, Hispanic, Asian and other). Asian patients were than categorized as SA or EA. Nearly 98% of Asians lives in greater Atlanta area and CHOA is the only pediatric provider for IBD care in children.Results:
Out of 1284 pediatric IBD subjects in GA, 777 (61%) were Caucasians, 381 (29%) were African-Americans, 37 (2.6%) were hispanic and 35 (2.6%) were Asians mirroring the state population demographics. Of that 2.6% (n = 35) Asian IBD, SAs account for 1.93% of the pediatric IBD and EAs account for only 0.7%. At population level, EA are in the majority at 2.5% of the state population while SA were only at 0.7% in GA. Incidence of IBD among SAs is about 3 times more common compared with Caucasians and African Americans and about 6 times higher compared to EA. Among SA IBD, 56% CD and 44% UC. Amonf EA 33% were UC and 67% were CD. There were no difference in disease severity, need for surgery or biologic exposure in SA IBD compared with Caucasians or African Americans children with IBD.Conclusions:
IBD is an equal opportunity condition affecting each racial/ethnic group including Asians in GA. The incidence of IBD among SA children is higher than Caucasians and African Americans living in GA. The incidence of IBD among EA remains low. Although SA represent a small percentage of population in GA, IBD among SA is increasing, whose phenotypic expression and natural history is relatively unknown. As IBD becomes more prevalent SAs populations need to be more represented in research.