title: Manifestations of inflammatory bowel disease in patients of Haitian and Cape Verdean descent.
abstract: OBJECTIVE
  Several studies have reported unique ethnic phenotypes of inflammatory bowel disease (IBD). An appreciation of disease manifestations in different populations may improve clinical outcomes. There are no studies examining IBD in patients of Haitian or Cape Verdean descent. We sought to define the IBD phenotype in these populations.
  
  
  METHODS
  This was a retrospective review comparing Haitian and Cape Verdean immigrant IBD patients to Caucasians, all receiving care at Boston Medical Center in Boston, Massachusetts, USA. The following variables were analyzed: family history, smoking history, vaccinations/cancer screening, age of diagnosis, disease duration, disease location, medication use, and complications.
  
  
  RESULTS
  Thirty-one Haitians and 21 Cape Verdeans were matched to Caucasian controls. Haitians (mean age 42 years) and Cape Verdeans (mean age 47 years) with Crohn's disease were diagnosed with IBD later than Caucasians (mean age 31 years, p = 0.04 and 0.02, respectively). Haitians with Crohn's were less likely to have a history of tobacco use compared to Caucasians (13% vs. 51%, p = 0.02). Cape Verdeans with Crohn's were less likely to have perianal involvement (0% vs. 50%, p = 0.01). Haitians with IBD were less likely to have ever used glucocorticoids (48% vs. 76%, p = 0.02). There was no difference in vaccination rates, cancer screening, or disease complications.
  
  
  CONCLUSIONS
  This study demonstrates differences in IBD presentation and disease course among Haitians and Cape Verdeans. Our results suggest a more mild disease in these ethnic groups. Future studies are needed to identify the influence of environmental factors.
authors: Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine , Boston, MA , USA.
authors: Christopher
authors: C
authors: Stallwood
authors: Karenpreet
authors: K
authors: Shergill
authors: Joseph
authors: J
authors: Wu
authors: Francis A
authors: FA
authors: Farraye
authors: Hannah L
authors: HL
authors: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055726:Cabo Verde; D003107:Colorectal Surgery / Q000145:classification*; D018450:Disease Progression; D054242:Emigrants and Immigrants; D005260:Female; D006205:Haiti; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000208:ethnology* / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
keywords: Cape Verde; Crohn’s; Haiti; ethnicity; inflammatory bowel disease; ulcerative colitis