Northeastern Region Of Brazil Research Articles

Coinfection with Canine Distemper Virus and Yellow Fever Virus in a Neotropical Primate in Brazil

We describe a natural coinfection with canine distemper virus (CDV) and yellow fever virus in a free-ranging neotropical primate of the genus Callithrix, found dead in the northeastern region of Brazil. The laboratory diagnosis included histopathology, immunohistochemistry, rRT-PCR, and phylogenetic analyses. The CDV sequences from this primate in Brazil represent a divergent lineage in Rio Grande do Norte, closely related to genotypes EU1/South America 1 and South America 2. To our knowledge, this is the first report of natural coinfection by CDV and yellow fever virus in a neotropical primate, underscoring the need to further investigate the circulation of this virus in Brazilian nonhuman primates and its potential implications for wildlife conservation.

A New Species of Nealiolus Mason, 1974 (Hymenoptera: Braconidae) from Traditional Cocoa Agroforestry and Brazilian Atlantic Rainforest.

The genus Nealiolus Mason, 1974 (Hymenoptera: Braconidae, Brachistinae) is recorded for the first time in the Atlantic forest remnants and traditional cocoa agroforests, Theobroma cacao (Malvaceae) in the northeastern Brazilian region. A new species Nealiolus seb Silva, Shimbori & Fernandes sp. n. is described and named in honor of the "Sociedade Entomológica do Brasil - SEB", on the occasion of its fiftieth anniversary (golden jubilee). Digital images, map and an identification key for all Brazilian species of Nealiolus are provided.

Beyond the Basics: Taxonomic Classification and Pathogenomics in Recently Discovered Dickeya dadantii Isolates

The genus Dickeya consists of Gram-negative bacteria capable of causing soft rot symptoms in plants, which involves tissue breakdown, particularly in storage organs such as tubers, rhizomes, and bulbs. These bacteria are ranked among the top ten most relevant phytopathogens and seriously threaten economically valuable crops and ornamental plants. This study employs a genomic analysis approach to taxonomically classify and characterize the resistome and virulome of two new strains, CCRMP144 and CCRMP250, identified as Dickeya dadantii. These strains were found to be the causative agents of soft rot symptoms in chili pepper (Capsicum spp.) and lettuce (Lactuca sativa), respectively, in the northeastern region of Brazil. The methodology employed in silico techniques, including tetra correlation search (TCS) and Average Nucleotide Identity (ANI) analysis, in association with a phylogenomic tree inference. TCS and ANI analysis showed that the studied strains belong to the Dickeya dadantii species. The phylogenomic analysis grouped the studied strains in the D. dadantii clade. The genomic characterization demonstrates 68 virulence genes, 54 resistances of biocide and heavy metal genes, and 23 antibiotic resistance genes. As far as we know, this is the first genomic study with Brazilian D. dadantii strains. This study demonstrates the efficacy to taxonomic classification and provides insights into the pathogenesis, host range, and adaptability of these strains which are crucial for the development of more effective management and control strategies for soft rot diseases.

“Tecnologias Sociais” and The Northeast Brazilian Semi-Arid: A Study on the Cisterns Program

Purpose: To analyze the role of the Cisterns Program as a generator of “tecnologias sociais” in the Northeast Brazilian Semi-Arid. Theoretical framework: Characteristics, mechanisms and requirements of “Tecnologia Social”. Design/methodology/approach: Instrumental single case study in the Cisterns Program, using interviews and document analysis for data collection. Categorical content analysis to evidence analysis. Findings: The results show that the “tecnologias sociais” designed by the Cisterns Program have positive impacts beyond access to potable water. These include, among others, mitigation of desertification and articulation and mobilization between communities. Such findings corroborate the understanding that the Cisterns Program as a “supplier” of “tecnologias sociais” and its relevance to the advancement of the regions where it operates, mainly in the northeastern Brazilian semi-arid region. Originality: This study deepens analyzes of the component elements of "tecnologia social", ways of acting by the groups involved and social implications (results), aspects with little discussion in the literature on the subject. Theoretical and practical contributions: The study summarizes the forms of action, the groups involved, the mechanisms, the bottlenecks in the process, and the impacts related to social technologies in a set of elements that can serve as a guide for the implementation of social technologies in other places. It also identifies mechanisms for creating/strengthening actions and public policy to scale up, disseminate, and optimize these technologies. Keywords: “Tecnologia Social”. Cisterns Program. Northeast Brazilian semi-arid.

Soil compaction in a crop-livestock system with maize (Zea mays L.) cultivation in the northeastern region of Brazil

Soil compaction in a crop-livestock system with maize (Zea mays L.) cultivation in the northeastern region of Brazil

When boosting gender stereotypes increases flow experience and reduces self-handicapping in gamified tutoring systems

The threat of stereotypes affects various psychological mechanisms, including affective/subjective, cognitive, and motivational ones, and can be present in gamified online educational environments in various ways. In this study, we aimed to investigate whether gender stereotypes in gamified virtual environments could affect the flow experience, self-handicapping behavior, and performance of Brazilian students. To achieve this, we experimented with 147 participants (60 males and 87 females) who were high school and higher education students from public and private institutions in the state of Alagoas, located in the northeastern region of Brazil. We randomly allocated the participants to three distinct virtual environments: a neutral environment, a male-stereotyped environment, and a female-stereotyped environment. We introduced the stereotype threat condition when the participant was in an environment that did not correspond to their gender. In contrast, the boost condition occurred when the environment corresponded to their gender. The results of this study indicate that the presence of gender stereotypes can influence both the flow experience and the self-handicapping behavior of Brazilian students in gamified virtual environments. We observed statistically significant differences that suggest that the implementation of stereotypes can influence the relationship between variables.

Multivariate Geostatistics for Mapping of Transmissivity and Uncertainty in Karst Aquifers

Due to their complex morphology, karst terrains are particularly more fragile and vulnerable to environmental damage compared to most natural systems. Their hydraulic properties, such as their transmissivity (T) and spatial variability, can be relevant for understanding groundwater flow and, consequently, for the sustainable management of water resources. The application of geostatistical methods allows for spatial interpolation and mapping based on observations combined with uncertainty quantification. Direct measurements of T are typically scarce, while those of the specific capacity (Sc) are more frequent. We established a linear and spatial relationship between the logarithms of T and Sc measured in 174 wells in a semi-arid karst region in northeastern Brazil. These relationships were used to construct a cross-variogram, whose Linear Model of Coregionalization proved valid. The values and the cross-variogram of logT and logSc were used to generate interpolations over 2554 values of logSc, which did not spatially coincide with logT. We used ordinary co-kriging (CO-OK) and conditional sequential Gaussian co-simulation (CO-SGS) to generate the interpolations. The cross-variogram of logT and logSc, when considering 174 wells, was isotropic with an exponential structure, a nugget effect of approximately 20% of the sill, and a range of 5 km. Cross-validation indicated an optimal number of 10 neighboring wells used in CO-OK, and we used 500 stochastic realizations in CO-SGS, which were then used to generate maps of logT estimates, deviations derived from the interpolations, and probabilistic scenarios. The resulting transmissivity maps are relevant for the design of groundwater management strategies, including stochastic approaches where the transmissivity realizations can be used to parameterize multiple executions of numerical flow models.

Economics of small-scale aquaculture farms in Brazilian Northeastern semi-arid region: Characteristics, feasibility, and profitability models

Inland aquaculture represents a significant component of the aquaculture sector in Brazil. This activity is present in all Brazilian regions, yet the economic feasibility and the relationship between their productive variables and profitability indices remain poorly accessed in Brazil's semi-arid regions. This study aims to characterise, assess the economic feasibility, and evaluate the relationship between productive variables and profitability indices in the aquaculture sector in Feira Nova (Northeast Brazil). The data was collected through interviews with all producers in Feira Nova city and modelled using the software R. The aquaculture sector in Feira Nova is predominantly small-scale and encompasses a wide range of production strategies for shrimp and fish cultures, with profitable outcomes. The models demonstrated that economic and management variables were more closely associated with profitability indices than farm characteristics such as farm size. Feira Nova's profitability indices reinforces the small-scale aquaculture as a promising activity to alleviate poverty and generate wealth in Brazil semi-arid regions. However, governance improvements are necessary to boost the development of inland aquaculture in the country.

Assessment of Biochemical, Inflammatory Biomarkers and Ultra-Processed Food Consumption in Children with Small Intestinal Bacterial Overgrowth: A Cross-Sectional Study.

This study evaluated anthropometric, biochemical, and inflammatory biomarkers, as well as dietary intake in Brazilian children diagnosed with small intestinal bacterial overgrowth (SIBO) and compared them with their counterparts without SIBO. This was a cross-sectional study with 106 children aged 7 to 10 years. A glucose-hydrogen breath test was performed to diagnose small intestinal bacterial overgrowth (SIBO). Anthropometric and dietary characteristics were assessed. Blood samples were collected and serum biochemical parameters and cytokines were measured. The occurrence of SIBO was 13.2%. Age, BMI, BMI/age WC, BFP, sex and biochemical markers were similar between SIBO-positive and SIBO-negative children (p > 0.05). High consumption of ultra-processed foods tended to be higher in SIBO-positive compared to SIBO-negative children (47.8 ± 8.2 vs. 42.6 ± 9.5, p = 0.06). Serum levels of IL-17 were higher in SIBO-positive than in SIBO-negative children [69.5 (5.4-125.7) vs. 53.4 (2.3-157.7), p = 0.03], while serum levels of IL-10 were lower in SIBO-positive than in SIBO-negative children [2.3 (0.6-7.2) vs. 5.7 (0.5-30.8), p = 0.04]. Finally, in a logistic regression adjusted for sex, BMI and age, consumption of ultra-processed foods (p = 0.03) and IL-6 levels (p = 0.003) were found to contribute to the occurrence of SIBO. this study identified for the first time an occurrence of 13% of SIBO in children living in the northeastern region of Brazil and showed that consumption of ultra-processed foods and serum levels of IL-6 may influence the occurrence of the SIBO in the pediatrics population.

New records of Cassidinae and Cerambycidae (Coleoptera: Chrysomeloidea) from Baturité Massif, Brazil, with the description of a new species of Charidotis (Coleoptera: Chrysomelidae: Cassidinae)

The Baturité massif, situated in Ceará state’s central hinterland, is one of the largest humid mountain ranges in the Brazilian semi-arid region. Flora and vertebrate surveys have been conducted in the region, revealing endemic species, as well as a combination of fauna and flora from neighboring biomes, the Atlantic and Amazon rainforests. However, invertebrate inventories have been scarce, leaving a significant portion of the region’s biodiversity unexplored. This paper presents the outcomes of collaborative expeditions conducted by the recently established Museu de História Natural do Ceará Prof. Dias da Rocha and Museu Nacional/Universidade do Rio de Janeiro to fill this knowledge gap by promoting surveys to document the region’s biodiversity. As a result, one new species of tortoise beetle is described from the massif, Charidotis rochai Simões and Sekerka, new species. Additionally, we report thirteen new state records for the beetle subfamilies Cassidinae (Chysomelidae), and Cerambycinae and Lamiinae (Cerambycidae). Among these records, eight genera are documented for the first time in the state of Ceará, and the species Centrocerum variatum (Newman, 1841) constitutes the first record in the northeastern region of Brazil. These findings underscore the significance of survey initiatives and the need for comprehensive biodiversity study within the Baturité massif.

The longest multiannual drought in Northeastern Brazil

The Northeastern region of Brazil has long history of drought with impacts on water supply for cities and agriculture. However, the last drought that occurred in the region had unprecedented magnitude and periodicity, making it the longest multiannual drought in Northeastern Brazil. Thus, understanding and characterizing the behavior of this phenomenon is necessary, considering that another episodes may occur. Thus, the objective of this study was to characterize the drought trend in the Northeastern region of Brazil, with the application of the Palmer Drought Severity Index (PDSI). The application of PDSI was carried out with the monthly calculation of the water balance coefficients referring to the soil water balance between the years 2000 and 2019, depending on the relative soil moisture values. The results obtained were submitted to the Mann-Kendall test to identify monthly trends in the index. The annual drought variability in Northeastern Brazil showed moderate to extreme intensity, with the worst drought being observed between the years 2012 and 2019. The monthly drought average shows the Mid-Northern and “Sertão” regions as the most critical, with monthly trend of significant drought severity. The positive trend was observed in the Eastern, Southern and Western coast regions of NEB.

Urban Heat Island Assessment in the Northeastern State Capitals in Brazil Using Sentinel-3 SLSTR Satellite Data

The lack of a solid methodology defining urban and non-urban areas has hindered accurately estimating the Surface Urban Heat Island (SUHI). This study addresses this issue by using the official national urban areas limit together with a surrounding areas classification to define three different reference classes: the urban adjacent (Ua), the future urban adjacent (FUa), and the peri-urban (PUa), consequently providing a more accurate SUHI estimation on the nine northeastern Brazilian capitals. The land surface temperature was obtained in this study using the Sentinel-3 satellite data for 2019 and 2020. Subsequently, the maximum and average SUHI and the complementary indexes, specifically the Urban Thermal Field Variation Index (UTFVI) and the Thermal Discomfort Index (TDI), were calculated. The UTFVI expresses how harmful the eco-environmental spaces are, with a very strong SUHI for three capitals. In addition, the TDI, with values between 24.6–28.8 °C, expresses the population’s thermal comfort, with six capitals showing a very hot TDI. These findings highlight the need for strategies to mitigate the effects of the SUHI and ensure the population’s thermal comfort. Therefore, this study provides a better SUHI understanding and comparison for the Brazilian northeastern region, which has diverse areas, populations, and demographic variations.

Canine visceral leishmaniasis: Seroprevalence and georeferencing in the state of Santa Catarina, Brazil

Canine visceral leishmaniasis (CVL) has long been considered an endemic disease in the northern and northeastern regions of Brazil, while the southern region remains non-endemic. However, in recent years, several cases of CVL have been reported in southern states. The objective of this work was to determine the seroprevalence of CVL in dogs in the state of Santa Catarina, Brazil, through immunochromatographic tests (DPP®) and ELISA (Enzyme-Linked Immunosorbent Assay) and its correlation with environmental characteristics through georeferencing. Blood samples from dogs (n = 1227) were collected in six mesoregions of the state and evaluated by the rapid test (DPP®). Positive samples were sent to Lacen (Central Public Health Laboratory) in Santa Catarina to be tested using ELISA. Information obtained from the epidemiological questionnaire was subjected to statistical analysis (Chi-square and Student's t-test; P < 0.05) to verify the correlation between serology and the analyzed variables. The locations (GPS) of the samples were used for georeferencing and creating heatmaps (Kernel Method). Four animals that died from CVL were necropsied and organ samples were collected for molecular analysis (PCR), immunohistochemistry, and histopathology (HE). Of the 1227 dogs analyzed, 22 (1.8%) were reactive in the DPP® and of these, 7 (0.6%) were also positive in the ELISA. A correlation (P < 0.01) was observed between positive serology and region, environment, access to the street, and clinical signs. The positive cases were concentrated in the eastern region of the state, in low-altitude areas with average rainfall and higher average temperatures, and in more populated areas close to forest fragments. PCR, HE, and immunohistochemistry, along with serology, have proven to be efficient for characterizing positive cases.

Drastic reduction in the notification of acute cases of Chagas disease in the Northeast region of Brazil. Epidemiological evaluation in the period 2001–2021

Chagas disease (CD), caused by the protozoan Trypanosoma cruzi (T. cruzi), is a neglected disease endemic to some Latin American countries, including Brazil. Soon after infection, individuals develop an acute phase, which in most cases is asymptomatic and may go undetected. However, when CD is detected early, notification in the Notifiable Diseases Information System (SINAN), is mandatory. This study aimed to evaluate the information registered in the SINAN database and to determine the epidemiological profile of acute CD in Northeast Brazil, an endemic region, from 2001 to 2021. According to this survey, 1,444 cases of acute CD were reported in the Northeastern region of Brazil during this period. During the first six years, referred to as period 1, 90.24% of the notifications were registered, while the number of notifications significantly decreased in the subsequent years, referred to as period 2. Most individuals diagnosed with acute CD were Afro-Brazilian adults. All known routes of infection by the parasite were reported. Vector-borne transmission was predominant during period 1 (73.29%) and oral transmission during period 2 (58.87%). All nine states in Northeast Brazil reported cases in both periods. A higher incidence of disease was reported in Rio Grande do Norte (RN) during period 1, and in Maranhão (MA) during period 2. Our results show that CD remains a significant public health challenge.

Effects of the latest drought on the alluvial aquifer of a semiarid region in northeastern Brazil

Effects of the latest drought on the alluvial aquifer of a semiarid region in northeastern Brazil

Predictive Potential of Maize Yield in the Mesoregions of Northeast Brazil

Most of the northeastern region of Brazil (NEB) has a maize production system based on family farming, with no technological advances and totally dependent on the natural rainfall regime, which is concentrated in 4 to 5 months in most parts of the region. This means that the productivity of this crop is low in the NEB. In the northern mesoregions of the NEB, rainfall is concentrated between January and June, in the east of the NEB from April to September, and in the west of the NEB from October to March. The growing season takes place during these semesters. With this in mind, our objective was to develop a model based on canonical correlation analysis (CCA) to predict corn production in the mesoregions of the NEB between 1981 and 2010, using accumulated precipitation per semester as the predictor variable and predicting the observed production in kg/ha. Our results showed that the CCA model presented higher correlations between observed and simulated production than that obtained simply from the direct relationship between accumulated rainfall and production. The other two metrics used, RMSE and NRMSE, showed that, on average, in most mesoregions, the simulation error was around 200 kg/ha, but the accuracy was predominantly moderate, around 29% in most mesoregions, with values below 20% in six mesoregions, indicative of better model accuracy, and above 50% in two mesoregions, indicative of low accuracy. In addition, we investigated how the different combinations between two modes of climate variability with a direct influence on precipitation in the NEB impacted production in these 30 years, with the combination of El Niño and a positive Atlantic dipole being the most damaging to harvests, while years when La Niña and a negative Atlantic dipole acted together were the most favorable. Despite the satisfactory results and the practical applicability of the model developed, it should be noted that the use of only one predictor, rainfall, is a limiting factor for better model simulations since other meteorological variables and non-climatic factors have a significant impact on crops. However, the simplicity of the model and the promising results could help agricultural managers make decisions in all the states that make up the NEB.

Filarial Nematodes in Dogs from the Northeast Region of Brazil.

Medical and veterinary filarial nematodes are transmitted by blood-feeding vectors. In dogs, these parasites are mainly represented by nematodes in which microfilariae dwell in the blood (Dirofilaria spp. and Acanthocheilonema spp.) or skin (Cercopithifilaria spp. and Onchocerca lupi). The aim of this study was to determine the prevalence of these filarial infections in dogs residing in a touristic, heavily populated location in the northeastern region of Brazil. Blood samples (n = 245) were assessed by a modified Knott test, followed by a qualitative ELISA test (SNAP® 4Dx® Plus, IDEXX Laboratory, Westbrook, Maine, USA) for the detection of antibodies against Anaplasma spp., Borrelia burgdorferi sensu lato, Ehrlichia spp. and antigens of Dirofilaria immitis. Skin samples (n = 71) were microscopically examined and molecularly assessed through a PCR targeting the 12S rRNA gene. Microfilariae and antigen of D. immitis were detected simultaneously in 15 (6.1%; 95% CI = 3.7-9.8) animals. Nine animals (3.6%; 95% CI = 1.9-6.8) were D. immitis antigen positive but microfilariae negative and nine other animals (3.6%; 95% CI = 1.9-6.8) were microfilariae positive but D. immitis antigen negative. D. immitis positive dogs were found in four different municipalities. No filarioids were detected in the skin after microscopical and molecular analyses. Data from this study demonstrate that D. immitis is the main filarial nematode infecting dogs in coastal areas in northeastern Brazil. Based on the potential risk of infection in which animals are submitted, it is essential to perform tests to detect microfilariae and D. immitis antigen. Preventive measures must be adopted by using microfilaricidal compounds and anti-feeding insecticides to prevent canine infection.

Impact of feeding native Caatinga pasture on the rumen histomorphometry of sheep raised in semi-extensive management.

In the northeastern region of Brazil, sheep and goat farming, encompassing around 20 million animals, is predominantly a subsistence activity. Forage quality plays a crucial role in animal productivity, posing a complex interplay between plant and animal aspects. The Caatinga biome, vital for livestock in the region, serves as a significant source for animal diet through pastures. This study aimed to conduct a histomorphometric evaluation of sheep rumens in a semi-extensive system, comparing those feeding on native Caatinga pastures to those on cultivated pastures. Histological processing followed standard protocols, with morphometry focusing on six viable rumen papillae and the submucosa and muscular layer thickness. Statistical correlation analysis revealed morphological differences in papillae across various rumen regions. Morphometric data indicated no significant difference in papillae area between the groups, with average values in Group A surpassing those in Group B, except for width. This study establishes a morphological and morphometric pattern for rumen regions linked to diet types-native or cultivated. The findings not only enhance understanding of the dietary foundation in the Caatinga's extensive system, but also contribute valuable insights for formulating nutritional strategies to enhance sheep production in the region. This research sheds light on the intricacies of forage-based animal nutrition, particularly in semi-extensive systems, offering a foundation for future studies and practices to optimise livestock management in the northeastern Brazilian context.

Implementation of a pulmonary rehabilitation program for patients with long COVID in Northeastern region of Brazil: a feasibility study

Objective: to implement and evaluate the feasibility of a pulmonary rehabilitation (PR) program for patients with long covid in the northeast region of Brazil. Methods: patients participated in a 12-week (2 sessions per week, 60 minutes per day) outpatient comprehensive PR programme. Socio-demographics and clinical variables were recorded during the baseline assessment. The feasibility was assessed through adherence analysis to the PR program. Exercise capacity, functional capacity, functional status, depressive symptoms severity and dyspnoea were assessed at baseline and after completion of study protocol. Results: the per-protocol study population consisted of 28 patients (64.2% female), mean age 55.3 ± 17.3 years, and the main complaint was limitation of efforts (67.8%). The feasibility of the PR program was 82.1% (n=23). Following PR, significantly improvements were found for the following parameters: exercise capacity (p&lt;0.001), functional capacity (p&lt;0.001), functional status (p=0.01), depressive symptoms severity (p=0.001) and dyspnea (p=0.01). Conclusion: PR is a feasible and effective intervention for improving physical and psychosocial outcomes of patients with long covid.&#x0D;

P1108 Factors Associated with Delayed Diagnosis of Inflammatory Bowel Disease and Risk of Complications: Analysis of the Brazilian National Registry

Abstract Background The Brazilian Organization for Crohn's Disease and Colitis (GEDIIB) has established a national registry of inflammatory bowel disease (IBD). Timely diagnosis and treatment of the disease are crucial to mitigate the risk of complications in this patient population. Therefore, this study aimed to assess the variables associated with delayed diagnosis and the frequency of complications in IBD patients in Brazil. Methods A cohort study was conducted from August 2020 to August 2023. Data were obtained from medical records and patient consultations using the REDCap platform, with approvals from the ethics boards of participating institutions. Patients were categorized based on the time from symptom onset to diagnosis: &amp;lt; 1 year, 1 to 1 year 11 months, and ≥ 2 years. Socioeconomic and clinical data, such as disease extension, use of biological therapy, and complications like the need for surgery or hospitalization, were evaluated. Results The study included 2,436 patients, with 1,147 diagnosed with ulcerative colitis (UC) and 1,289 with Crohn's disease (CD). Of these, 62% were managed in public centers, and 38% in the private system. The age at diagnosis was 38 ± 15.5 years for UC and 33.7 ± 14.9 years for CD, with females predominating (64.5% for UC and 53.4% for CD). Among UC patients, disease extension included pancolitis (43.5%), left colitis (28.8%), and proctitis (27.7%). The time between symptom onset and diagnosis was longer in CD patients (p&amp;lt;0.001), as follows: &amp;lt; 1 year (UC 58.4% and CD 50.9%), 1 to 1 year 11 months (UC 22.3% and CD 21.1%), and ≥ 2 years (UC 19.3% and CD 28%). The shortest interval in UC patients was observed in private services (p&amp;lt;0.001), Southern and Northeastern regions of Brazil (p&amp;lt;0.001), and in patients without extraintestinal manifestations (EIM) (p=0.003). No differences were noted regarding disease extent, need for surgery, hospitalization, presence of cancer, or use of biological therapy. In CD patients, the shortest interval was observed in private services (p&amp;lt;0.001), the Southern region of Brazil (p&amp;lt;0.001), and was associated with a lower rate of hospitalization due to complications or disease activity (p=0.032). Among those who underwent surgery (35.6%), patients operated on in a public university hospital experienced a greater delay in diagnosis (p=0.014). No differences were observed regarding the presence of perianal disease, need for surgery, cancer, or use of biological therapy. Conclusion The window of opportunity is imperative to reduce complications, especially in CD. Further epidemiological studies are needed to shape national public health policies, emphasizing early diagnosis and appropriate treatment of IBD.