Whipple's disease epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Whipple's disease is a systemic disease among middle-aged white males in North America and western Europe. It affects males 8 times more than females. Few studies were done to evaluate the demographics of Whipple's disease due to the sparsity of the disease. The incidence of Whipple's disease is approximately 0.1 per 100,000 individuals and the prevalence is approximately 0.3 per 100,000 individuals in north-western Italy. Although the prevalence of carrier state is higher in Asian and African countries, the prevalence of the classic Whipple's disease is less than American and western European countries. The case-fatality rate of Whipple's disease is approximately 100%, if left untreated. The case-fatality rate of treated Whipple's disease is unknown.
Epidemiology and Demographics
Incidence
- The incidence of Whipple's disease is approximately 0.1 per 100,000 individuals in north-western Italy.[1]
- The incidence of Whipple's disease is approximately 12 annually worldwide.[2]
- Between 1907 and 1987, the incidence of Whipple's disease was estimated to be 696 cases worldwide.[2]
Prevalence
Classic Whipple's disease
- The prevalence of Whipple's disease is approximately 0.3 per 100,000 individuals in north-western Italy.[1]
Carrier state
- In Europe, the prevalence of chronic carrier of Tropheryma whipplei is 1,000-11,000 per 100,000 of general adult population.[3][4]
- In Senegal, the prevalence of chronic carrier of Tropheryma whipplei is 75,000 per 100,000 of children under 4 years of age.[5]
- In Laos, the prevalence of chronic carrier of Tropheryma whipplei is 48,000 per 100,000 individuals by using quantitative real-time PCR (qPCR) of the feces of children.[6]
- In Ghana, the prevalence of chronic carrier of Tropheryma whipplei is 27,500 per 100,000 individuals by using quantitative real-time PCR (qPCR) of the feces of children.[7]
Case-fatality rate
- The case-fatality rate of Whipple's disease is approximately 100%, if left untreated.[8]
- The case-fatality rate of treated Whipple's disease is unknown.[9]
Age
- Whipple's disease commonly affects individuals between 40 to 60 years of age; the median age at diagnosis is 50 years.[10]
Race
- Whipple's disease usually affects individuals of the caucasian race. Africans and Asians are less likely to develop Whipple's disease.[11]
Gender
- Males are more commonly affected by Whipple's disease than females. The male to female ratio is approximately 8 to 1.[10]
Region
- The majority of Whipple's disease cases are reported in North America and western Europe.[12]
Developed Countries
- In Europe, the prevalence of chronic carrier of Tropheryma whipplei is 1,000-11,000 per 100,000 of general adult population.[3][4]
Developing Countries
- In Senegal, the prevalence of chronic carrier of Tropheryma whipplei is 75,000 per 100,000 of children under 4 years of age.[5]
- In Laos, the prevalence of chronic carrier of Tropheryma whipplei is 48,000 per 100,000 individuals by using quantitative real-time PCR (qPCR) of the feces of children.[6]
- In Ghana, the prevalence of chronic carrier of Tropheryma whipplei is 27,500 per 100,000 individuals by using quantitative real-time PCR (qPCR) of the feces of children.[7]
References
- ↑ 1.0 1.1 Biagi, F.; Balduzzi, D.; Delvino, P.; Schiepatti, A.; Klersy, C.; Corazza, G. R. (2015). "Prevalence of Whipple's disease in north-western Italy". European Journal of Clinical Microbiology & Infectious Diseases. 34 (7): 1347–1348. doi:10.1007/s10096-015-2357-2. ISSN 0934-9723.
- ↑ 2.0 2.1 Dobbins W, III. 1987. Whipple’s disease. Charles C Thomas, Publisher, Springfield, IL.
- ↑ 3.0 3.1 Fenollar, Florence; Laouira, Sonia; Lepidi, Hubert; Rolain, Jean‐Marc; Raoult, Didier (2008). "Value ofTropheryma whippleiQuantitative Polymerase Chain Reaction Assay for the Diagnosis of Whipple Disease: Usefulness of Saliva and Stool Specimens for First‐Line Screening". Clinical Infectious Diseases. 47 (5): 659–667. doi:10.1086/590559. ISSN 1058-4838.
- ↑ 4.0 4.1 Fenollar, Florence; Trani, Michèle; Davoust, Bernard; Salle, Bettina; Birg, Marie‐Laure; Rolain, Jean‐Marc; Raoult, Didier (2008). "Prevalence of AsymptomaticTropheryma whippleiCarriage among Humans and Nonhuman Primates". The Journal of Infectious Diseases. 197 (6): 880–887. doi:10.1086/528693. ISSN 0022-1899.
- ↑ 5.0 5.1 Keita, Alpha Kabinet; Raoult, Didier; Fenollar, Florence (2013). "Tropheryma whippleias a commensal bacterium". Future Microbiology. 8 (1): 57–71. doi:10.2217/fmb.12.124. ISSN 1746-0913.
- ↑ 6.0 6.1 Small, Pamela L.; Keita, Alpha Kabinet; Dubot-Pérès, Audrey; Phommasone, Koukeo; Sibounheuang, Bountoy; Vongsouvath, Manivanh; Mayxay, Mayfong; Raoult, Didier; Newton, Paul N.; Fenollar, Florence (2015). "High Prevalence of Tropheryma whipplei in Lao Kindergarten Children". PLOS Neglected Tropical Diseases. 9 (2): e0003538. doi:10.1371/journal.pntd.0003538. ISSN 1935-2735.
- ↑ 7.0 7.1 Vinnemeier CD, Klupp EM, Krumkamp R, Rolling T, Fischer N, OwusuDabo E, Addo MM, Adu-Sarkodie Y, Kasmaier J, Aepfelbacher M, Cramer JP, May J, Tannich E. 2016. Tropheryma whipplei in children with diarrhoea in rural Ghana. Clin Microbiol Infect 22:65.e1– 65.e3
- ↑ Durand DV, Lecomte C, Cathébras P, Rousset H, Godeau P (1997). "Whipple disease. Clinical review of 52 cases. The SNFMI Research Group on Whipple Disease. Société Nationale Française de Médecine Interne". Medicine (Baltimore). 76 (3): 170–84. PMID 9193452.
- ↑ Marth, Thomas; Raoult, Didier (2003). "Whipple's disease". The Lancet. 361 (9353): 239–246. doi:10.1016/S0140-6736(03)12274-X. ISSN 0140-6736.
- ↑ 10.0 10.1 Marth, Thomas (2015). "Tropheryma whipplei, Immunosuppression and Whipple's Disease: From a Low-Pathogenic, Environmental Infectious Organism to a Rare, Multifaceted Inflammatory Complex". Digestive Diseases. 33 (2): 190–199. doi:10.1159/000369538. ISSN 0257-2753.
- ↑ Dolmans, Ruben A. V.; Boel, C. H. Edwin; Lacle, Miangela M.; Kusters, Johannes G. (2017). "Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections". Clinical Microbiology Reviews. 30 (2): 529–555. doi:10.1128/CMR.00033-16. ISSN 0893-8512.
- ↑ Fenollar, Florence; Puéchal, Xavier; Raoult, Didier (2007). "Whipple's Disease". New England Journal of Medicine. 356 (1): 55–66. doi:10.1056/NEJMra062477. ISSN 0028-4793.