The Epidemiology of Celiac Disease in the General Population and High-Risk Groups in Arab Countries: A Systematic Review

Abstract

Background and Aims. Celiac disease (CD) is possibly the most common autoimmune disorder, which may lead to dietary problems in the Arab region. This paper is aimed at exploring the epidemiology of the celiac disease in Arab countries, including its prevalence, associated risk factors, and clinical patterns. Methods. An extensive search of the literature was conducted from electronic databases such as PubMed, Embase, and Google Scholar. In total, 134 research papers were retrieved. We extracted studies published from January 1996 to December 2019. Our search was limited to studies published in English. Findings. The review included 35 studies with 22,340 participants from 12 countries and demonstrated a wide variation in the prevalence of CD. The highest prevalence among the general population (3.2%) was reported in Saudi Arabia, and the lowest (0.1%) was reported in Tunisia. Women demonstrated a higher prevalence of celiac disease relative to men. The peak age at diagnosis fell between 1 and 3 years and 9-10 years. Most studies focused on type 1 diabetes. Children with type 1 diabetes have a higher prevalence of CD (range from 5.5% to 20%), while the prevalence of CD in Down’s syndrome patients was 1.1% and 10.7% in UAE and Saudi Arabia, respectively. Other autoimmune diseases associated with CD are thyroid disease and irritable bowel disease. The most widely recognized clinical presentation was an inability to flourish and poor weight gain, followed by short stature, abdominal pain, abdominal distension, bloating, and chronic diarrhea. Conclusion. The prevalence of the celiac disease in Arab countries varies with sex and age. However, we found that celiac disease presented similar clinical characteristics independent of the geographic region. Longitudinal population-based studies are needed to better identify the true burden and determinants of celiac disease.

The Effect of Using Rome IV Criteria on the Prevalence of Functional Abdominal Pain Disorders and Functional Constipation among Children of the Western Region of Saudi Arabia

“…Furthermore, H-pylori and celiac disease incidences are 3.2% and 27.4%, respectively; 2 common examples of organic gastrointestinal disorders that do share clinical features of FAPDs. 10 , 22 In a prospective study, the diagnostic yield of upper endoscopy in pediatric patients with chronic abdominal pain was 38%. 23 In Telmesani’s study; up to 72% of recurrent abdominal pain cases had a positive H-pylori test.…”

The prevalence of celiac disease in Saudi patients with type 1 diabetes mellitus

“…10 In Arab countries, the prevalence of CD in children with T1DM range from 5.5% to 20%. 11 Internationally, the prevalence ranges from 3%-12%. [12][13][14] There are multiple possible reasons for the low prevalence of confirmed CD in this study, including early screening of asymptomatic T1DM patients, the low referral rate for endoscopy by the treating physician, patient or family refusal to undergo an endoscopy, and loss of patient follow-up at the gastroenterology service.…”

“…Table 1 summarizes the available literature related to CD prevalence in T1DM patients. [4][5][6][7][8][9][10][11][12] This study aimed to determine the prevalence of CD in adolescents and adults with T1DM. The clinical characteristics and differences between T1DM patients with or without a positive CD screening test were also investigated.…”

Prevalence of celiac disease in irritable bowel syndrome patients: A single centre experience from a large teaching hospital of Lahore, Pakistan

“…23 Farther in the Arab world a rising prevalence is observed and Saudi Arabia is having 9.6% Celiac disease in IBS patients. 24 While our close neighbors India and Bangladesh have 6.1% and 9% prevalence respectively. [17][18] This much difference in different studies is probably due to ethnicity, dietary habits, availability of resources for diagnosis, and genetic make-up.…”