Evaluation of dietary compliance among Sudanese children with coeliac disease

The compliance to a gluten-free diet in Sudan is difficult because many Sudanese tribes depend on wheat product for their food with no access to gluten-free food. To evaluate dietary compliance among Sudanese children with coeliac disease (CD), a longitudinal, prospective and hospital-based study was carried out at Ibn Sina Hospital (Coeliac Clinic) and Gaafar Ibn Auf Children's Hospital (Gastroenterology Clinic) from July 2011 to February 2012. Fifty children diagnosed with CD, followed for more than 6 months, were assessed for dietary compliance. Dietary good-compliant and poor-compliant groups were compared to assess factors affecting the dietary compliance. History, clinical examination and investigations were done initially and then 6 months later. Diagnosis of CD was based on serological tests and duodenal biopsy. The mean age of children with CD was 6.5 (± 2) years. More than three quarters of participants (38%-76%) had poor dietary compliance. Causes of poor compliance were as follows: in 7 (18.4%) was due to refusal of children, in 9 (23.7%) due to unpalatability of gluten free diet (GFD), in 12 (31.6%) due to difficulty in finding GFD and in 10 (26.3%) due to lack of awareness of parents about CD and GFD. The study showed significant correlation between the initial and after 6-month follow up, and the following measures: clinical assessment, nutrition status and difference in haemoglobin level (p < 0.05). To improve compliance, a team working among families is needed with specialised dietitian as well as follow-up at specialised CD clinics.