PREVALENCE AND CLINICAL-FEATURES OF CHRONIC-PANCREATITIS IN SOUTHERN INDIA

We have conducted a field study in India in the state of Kerala involv ing 28,567 inhabitants to determine the prevalence and clinical featur es of chronic pancreatitis of the tropics (CPT), an illness that is en demic in several regions of India. Selection criteria for the present study included: 1. Characteristic abdominal pain; 2. Evidence of diabe tes mellitus; and 3. Evidence of malnutrition/malabsorption. A diagnos is of chronic calcific pancreatitis (CCP) was established by evidence of either 1, 2, or 3 plus X-ray evidence of pancreatic calculi. Diagno sis of noncalcifying chronic pancreatitis (NCCP) was established by 1, 2, or 3 plus an abnormal ultrasound of the pancreas and an abnormal b entiromide test. CPT was discovered among 36 individuals (prevalence 1 :793). Strict entry criteria may have excluded additional cases. CPT w as far advanced at the time of diagnosis in that 28 had evidence of ca lcification, 19 had diabetes mellitus, and 27 had an abnormal bentirom ide test. The major differences from previous hospital-based studies w ere female predominance (male/female ratio, 1:1.8), onset of disease a t an older age (mean 23.9 yr), and evidence of milder disease. We conc lude that previous hospital-based reports that CPT is a severe illness with a male predominance may reflect greater access of seriously ill individuals in general and males in particular to medical care.