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Several cross-sectional surveys have been conducted to study the prevalence of irritable bowel syndrome (IBS) in children. The aim of the present study was to conduct a systematic review and a meta-analysis of published literature to estimate the prevalence of IBS among Asian children.

Several cross-sectional surveys have been conducted to study the prevalence of irritable bowel syndrome (IBS) in children. The aim of the present study was to conduct a systematic review and a meta-analysis of published literature to estimate the prevalence of IBS among Asian children. A computer-assisted search of MEDLINE, EMBASE, PsycINFO, and regional databases of Asia was carried out. Selected articles were reviewed in depth and data were extracted. Pooled prevalence, sex differences, and 95% confidence intervals were calculated. Heterogeneity of the studies was assessed using the I2test. A total of 16 cross-sectional studies that reported prevalence of IBS (in children and adolescents) and qualified to be included were taken into the final analysis containing 38,076 patients. Selected studies are from China, Korea, Japan, Iran, Sri Lanka, and Saudi Arabia. Studies showed a marked heterogeneity with I2of 98.59 (P< 0.0001). Prevalence of IBS ranges from 2.8% to 25.7%, with a pooled prevalence of 12.41% (95% confidence interval 9.87–14.95). Prevalence risk ratio of girl:boy is 1.39. Prevalence of subtypes is diverse and varies between studies. The published data indicate that IBS is a significant problem among Asian children and adolescents. Female sex predisposes children and adolescents to develop IBS.

The authors conducted a cross-sectional comparative prevalence study to evaluate the effect of pollution on individuals who lived in an industrial zone in Sri Lanka. In this study, 81 male and female children who were 1-12 yr of age and 158 adults (51 males, 107 females) in the industrial zone were matched with 73 children (32 males, 41 females) and 146 adults (58 males, 88 females), respectively, who lived in a nonindustrialized area and whose ages were similar to those of the exposed individuals. The authors used a pretested questionnaire and a detailed clinical examination, including peak expiratory flow rate measurements, to assess the prevalence of illness. Children in the industrial area were 2.3 times more likely to have unexplained episodic cough (95% confidence interval [Cl] = 0.98, 10.3) and 2.8 times more likely to have rhinitis (95% Cl = 1.1, 7.1). The adult population was 2.1 times more likely to have unexplained episodic cough (95% Cl = 1.13, 7.09), 3.7 times more likely to have unexplained headaches (95% Cl = 2.2, 6.3), and adults had a significantly greater reduction in expiratory flow (peak expiratory flow rate = 446 - 92x [industrial area] + 91 x [male] - 0.8x [years lived in the area]).

The national screening policy for hemoglobinopathies uses the cutoffs for red cell indices mean corpuscular volume >80 and mean corpuscular hemoglobin >27, a strategy known to miss some individuals with Hb E trait (EBT), the most common abnormal hemoglobin in Sri Lanka. We wanted to determine if red cell distribution width (RDW) cutoff values would help in increasing the sensitivity of screening for Hb E trait. High-performance liquid chromatography was carried out as the gold standard to detect hemoglobinopathies and red blood cell parameters with colter counter. Receiver operating characteristic curve was drawn to determine the cutoff value for EBT against -trait (BTT) and other anemias. Of the 504 patients, 246 had BTT, 110 had EBT, and 151 had other types of anemias. Mean (SD) RDW among patients with BTT was 16 (2.8), with EBT 14.5 (2.9), and with other anemias 15.8 (4.2) (P>0.001). With 14.45 as the cutoff for RDW and considering accepted values for mean corpuscular volume >80 and mean corpuscular hemoglobin >27, it gave a predictive sensitivity of 98.2 for EBT. By using RDW cutoff at 14.45 in addition to the accepted screening indices, sensitivity of Hb E trait detection went up to 98.2 from 86.6. This study highlights the importance of taking RDW into consideration for screening.