Ulcerative colitis in the Tuzla region of Bosnia and Herzegovina between 1995 and 2006: epidemiological and clinical characteristics
Background Bosnia and Herzegovina (B&H) is one of the Eastern European countries that lacks data on the epidemiology of ulcerative colitis (UC). Aims We aimed to assess the epidemiological and clinical characteristics of UC in Tuzla Canton of B&H during a 12-year period (1995–2006). Patients and methods We retrospectively evaluated hospital records of both UC inpatients and outpatients residing in Tuzla Canton of B&H (total of 496 280 inhabitants) between 1995 and 2006. Patients that firmly satisfied the diagnostic criteria for UC were included in the study. Incidence rates were calculated with age standardization using European population standards. Trends in incidence were evaluated as moving 3-year averages. Results During the observed period, 214 patients met the diagnostic criteria for UC. The average age-standardized incidence was found to be 3.43/105 inhabitants [95% confidence interval (CI) = 2.97–3.89], ranging from 0.22 to 7.44 per 105. The mean annual crude incidence in the last 5 years of study (2002–2006) was 5.55/105 (95% CI = 4.63–6.48). The prevalence of UC during the observed period was found to be 43.1/105 (95% CI = 37.3–48.8). The incidence of UC increased dramatically from the average of 1.01/105 in the period between 1995 and 1997 to 6.04/105 between 2004 and 2006, as did the number of colonoscopies performed, from 29 in 1995 to 850 in 2006. The average yearly incidence of confirmed UC cases detected on colonoscopy was 5.56 per 100 colonoscopies per year (95% CI = 4.81–6.30) and only 3.92 per 100 colonoscopies (95% CI = 3.26–4.57) in the last 5 years of the observed period. Conclusion Tuzla Canton of B&H is a region with an increasing incidence of UC, which is most likely a direct consequence of a wider use of colonoscopy. We believe that in the next few years, the incidence of UC in this region will probably reach the annual incidence rate of 6 per 105 inhabitants.