Clinical characteristics of colonoscopy in 448 patients in the Zanzibar Archipelago: a cross-sectional study

Introduction: the aim was to investigate the demographic characteristics, primary colonoscopy findings, main indications, and feature of colorectal cancer (CRC) patients at Mnazi Mmoja Referral Hospital in the Zanzibar Archipelago, Tanzania. Methods: between December 2013 and October 2021, a total of 448 eligible participants were finally enrolled in present cross-sectional study. Demographic information and primary colonoscopy findings of each participant were retrieved. Results: among all enrolled subjects, 205 (45.80%) are females, remaining 243 (54.20%) are males. The median age of present cross-sectional study was 47 years old (ranging from 8 to 90 years). The main presenting indications included diarrhea (22.54%), abdominal pain (21.21%), hematochezia (18.53%), difficult defecation (16.96%), mucoid stool (10.49%), and anemia (8.70%). The common identified colonoscopy findings comprised colitis (28.57%), colonic polyps (25.22%), CRC (17.63%), inflammatory bowel disease (IBD) (13.52%), hemorrhoids (4.24%), and colonic diverticulum (4.02%), respectively. Unconditional logistic regression analyses demonstrated the elder group had significant higher risk of CRC (OR, 1.03; 95% CI, 1.01-1.03, P<0.001), meanwhile a significant higher possibility of suffering hematochezia (OR, 2.29; 95% CI, 1.32-3.99, P=0.003) and anemia (OR, 2.96; 95% CI, 1.46-6.00, p=0.003) in CRC group. Conclusion: the present study demonstrated that colitis, colonic polyps, CRC, and IBD are the most common colonoscopy diagnoses in Zanzibar. The indication of hematochezia or anemia showed a statistically higher risk of CRC.