Screening for Celiac Disease In Rural Areas in Egypt

1
Screening for Celiac Disease In Rural Areas in
Egypt

• Prof. Dr Mona Abu Zekry
• Cairo University

2
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.

3

• A previous pilot study done by our group in 2008
  showed
• Out of the total 1500 cases studied, 21 cases
  were found to be positive for celiac
  disease.
• This represents prevalence of 1.4.
• Prevalence detected in different serological
  studies conducted worldwide ranges from 0.5 -
  1.5 (Dubé et.al.,2005).

4
Map Of Egypt
5

• 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.
• 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.

6

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

7
Health Care Unit In Egypt
8

• 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

9

• We can do a rapid tTg 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.
• Another group with no sypmtoms ( normal school
  children) will be taken as controls.
• This will give a good indication of the
  prevalence of CD among Egyptian children

10
School Children in Egypt
11

• For positive cases, genetic studies and
  examination of family members will be offered.
• If resources are available, the same procedure
  can be done in urban areas and we would have
  results of 10000 individuals.
• 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.

12
Health Education In Egypt
13
Thank you