Screening for Celiac Disease In Rural Areas in

Screening for Celiac Disease In Rural Areas in Egypt Prof. Dr: Mona Abu Zekry Cairo University

Situation of CD In EGYPT Until the year 2000 Celiac Disease was almost unknown in Egypt. Although symptoms and signs of CD are very common in the Egyptian population, children as well as adults, it is very rarely put in the differential diagnosis.

A previous pilot study done by our group in 2008 showed: Ø Out of the total 1500 cases studied, 21 cases were found to be positive for celiac disease. Ø This represents prevalence of 1. 4%. Ø Prevalence detected in different serological studies conducted worldwide ranges from 0. 5% 1. 5% (Dubé et. al. , 2005). n

Map Of Egypt

n Egypt is mainly a rural and agricultural country. Above seventy percent of the population live in the rural areas out of 85 million , around sixty million. n In Egypt the main bulk of cases with acute gastroenteritis and malnutrition is due to infective and chronic diarrhea. In the middle of these cases are certainly many children with undiagnosed Celiac Disease.

n To screen for Celiac Disease in the rural areas we will choose two or three villages near Cairo. n There are health care units where mothers and children are recorded and can be recruited for health education and physical assessment.

Health Care Unit In Egypt

We can recruit 5000 mother and children and detect the symptomatic patients suffering from: Chronic diarrhea/abnormal stool/Irregular bowel function Weight loss/Failure to thrive/ Short stature Anorexia/ lack of appetite Vomiting Globous abdomen Abdominal pain Anaemia Constipation Asthenia/ irritability n

n We can do a rapid t. Tg test to spot the cases. For confirmation we will take serum from these cases and do all the serological tests needed. Positive cases will be offered intestinal biopsy. q Another group with no sypmtoms ( normal school children) will be taken as controls. q This will give a good indication of the prevalence of CD among Egyptian children

School Children in Egypt

n For positive cases, genetic studies and examination of family members will be offered. n If resources are available, the same procedure can be done in urban areas and we would have results of 10000 individuals. n The next step would be to provide educational and social support through an International Celiac Disease Foundation and the production of suitable gluten free nutrition.

Health Education In Egypt