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Abstract

A retrospective, cross-sectional study was conducted to assess the prevalence, clinical presentation, and diagnostic practices of inflammatory bowel disease (IBD) in Djibouti, using clinical data from four major hospitals in the country. A total of 657 patients with chronic gastrointestinal symptoms were included in the analysis. Results showed that nearly half of the patients (48.5%) presented with symptoms characteristic of Crohn's disease. However, only two patients received a formal diagnosis of IBD, including one confirmed case of ulcerative colitis. Other diagnoses included erosive gastritis, duodenogastric reflux, and villous atrophy. Regarding diagnostic practices, a biopsy was performed in only 26.8% of cases, with a notable gender disparity in biopsy rates. This low frequency of biopsies highlighted a problem of insufficient diagnostic infrastructure. Furthermore, the presence of typical symptoms of Crohn's disease, combined with a low number of confirmed diagnoses, revealed an underdiagnosis of IBD in the country. The underlying immunopathological mechanisms of IBD were also addressed, highlighting abnormal activation of the immune system that leads to chronic intestinal inflammation. These diseases are characterized by excessive immune responses, influenced by environmental and genetic factors. This study highlighted the importance of improving diagnostic tools, increasing awareness among healthcare professionals, and facilitating access to diagnostic procedures such as biopsy, to better manage IBD in Djibouti‎.

Keywords: Bowel diseases, Crohn's disease, Djibouti, EDiagnosis

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