Prevalence of celiac disease in Egyptian children disputes the east-west agriculture-dependent spread of the disease

J Pediatr Gastroenterol Nutr. 2008 Aug;47(2):136-40. doi: 10.1097/MPG.0b013e31815ce5d1.

Abstract

Objectives: Celiac disease (CD) seems to be a common disorder in north Africa; however, to our knowledge no data are yet available on its prevalence in Egypt. This study was undertaken to investigate the frequency of CD in Egyptian children.

Patients and methods: We investigated a sample of the general pediatric population (1500 individuals, 656 girls and 844 boys, age range 7 months to 18 years, median age 8.0 years) (group A); 150 children (age range 6 months to 13 years, median age 16 months) admitted for diarrhea or failure to thrive (group B); and 250 children and adolescents with type 1 diabetes (group C). The screening test was serum class A anti-transglutaminase (anti-tTG) antibody; immunoglobulin A (IgA) antiendomysium, total IgA, and IgG anti-tTG, and small bowel biopsy was performed for confirmation of diagnosis.

Results: In group A, 8 of 1500 children fulfilled the criteria for CD diagnosis; the prevalence of CD was at least 1 in 187 individuals (0.53%; 95% CI 0.17%-0.89%). In group B, 7 of 150 children had CD (4.7%, 95% CI 1.4-7.9). In group C, 16 of 250 sera showed positive results to both the IgA anti-tTG and the IgA antiendomysium test (6.4%; 95% CI 3.4-9.4).

Conclusions: Celiac disease is a frequent disorder among Egyptian children, both in the general population and in at-risk groups. Therefore, our data do not support the theory of a Middle East-Europe CD prevalence gradient secondary to the pattern of agriculture spreading from the so-called Fertile Crescent.

MeSH terms

  • Adolescent
  • Agriculture*
  • Autoantibodies / blood*
  • Celiac Disease / blood
  • Celiac Disease / epidemiology*
  • Child
  • Child, Preschool
  • Demography
  • Diabetes Mellitus, Type 1 / complications
  • Egypt / epidemiology
  • Failure to Thrive
  • Female
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin G / blood
  • Infant
  • Male
  • Mass Screening
  • Prevalence
  • Risk Factors
  • Transglutaminases / immunology*

Substances

  • Autoantibodies
  • Immunoglobulin A
  • Immunoglobulin G
  • Transglutaminases