Future of research on inflammatory bowel disease in Nigeria: Gaps and opportunities

Table 1 Inflammatory bowel disease related studies conducted in Nigeria

Ref.	Key objective	Study type	Regional location	Key findings
Alatise et al[28] (2012)	To present the experience of 3 tertiary health centres on IBD	Retrospective study	South-West	UC was reported in 66.7% of patients, with 33.3% diagnosed with CD. Severe disease was present in 83.3% of cases, and the primary clinical feature was muco-bloody diarrhoea
Forae et al[29] (2016)	Determine the frequency and morphological patterns of IBD in Benin City, Nigeria	Retrospective study	South-South	CD was observed in 43.8% of cases, UC in 37.5%, and IC in 18.7%. The male-to-female ratio was 1.9:1, with a mean age of 51.1 ± 7.2 years
Ekwunife et al[30] (2015)	Contribute to the growing literature on UC among Nigerians	Case series	South-East	Three cases of UC were reported: One patient underwent bowel resection due to massive gastrointestinal haemorrhage, while the others were diagnosed following colonoscopy and biopsy
Adeniyi et al[31] (2020)	Increase the awareness of this emerging condition in African children	Retrospective study	South-West	Eight children with IBD were evaluated, with a median age of 12.0 years. The most common presentation was chronic abdominal pain (50%). Two cases were CD, three were UC, and three were IC. Treatments included 5ASA, MTX, excusive enteral nutrition, and steroids
Ibukun et al[35] (2021)	The assessment focused on poverty levels among individuals with NCDs and the out-of-pocket expenses associated with these conditions	Cross sectional study	South-West	Twenty-five percent of respondents were multidimensionally poor, and 72% had no health insurance coverage
Kooffreh-Ada et al[39] (2024)	To share the experience of our gastroenterology practice in Calabar	Retrospective study	South-South	Eight patients presented with features consistent with IBD: Six had UC and two had CD. Seven patients had moderate disease, with recurrent mucoid bloody diarrhea as the main clinical feature. All cases were treated with 5ASA and AZA
Senbanjo et al[40] (2020)	The study highlights the occurrence, presentation, and management challenges associated with IBD	Case series	South-West	The median age was 9 years, with five cases identified. Three cases were diagnosed due to bloody diarrhea, while two were confirmed following surgical intervention for acute abdomen symptoms
Adepoju et al[41] (2021)	To demonstrate a rare concurrence of IBD and hemoglobinopathy	Case report	South-West	A 16-year-old girl was diagnosed with co-existing SCA and UC after presenting with a one-year history of recurrent peri-umbilical pain and bloody stools
Adeniyi et al[42] (2019)	CD has been reported to occur following therapy with etanercept in JIA patients	Case report		A 9-year-old with ileocecal disease CD was treated with steroids and sulfasalazine
Ukwenya et al[43] (2011)	Is IBD still a rare diagnosis?	Case series	North-West	3 cases of UC and one case of CD diagnosed in a tertiary institution
Senbanjo et al[44] (2012)	Reporting a case of ulcerative colitis in a 7-year-old girl	Case report	South-West	Left-sided colitis was confirmed by colonoscopy and biopsy in a patient who presented with frequent blood-stained stools, abdominal pain, and significant weight loss
Onyia et al[38] (2023)	Reporting a 40-year-old patient with UC who developed PG	Case report	South-East	A patient with UC diagnosed 20 years ago developed ulcers on the flexor surface of the right lower limb following trauma 10 years prior, diagnosed as PG. The patient was treated with infliximab and later mesalazine
Ajayi et al[45] (2010)	Reporting a case of CD presenting with a recurrent perianal fistula	Case report	South-West	A 23-year-old Asian male presented with recurrent abdominal pain, fever, arthralgia, perianal swelling, and a perianal fistula. Colonoscopy revealed CD affecting the entire colon. He was treated with corticosteroids and aminosalicylates
Alese et al[46] (2008)	Reporting on a 45-year-old man who presented with PG associated with UC	Case report	South-West	A 45-year-old man presented with rectal bleeding, lower abdominal pain, and superficial ulcerative lesions on the hand, neck, scalp, right gluteus, right inguinal area, and leg, confirmed as PG. He was treated with dapsone and prednisolone
Naish et al[47] (2015)	Reporting a rare occurrence of UC and pyostomatitis vegetans among the Nigerian population	Case report	South-West	A 26-year-old patient presented with bloody stools and oral rashes involving the mucosa of the cheeks, palate, buccal and vestibular surfaces of the gums, lateral margin of the tongue, and upper and lower lips. Sigmoidoscopy and biopsy revealed UC
Musa et al[49] (2021)	This study aimed to identify indications and colonoscopic findings among patients who underwent colonoscopy	Retrospective study	North-West	A total of 839 patient records were reviewed, with a mean age of 43.86 ± 18.36 years. The most common indication for the procedure was rectal bleeding (52.4%). The predominant finding was hemorrhoids (42.3%), followed by IBD lesions (18.1%)
Alatise et al[50] (2012)	This study aims to evaluate the demographic data of patients presenting for colonoscopy	Cross sectional study	South-West	In this study, 320 patients were recruited, with 56.9% being male and 43.1% female. The most common indications for colonoscopy were lower GI bleeding and changes in bowel habits (79.0%). The commonest endoscopic findings included hemorrhoids (20.6%, 66 cases), colorectal cancer (15.6%, 50 cases), polyps (10.3%), and IBD (3.8%)
Irowa et al[51] (2024)	This study aims to highlight the causes of hematochezia	Cross sectional study	South-South	Over a 9-year period, a total of 365 colonoscopies were performed. Hematochezia was the indication for 44% of these procedures. The causes of hematochezia included hemorrhoids (32.5%), colon cancer (23.8%), and inflammatory bowel disease (6.3%)
Akere et al[52](2016)	To evaluate the pattern of indications and spectrum of colonic disease at a tertiary healthcare facility	Cross sectional study	South-West	In this study, 250 patients were examined with male to female ratio of 1.1:1, mean age of 57.9 ± 14.2 years. Most common presentation was hematochezia (34.0%), the most common findings were colonic polyps (23.2%), and hemorrhoids (20.8%). IBD was seen in 4.0%
Oyewole et al[83] (2015)	To provide evidence-based information that will promote healthy lifestyle among urban dwellers	Systemic review	South-West	Industrialisation promotes creation of more job opportunities. However, many of the available workplaces in urban areas are not health-promoting because employees have poor access to preventive health information and sensitisation to healthy lifestyle has been poorly considered

IBD: Inflammatory bowel disease; UC: Ulcerative colitis; CD: Crohn's disease; 5ASA: 5-aminosalicylate; AZA: Azathioprine; SCA: Sickle cell anaemia; PG: Pyoderma gangrenosum.