Serological screening for celiac disease in schoolchildren in Jordan. Is height and weight affected when seropositive?

Abstract

Background Celiac disease (CD) emerged as a public health problem, and the disease prevalence varies among different races. The present study was designed to investigate the prevalence of CD using serological markers in apparently healthy schoolchildren in Irbid City, Jordan. Additionally, the effect of positive serology on height, weight and body mass index (BMI) was evaluated. Methods The study population consisted of 1985 children (1117 girls and 868 boys), age range was 5.5 to 9.5 years. Height and weight were measured and blood samples were collected from each individual. Serum samples were analyzed for IgA anti-tissue transglutaminase antibodies (tTG) using a commercial enzyme-linked immunosorbent assay (ELISA). tTG positive samples were further analyzed for IgA anti-endomysium antibodies (EmA) with a commercial ELISA. Samples confirmed positive with EmA were considered seropositive. Results Sixteen children were CD positive. The serological prevalence was estimated to be 1:124 (0.8%; 95% CI, 0.5% to 1.3%). Significant impact on growth (height) was found in seropositive children. When both sexes were individually analyzed, only boys showed height reduction. Furthermore, seropositive boys also had a significant weight reduction. Conclusion This study demonstrated that CD is prevalent among schoolchildren in Jordan. The seropositive children tend to have lower height, weight, and BMI than the seronegative group. These differences were significant only for boys. None of the participants is known to have CD prior to the study.

Systematic review: worldwide variation in the frequency of coeliac disease and changes over time

“…Fourteen studies were European, [67][68][69][70][71][72][73][74][75][76][77][78][79][80] two African 81,82 and one Asian. 83 The prevalence of positive IgA EMA, elevated IgA tTG levels and biopsy-positive CD in these studies ranged from 0.78% to 5.66%, 0.43% to 2.42% and 0.11% to 1.71% respectively. 81 In Saharawi, sub-Saharan Africa, 5.6% of 989 unselected children had elevated tTG levels and also tested positive for IgA EMA.…”

Prevalence of celiac disease in Asia: A systematic review and meta‐analysis

“…Eighteen studies included in this meta-analysis reported seroprevalence of CD in various Asian countries. [16][17][18][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] In these studies, 47 873 individuals were screened using anti-tTG ab and/or AEA, and 884 individuals were reported to be seropositive for CD. Hence, the pooled sero-prevalence of CD using anti-tTG ab and/or AEA in Asian countries was 1.6% (95% CI 1.1%, 2.0%) (Fig.…”

“…Of 18 studies reporting sero-prevalence, intestinal mucosal biopsies were not performed in four of the studies; hence, they were excluded from estimating the pooled prevalence of CD. 32,33,40,41 Of 43 955 individuals screened in the remaining 14 studies, 809 individuals were seropositive for CD using anti-tTG ab and/or AEA. [16][17][18][29][30][31][34][35][36][37][38][39]42,43 Of them, 344 (42.5%) individuals did not undergo duodenal biopsies.…”

Value of clinical data in diagnosis of symptomatic celiac disease in children

“…Esophagogastroduedinoscopy and biopsy was done in Alsalam General Hospital in Mosul city where three sites of duodenum were biopsied from every patient. Biopsy specimens were evaluated in the same hospital and pathology reports were analyzed according to Marsh criteria (4) .…”

“…The prevalence of celiac disease in Tunisian schoolchildren, estimated to be about 1/157 which is close to the European prevalence (2) . In Jordan the serological prevalence was estimated to be 1:124 in schoolchildren (4) , whereas the average annual incidence in Kuwait is 1:3000 (5) . To date no prevalence of celiac disease data were reported from Iraq.…”