title: Prevalence of celiac disease in Egyptian children disputes the east-west agriculture-dependent spread of the disease.
abstract: OBJECTIVE
  Celiac disease (CD) seems to be a common disorder in north Africa; however, to our knowledge no data are yet available on its prevalence in Egypt. This study was undertaken to investigate the frequency of CD in Egyptian children.
  
  
  METHODS
  We investigated a sample of the general pediatric population (1500 individuals, 656 girls and 844 boys, age range 7 months to 18 years, median age 8.0 years) (group A); 150 children (age range 6 months to 13 years, median age 16 months) admitted for diarrhea or failure to thrive (group B); and 250 children and adolescents with type 1 diabetes (group C). The screening test was serum class A anti-transglutaminase (anti-tTG) antibody; immunoglobulin A (IgA) antiendomysium, total IgA, and IgG anti-tTG, and small bowel biopsy was performed for confirmation of diagnosis.
  
  
  RESULTS
  In group A, 8 of 1500 children fulfilled the criteria for CD diagnosis; the prevalence of CD was at least 1 in 187 individuals (0.53%; 95% CI 0.17%-0.89%). In group B, 7 of 150 children had CD (4.7%, 95% CI 1.4-7.9). In group C, 16 of 250 sera showed positive results to both the IgA anti-tTG and the IgA antiendomysium test (6.4%; 95% CI 3.4-9.4).
  
  
  CONCLUSIONS
  Celiac disease is a frequent disorder among Egyptian children, both in the general population and in at-risk groups. Therefore, our data do not support the theory of a Middle East-Europe CD prevalence gradient secondary to the pattern of agriculture spreading from the so-called Fertile Crescent.
authors.affiliation: Department of Gastroenterology, Cairo University Children's Hospital, Cairo, Egypt.
authors.forename: M
authors.initials: M
authors.lastname: Abu-Zekry
authors.forename: D
authors.initials: D
authors.lastname: Kryszak
authors.forename: M
authors.initials: M
authors.lastname: Diab
authors.forename: C
authors.initials: C
authors.lastname: Catassi
authors.forename: A
authors.initials: A
authors.lastname: Fasano
mesh_terms: D000293:Adolescent; D000383:Agriculture; D001323:Autoantibodies / Q000097:blood*; D002446:Celiac Disease / Q000097:blood / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003710:Demography; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D004534:Egypt / Q000453:epidemiology; D005183:Failure to Thrive; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D012307:Risk Factors; D011503:Transglutaminases / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D011503:Transglutaminases