Our results pave the way to optimize the future need for health care systems for IBD. In other words, policymakers will have opportunities to take suitable measures and implement interventions. We observed an emerging epidemic of IBD in Asia and Iran by 2035. In Iran we expect, the IBD prevalent cases will be increased 2.5 times (fold) from now until 2030. In North Africa and the Middle East, a 2.3-fold increment in prevalence is expected from 2020 to 2035. For India, the quadrupling of the prevalence from now to 2035 was projected. In the East Asia region, a 1.6-fold increase in the number of prevalent cases was estimated by 2035. In High‐income Asia‐Pacific and Southeast Asia regions around 1.7 times increase in prevalence by 2035 was predicted. Our results emphasize the need for emergency action by the health policymakers in Asia and Iran to curb this increasing trend and subsequently emerging epidemic.
According to previously eminent evidence , most of the countries included in our study or/and classified by IHME in Asia regions have just experienced two phases of IBD evolution(stages) epidemiological by 2020, emergence and acceleration in incidence (shifting from sporadic cases to markedly increase in the number of new cases). In other words, in Asia, we will confront two additional stages in the evolution of the IBD, compounding prevalence and prevalence equilibrium (increment and drop down in prevalent cases). But the pace of IBD evolution in some Asian regions tends to be higher than in the Western world. So, the length of the struggle between incidence and death (stage 3) is expected to be shorter.
We estimated that the doubling of the prevalence period in Iran will be nearly 12 years, with 18,000 cases between 2020 and 2032. From now on, this timespan for North Africa and the Middle East appears to will be about 2031 to 2032 with 425-444 thousand cases of IBD. The time for doubling of prevalence in India is around 2025 with 1.11 million cases. For Iran, the Middle East, and India, the anticipated period is much shorter than that reported in the Western world at 20 to 25 years. By contrast, it appears like we will not see Southeast Asia, East Asia, and High‐income Asia‐Pacific doubling in prevalence by 2035. In other words, the number of cases in these areas will not reach 235 thousand cases, around 6 million cases and 209 thousand cases, respectively.
Hence, countries or regions of Asia are not homogeneous in terms of the epidemiological evolution of the disease. Therefore, despite the increasing prevalence of the IBD in different regions of Asia, there will be discrepancies in optimizing the potential needs of the health system for disease management. Which is beyond the scope of this article. However, apart from the capacity of the disease diagnostic system and the extent of access to healthcare, the obvious explanation may be related to the particular lifestyles of the inhabitants of those regions, that is a set of habits, relationships and beliefs.
One of the limitations of our research was that, despite an independent attempt for access to IBD incidence data in each region/country, the incidence of certain countries has been considered fixed for those countries since the publication of the last study. Another drawback of our work is that we do not take into account the model's potential variations in age and gender. Since age and gender differences were tangible in a related study in Canada. However, we have not been able to use this information in the current model given the lack of access to suitable population-based information. The use of time-series models, on the other hand, often involves several years of disease information that was not present in our research. But the present research, as far as we know, is the first effort to explain the epidemiological future of IBD in Asia.
In light of the epidemiological transition theory preserving conventional dietary and behavioral patterns or in other words, the correct embrace of urbanized and westernized lifestyle is one of the crucial factors to curb this emerged epidemic. From this standpoint, in the following lines, we attempt to clarify the strategies required by policymakers to provide an optimal platform for this adoption, because IBD is one of the modern lifestyle diseases. In 2016, these modern lifestyle diseases were responsible for around 71% of all deaths.
Contemplating that one of the rational alternatives of globalization or/and modernization is sustainable development and that globalization and indices of sustainable development goals are relevant to each other. We have sought to address our workaround within the context of the Sustainable Development Goals (SDGs). However, it is inevitable to accomplish these goals without taking into consideration the underlying characteristics of nations, populations, and communities. Therefore, we suggest that countries or/ and policymakers, design accurate and step-by-step field studies, attempt to include the imminent direction of modernity at the core of their culture. It helps to regulate the detrimental effects of modernity by not depriving society of its beneficial effects. In other words, since health encompasses not only the lack of diseases but also mental and social health, the lifestyles of people can be improved by closely examining the facilities and focusing on the communities' available resources.