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EPIDEMIOLOGY, CLINICAL FEATURES AND DIAGNOSIS OF CELIAC DISEASE AMONG PEDIATRIC POPULATION IN KAZAKHSTAN
A Kapassova1, G Derbissalina1, B Iskakov2
11Astana Medical University, Kazakhstan.
Insights
Celiac disease (CD) prevalence in Kazakhstan children is 5.66 per 100,000. This study highlights significant differences in epidemiology and diagnostics for CD and gluten sensitivity, crucial for developing nations.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Public Health Epidemiology
Background:
- Celiac disease (CD) epidemiology, clinical presentation, and diagnostics are critical for developing countries.
- Kazakhstan lacks objective data on pediatric CD and gluten sensitivity prevalence.
- This study addresses the need for data on CD and gluten sensitivity in Kazakhstani children.
Purpose of the Study:
- To retrospectively evaluate CD prevalence in Kazakhstan children.
- To prospectively study clinical manifestations and diagnostic features of CD and gluten sensitivity in Kazakhstani children.
Main Methods:
- Retrospective epidemiological data collection for CD cases in Kazakhstan regions (2019).
- Prospective study of clinical features and diagnostics for CD and gluten sensitivity in Astana and Almaty (2018-2022).
- Analysis of diagnostic test performance, including EMA, IgA/IgG anti-tTG, and genetic analysis.
Main Results:
- Overall confirmed CD/gluten allergy prevalence in Kazakhstani children: 5.66 per 100,000, differing from global rates.
- Abdominal pain and nausea were more frequent in CD patients; extra-intestinal manifestations were more common in gluten allergy.
- Genetic analysis showed high sensitivity (81.82%) and specificity (97.59%); EMA, IgA/IgG anti-tTG also demonstrated diagnostic value. Nausea, thirst, and IgG anti-tTG predicted disease activity.
Conclusions:
- Discrepancies in epidemiological indicators have significant socio-economic implications for developing countries.
- The study provides crucial clinical and diagnostic insights into celiac disease and gluten sensitivity in children.
- Findings underscore the importance of accurate diagnostics and prevalence data for public health strategies.
Background:
Issues of epidemiology, clinical presentation and diagnostic approaches of celiac disease (CD) remain important for developing countries. At the moment, there are no objective data on the prevalence of CD/gluten sensitivity among children in Kazakhstan. Thus, this study was aimed at a retrospective evaluation of the prevalence of CD, as well as a prospective study of the clinical manifestations and diagnostic features of CD and gluten sensitivity among children in Kazakhstan.
Methods:
Epidemiological data were collected by regions of Kazakhstan for 2019 and was based on the number of confirmed cases of CD among children. To study the clinical features and diagnostic approaches of CD among children a prospective study was conducted during the 2018-2022 in the cities of Astana and Almaty.
Results:
The overall prevalence of confirmed cases of CD/gluten allergy among children in Kazakhstan was 5.66 per 100,000 population and showed a high difference between the results obtained with the global and predicted rates. Abdominal pain and nausea were more common in patients with CD. Extra-intestinal manifestations were seen more often in children with gluten allergy. The EMA titer test showed the highest value in CD diagnosis (AUC = 0.857). The IgA and IgG anti-tTG tests had the highest specificity. The sensitivity of genetic analysis in this study was 81.82%, and the specificity was 97.59% (AUC = 0.897). Moreover, the nausea, thirst, IgG anti-tTG test results were independent predictors of disease activity by MARSH.
Conclusions:
The results of this study showed high implications for the health systems of developing countries. Thus, the differences between the available and actual epidemiological indicators may lead to large socio-economic consequences. Moreover, this study describes the clinical and diagnostic features of celiac disease and gluten sensitivity, which has a high clinical significance.
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