PLoS One. 2022 Sep 9;17(9):e0274117. doi: 10.1371/journal.pone.0274117. eCollection 2022.

Ivana Kern ¹, Olaf Schoffer ², Thomas Richter ³, Wieland Kiess ⁴, Gunter Flemming ⁴, Ulf Winkler ⁵, Jürgen Quietzsch ⁶, Olaf Wenzel ⁷, Marlen Zurek ³, Ulf Manuwald ¹, Janice Hegewald ⁸, Shi Li ¹, Jens Weidner ⁹, Jan de Laffolie ¹⁰, Klaus-Peter Zimmer ¹⁰, Joachim Kugler ¹, Martin W Laass ¹¹, Ulrike Rothe ¹

Author information

¹Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine "Carl Gustav Carus", TU Dresden, Dresden, Germany.

²Center for Evidence-based Healthcare, University Hospital and Faculty of Medicine "Carl Gustav Carus", TU Dresden, Dresden, Germany.

³Clinic for Children and Adolescents, Hospital St. Georg, Leipzig, Germany.

⁴Center for Pediatric Research, Department of Women and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.

⁵Clinic for Children and Adolescents, Hospital Bautzen, Oberlausitz-Hospitals, Bautzen, Germany.

⁶Clinic for Children and Adolescents, DRK Hospital Lichtenstein, Lichtenstein, Germany.

⁷Clinic for Children and Adolescents, Helios Hospital Aue, Bad Schlema, Germany.

⁸Department of Occupational, Social and Environmental Epidemiology, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine "Carl Gustav Carus", TU Dresden, Dresden, Germany.

⁹Center for Medical Informatics, Institute for Medical Informatics and Biometry, Faculty of Medicine "Carl Gustav Carus", TU Dresden, Dresden, Germany.

¹⁰Department of General Pediatrics, Children's Gastroenterology/ Hepatology/ Nutrition, Justus-Liebig-University Gießen, CEDATA-GPGE Working Group, Gießen, Germany.

¹¹University Hospital for Children and Adolescents, Faculty of Medicine "Carl Gustav Carus", TU Dresden, Dresden, Germany.

Abstract

Aims: An increasing number of children and adolescents worldwide suffer from inflammatory bowel disease (IBD) such as Crohn's disease (CD) and ulcerative colitis (UC). The present work aims to investigate the incidence, prevalence and future trends of IBD in children and adolescents in Saxony, Germany.

Methods: The Saxon Pediatric IBD Registry collected data on patients up to 15 years of age from all 31 pediatric hospitals and pediatric gastroenterologists in Saxony over a 15-year period (2000-2014). In 2019, an independent survey estimated a registry completeness of 95.7%. Age-standardized incidence rates (ASR) per 100,000 person-years (PY) and prevalence per 100,000 children and adolescents were calculated. Evaluation was also been performed in sex and age subgroups. Joinpoint and Poisson regression were used for trend analyses and projections.

Results: 532 patients with confirmed IBD during 2000-2014 were included in the epidemiological evaluation. 63.5% (n = 338) patients had CD, 33.1% (n = 176) had UC and 3.4% (n = 18) had unclassified IBD (IBD-U). The 15-year IBD prevalence was 111.8 [95%-CI: 102.3-121.3] per 100,000. The incidence ASR of IBD per 100,000 PY over the whole observation period was 7.5 [6.9-8.1]. ASR for the subtypes were 4.8 [4.3-5.3] for CD, 2.5 [2.1-2.9] for UC and 0.3 [0.1-0.4] for IBD-U. The trend analysis of ASR using the joinpoint regression confirmed a significant increase for incidence of IBD as well as CD. For IBD, the ASR per 100,000 PY increased from 4.6 [2.8-6.3] in 2000 to 8.2 [7.5-13.6] in 2014; projected incidence rates for IBD in Germany are 12.9 [6.5-25.5] in the year 2025 and 14.9 [6.7-32.8] in 2030, respectively. Thus, the number of new IBD diagnoses in Germany would more than triple (325%) in 2030 compared to 2000. The increase is expected to be faster in CD than UC, and be more in males than in females. The expected number of newly diagnosed children with IBD in Germany is projected to rise to about 1,584 [1,512-1,655] in 2025, and to about 1,918 [1,807-2,29] in 2030.

Conclusion: The incidence of IBD in children and adolescents in Saxony increased at a similar rate as in other developed countries during the observation period. Given this trend, the health care system must provide adequate resources for the care of these young patients in the future.