Related Experiment Video
Updated: May 9, 2026
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
Celiac disease in Tunisian children: a second screening study using a "new generation" rapid test
Mongi Ben Hariz1, Lilia Laadhar, Maryam Kallel-Sellami
1Research Unit of Celiac Disease, Paediatric Department, Mongi SLIM's Hospital and Al Manar University, Tunis, Tunisia.
Insights
Celiac disease prevalence in Tunisian schoolchildren is 0.24-0.34%, with a rapid screening method proving feasible and well-accepted. This study highlights the need for improved diagnosis, even in symptomatic children.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Public Health
Background:
- Celiac disease diagnosis in children often faces delays, even with typical symptoms.
- Screening programs are essential for identifying undiagnosed cases in pediatric populations.
Purpose of the Study:
- To estimate celiac disease prevalence among schoolchildren on the island of Djerba, Tunisia.
- To assess the feasibility and acceptance of a rapid screening method for celiac disease and IgA deficiency.
- To evaluate the diagnostic yield of rapid versus conventional testing methods.
Main Methods:
- A rapid screening method for IgA anti-tissue transglutaminase and IgA deficiency was employed on 2064 schoolchildren.
- Positive cases underwent conventional serological testing (IgA anti-transglutaminase, anti-endomysium) and, where indicated, intestinal biopsy.
- IgA deficiency was confirmed using nephelometry, with IgG anti-endomysium testing performed in relevant cases.
Main Results:
- The rapid test identified 7 children; conventional serology confirmed all positive cases.
- Intestinal biopsy revealed total villous atrophy in 5 children, indicating celiac disease.
- The prevalence of celiac disease was estimated at 0.24-0.34%, and IgA deficiency at 0.5-0.6%.
- Silent celiac disease was diagnosed in 3 children, with other cases presenting with chronic diarrhea, growth failure, or borderline growth.
Conclusions:
- Celiac disease is relatively common in Tunisian schoolchildren, with a significant number escaping diagnosis despite symptoms.
- Rapid screening methods are a viable and well-accepted alternative to conventional blood tests, improving patient compliance.
- Early detection through effective screening is crucial for managing celiac disease and preventing long-term complications in children.
Abstract:
This work aims to estimate celiac disease prevalence in school-children in the island of Djerba and assess rapid method feasibility for screening. We screened 2064 schoolchildren by a rapid method to detect IgA anti-tissue transglutaminase and IgA deficiency. Children with positive results were tested for IgA anti-transglutaminase and anti-endomysium by conventional tests. In positive children, intestinal biopsy was performed. IgA deficiency suspected by rapid method was confirmed by nephelometry. In these cases IgG anti-endomysium was performed. Rapid test was positive in 7 children; conventional serology was positive in all and 6 of them accepted the biopsy. Total villous atrophy was observed in 5 while intestinal mucosa was normal in one. Among children with positive serology, 3 had silent form, 1 chronic diarrhea, one growth failure and 2 had borderline growth. IgA deficiency was suspected in 13 cases and was confirmed in 11 children tested. Prevalence of celiac disease was 0.24-0.34% and that of IgA deficiency 0.5-0.6%. This screening study confirms that celiac disease is relatively common in schoolchildren in Tunisia. It confirms also that even those with symptoms typical for celiac disease escape diagnosis. Rapid test is better accepted by parents and children than test requiring a venous blood sample.
