Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study

Introduction The epidemiology of inflammatory bowel disease (IBD) in sub-Saharan Africa is poorly documented. We have started a registry to determine the burden, phenotype, risk factors, disease course and outcomes of IBD in Zimbabwe.Methods and analysis A prospective observational registry with a n...

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Main Authors: Leolin Katsidzira, Wisdom F Mudombi, Rudo Makunike-Mutasa, Bahtiyar Yilmaz, Annika Blank, Andrew Macpherson, Stephan Vavricka, Innocent Gangaidzo
Format: Article
Language:English
Published: BMJ Publishing Group 2020-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/12/e039456.full
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spelling doaj-3b68f24b9e864d458b9a6c3cfb9c58d82021-09-10T09:00:04ZengBMJ Publishing GroupBMJ Open2044-60552020-12-01101210.1136/bmjopen-2020-039456Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control studyLeolin Katsidzira0Wisdom F Mudombi1Rudo Makunike-Mutasa2Bahtiyar Yilmaz3Annika Blank4Andrew Macpherson5Stephan Vavricka6Innocent Gangaidzo7Internal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, ZimbabweInternal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, ZimbabweHistopathology Unit, Faculty of Medicine and Heath Sciences, University of Zimbabwe, Harare, ZimbabweMaurice Müller Laboratories, Department for Biomedical Research, University of Bern, Bern, SwitzerlandInstitute of Pathology, University of Bern, Bern, SwitzerlandMaurice Müller Laboratories, Department for Biomedical Research, University of Bern, Bern, SwitzerlandDepartment of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, SwitzerlandInternal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, ZimbabweIntroduction The epidemiology of inflammatory bowel disease (IBD) in sub-Saharan Africa is poorly documented. We have started a registry to determine the burden, phenotype, risk factors, disease course and outcomes of IBD in Zimbabwe.Methods and analysis A prospective observational registry with a nested case–control study has been established at a tertiary hospital in Harare, Zimbabwe. The registry is recruiting confirmed IBD cases from the hospital, and other facilities throughout Zimbabwe. Demographic and clinical data are obtained at baseline, 6 months and annually. Two age and sex-matched non-IBD controls per case are recruited—a sibling or second-degree relative, and a randomly selected individual from the same neighbourhood. Cases and controls are interviewed for potential risk factors of IBD, and dietary intake using a food frequency questionnaire. Stool is collected for 16S rRNA-based microbiota profiling, and along with germline DNA from peripheral blood, is being biobanked. The estimated sample size is 86 cases and 172 controls, and the overall registry is anticipated to run for at least 5 years. Descriptive statistics will be used to describe the demographic and phenotypic characteristics of IBD, and incidence and prevalence will be estimated for Harare. Risk factors for IBD will be analysed using conditional logistic regression. For microbial analysis, alpha diversity and beta diversity will be compared between cases and controls, and between IBD phenotypes. Mann-Whitney U tests for alpha diversity and Adonis (Permutational Multivariate Analysis of Variance) for beta diversity will be computed.Ethics and dissemination Ethical approval has been obtained from the Parirenyatwa Hospital’s and University of Zimbabwe’s research ethics committee and the Medical Research Council of Zimbabwe. Findings will be discussed with patients, and the Zimbabwean Ministry of Health. Results will be presented at scientific meetings, published in peer reviewed journals, and on social media.Trial registration number NCT04178408.https://bmjopen.bmj.com/content/10/12/e039456.full
collection DOAJ
language English
format Article
sources DOAJ
author Leolin Katsidzira
Wisdom F Mudombi
Rudo Makunike-Mutasa
Bahtiyar Yilmaz
Annika Blank
Andrew Macpherson
Stephan Vavricka
Innocent Gangaidzo
spellingShingle Leolin Katsidzira
Wisdom F Mudombi
Rudo Makunike-Mutasa
Bahtiyar Yilmaz
Annika Blank
Andrew Macpherson
Stephan Vavricka
Innocent Gangaidzo
Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study
BMJ Open
author_facet Leolin Katsidzira
Wisdom F Mudombi
Rudo Makunike-Mutasa
Bahtiyar Yilmaz
Annika Blank
Andrew Macpherson
Stephan Vavricka
Innocent Gangaidzo
author_sort Leolin Katsidzira
title Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study
title_short Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study
title_full Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study
title_fullStr Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study
title_full_unstemmed Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study
title_sort inflammatory bowel disease in sub-saharan africa: a protocol of a prospective registry with a nested case–control study
publisher BMJ Publishing Group
series BMJ Open
issn 2044-6055
publishDate 2020-12-01
description Introduction The epidemiology of inflammatory bowel disease (IBD) in sub-Saharan Africa is poorly documented. We have started a registry to determine the burden, phenotype, risk factors, disease course and outcomes of IBD in Zimbabwe.Methods and analysis A prospective observational registry with a nested case–control study has been established at a tertiary hospital in Harare, Zimbabwe. The registry is recruiting confirmed IBD cases from the hospital, and other facilities throughout Zimbabwe. Demographic and clinical data are obtained at baseline, 6 months and annually. Two age and sex-matched non-IBD controls per case are recruited—a sibling or second-degree relative, and a randomly selected individual from the same neighbourhood. Cases and controls are interviewed for potential risk factors of IBD, and dietary intake using a food frequency questionnaire. Stool is collected for 16S rRNA-based microbiota profiling, and along with germline DNA from peripheral blood, is being biobanked. The estimated sample size is 86 cases and 172 controls, and the overall registry is anticipated to run for at least 5 years. Descriptive statistics will be used to describe the demographic and phenotypic characteristics of IBD, and incidence and prevalence will be estimated for Harare. Risk factors for IBD will be analysed using conditional logistic regression. For microbial analysis, alpha diversity and beta diversity will be compared between cases and controls, and between IBD phenotypes. Mann-Whitney U tests for alpha diversity and Adonis (Permutational Multivariate Analysis of Variance) for beta diversity will be computed.Ethics and dissemination Ethical approval has been obtained from the Parirenyatwa Hospital’s and University of Zimbabwe’s research ethics committee and the Medical Research Council of Zimbabwe. Findings will be discussed with patients, and the Zimbabwean Ministry of Health. Results will be presented at scientific meetings, published in peer reviewed journals, and on social media.Trial registration number NCT04178408.
url https://bmjopen.bmj.com/content/10/12/e039456.full
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