title: Inflammatory bowel disease in Accra: what new trends.
abstract: BACKGROUND
  Inflammatory bowel disease (IBD) has been more common in Western Europe and North America. Initially IBD had been thought to be low in incidence among Sub-Saharan Africans. However, it is now being increasingly recognised in patients of African descent.
  
  
  OBJECTIVE
  A comparative assessment of the patterns of IBD in Accra from 1997 to 2011.
  
  
  METHODS
  This study used a retrospective design to access clinical details of follow-up patients attending the Gastroenterology Unit of the Korle-Bu Teaching Hospital, Accra between February, 1997 and May, 2011. It was a comparative seven-year review of clinical presentations of IBD between April, 2004 -August, 2011 (t2) and February, 1997 - March, 2004 (t1) for changing patterns of disease in tertiary care.
  
  
  RESULTS
  Twenty-eight (28) new IBD patients were seen in the Gastroenterology Clinic, KBTH with IBD during 2004 - 2011 (t2) in comparison to 17 patients over 1997 - 2004 (t1). Presentations of severe diarrhoea were 70.4% and 55.6% in (t1) and (t2) respectively. Eighty-two percent (82%) of patients with IBD in (t2) had a severely inflamed colon on the index colonoscopy. Most patients (70-80%) responded to medical therapy (steroids, sulfasalazine) with no colon resections for steroid-refractory colitis.
  
  
  CONCLUSIONS
  Although relatively uncommon, IBD recorded a 65% rise in incidence over the study periods with a male preponderance. Most patients with IBD were presenting late with severe clinical and endoscopic features of disease yet medically responsive. Non-specific (indeterminate) colitis gained prominence in (t2).
authors.affiliation: Department of Medicine, University of Ghana Medical School, Box 4236, Korle-bu, Accra, Ghana.
authors.forename: T N
authors.initials: TN
authors.lastname: Archampong
authors.forename: K N
authors.initials: KN
authors.lastname: Nkrumah
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003967:Diarrhea / Q000209:etiology; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000209:etiology; D012189:Retrospective Studies; D017678:Sex Distribution; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents