Active Disease and Its Associated Factors Among Patients with Inflammatory Bowel Disease in Addis Ababa Ethiopia: A Hospital-Based Cross-Sectional Study

Zinabu Desalegn^1*Abate Bane²Guda Merdasa²Amanuel Arota³

• ¹School of Medicine, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
• ²School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Addis Ababa, Ethiopia
• ³Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Southern Nations, Nationalities, and Peoples' Region, Ethiopia

Inflammatory bowel disease (IBD) is a chronic inflammatory condition affecting the gastrointestinal tract, primarily classified into Crohn's disease (CD) and ulcerative colitis (UC), with some cases falling into the indeterminate category. A significant number of individuals with IBD may present with active disease, which is a major contributor to various complications. Therefore, early detection of patients with clinical active disease is essential for timely referral and appropriate management to prevent related complications. This study aimed to assess the prevalence of active disease and its associated factors among patients with inflammatory bowel disease.Methods: A hospital-based cross-sectional study was conducted at Tikur Anbessa Specialized Hospital and Adera Medical and Surgical Center, Addis Ababa, Ethiopia, in 2024. A total of 252 patients with inflammatory bowel disease (IBD) were selected using a consecutive recruitment technique. Data were collected from both medical records and patient interviews using a structured questionnaire. Bivariate logistic regression was performed, followed by multivariable analysis to examine the association between the outcome and predictor variables. Variables with a p-value ≤ 0.25 in the bivariate analysis were included in the multivariable model. A p-value < 0.05 was considered statistically significant.Result: A total of 242 individuals participated in the study, with a response rate of 96.03%. More than one-third, 82 (33.88%) of the patients, had active disease at the time of inclusion. The majority of IBD patients, 190 (78.51%), were diagnosed with Crohn's disease. IBD patients with a monthly income between 500-1000 Ethiopian Birr (ETB) had an approximately 80% lower risk of active disease at inclusion compared to those with an income of less than 500 ETB (AOR = 0.20; 95% CI: 0.05-0.79). Patients identified as being at high risk for malnutrition based on the Malnutrition Universal Screening Tool (MUST) score had about four times higher risk of active disease compared to those at low risk (AOR = 4.30; 95% CI: 1.69-10.91) Conclusion: Every third of IBD patients had active disease. MUST score and income level were found to be significant predictors of clinical activity of disease. Targeted interventions to address nutritional, clinical and socioeconomic determinants of IBD outcomes should be implemented.