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).


OBJECTIVE
We aimed to assess the epidemiological and clinical characteristics of UC in Tuzla Canton of B&H during a 12-year period (1995-2006).


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 3.43/10 inhabitants [95% confidence interval (CI) = 2.97-3.89], ranging from 0.22 to 7.44 per 10. The mean annual crude incidence in the last 5 years of study (2002-2006) was 5.55/10 (95% CI = 4.63-6.48). The prevalence of UC during the observed period was found to be 43.1/10 (95% CI = 37.3-48.8). The incidence of UC increased dramatically from the average of 1.01/10 in the period between 1995 and 1997 to 6.04/10 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.


CONCLUSIONS
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 10 inhabitants.
Salkic
Nermin N
NN
Department of Gastroenterology, Internal Medicine Hospital, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina. snermin@gmail.com
Pavlovic-Calic
Nada
N
Gegic
Adnan
A
Jovanovic
Predrag
P
Basic
Mirela
M
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D017522:Bosnia and Herzegovina / Q000453:epidemiology; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000453:epidemiology*; D003113:Colonoscopy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution; D013997:Time Factors; D055815:Young Adult