{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:57:50Z","timestamp":1790661470211,"version":"4.1.0"},"reference-count":81,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Brazilian Research Council","award":["306634\/2019-8"],"award-info":[{"award-number":["306634\/2019-8"]}]},{"name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro","award":["E26\/202.781\/2017"],"award-info":[{"award-number":["E26\/202.781\/2017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The epidemiology of inflammatory bowel disease (IBD) in developing countries may uncover etiopathogenic factors. We investigated IBD prevalence in Brazil by investigating its geographic, spatial, and temporal distribution, and attempted to identify factors associated with its recent increase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A drug prescription database was queried longitudinally to identify patients and verify population distribution and density, race, urbanicity, sanitation, and Human Development Index. Prevalence was calculated using the number of IBD patients and the population estimated during the same decade. Data were matched to indices using linear regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 162 894 IBD patients, 59% with ulcerative colitis (UC) and 41% with Crohn\u2019s disease (CD). The overall prevalence of IBD was 80 per 100 000, with 46 per 100 000 for UC and 36 per 100 000 for CD. Estimated rates adjusted to total population showed that IBD more than triplicated from 2008 to 2017. The distribution of IBD demonstrated a South-to-North gradient that generally followed population apportionment. However, marked regional differences and disease clusters were identified that did not fit with conventionally accepted IBD epidemiological associations, revealing that the rise of IBD was variable. In some areas, loss of biodiversity was associated with high IBD prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>When distribution is considered in the context of IBD prevalence, marked regional differences become evident. Despite a background of Westernization, hotspots of IBD are recognized that are not explained by population density, urbanicity, sanitation, or other indices but apparently are explained by biodiversity loss. Thus, the rise of IBD in developing countries is not uniform, but rather is one that varies depending on yet unexplored factors like geoecological conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izab346","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T09:33:00Z","timestamp":1643362380000},"page":"1696-1708","source":"Crossref","is-referenced-by-count":16,"title":["Geosocial Features and Loss of Biodiversity Underlie Variable Rates of Inflammatory Bowel Disease in a Large Developing Country: A Population-Based Study"],"prefix":"10.1093","volume":"28","author":[{"given":"Andre","family":"da Luz Moreira","sequence":"first","affiliation":[{"name":"D\u2019Or Institute for Research and Education , Rio de Janeiro , Brazil"},{"name":"Inflammatory Bowel Disease Center, NYU Langone Health, NYU Grossman School of Medicine , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Felipe","family":"de Campos Lobato","sequence":"additional","affiliation":[{"name":"Department of Surgery, Federal University of Minas Gerais , Belo Horizonte , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica Pronestino","family":"de Lima Moreira","sequence":"additional","affiliation":[{"name":"Institute of Collective Health Studies, Federal University of Rio de Janeiro , Rio de Janeiro , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronir Raggio","family":"Luiz","sequence":"additional","affiliation":[{"name":"Institute of Collective Health Studies, Federal University of Rio de Janeiro , Rio de Janeiro , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste","family":"Elia","sequence":"additional","affiliation":[{"name":"D\u2019Or Institute for Research and Education , Rio de Janeiro , 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Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"2023112213084295500_CIT0001","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1053\/j.gastro.2011.01.055","article-title":"Epidemiology and natural history of inflammatory bowel diseases.","volume":"140","author":"Cosnes","year":"2011","journal-title":"Gastroenterology."},{"key":"2023112213084295500_CIT0002","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/nrgastro.2015.186","article-title":"Immunopathogenesis of IBD: current state of the art.","volume":"13","author":"de Souza","year":"2016","journal-title":"Nat Rev Gastroenterol Hepatol."},{"key":"2023112213084295500_CIT0003","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1038\/nrgastro.2017.136","article-title":"Environmental triggers in IBD: a review of progress and evidence.","volume":"15","author":"Ananthakrishnan","year":"2018","journal-title":"Nat Rev 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