title: Celiac disease in Tunisian children: a second screening study using a "new generation" rapid test.
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.
authors.affiliation: Research Unit of Celiac Disease, Paediatric Department, Mongi SLIM's Hospital and Al Manar University, Tunis, Tunisia.
authors.forename: Mongi Ben
authors.initials: MB
authors.lastname: Hariz
authors.forename: Lilia
authors.initials: L
authors.lastname: Laadhar
authors.forename: Maryam
authors.initials: M
authors.lastname: Kallel-Sellami
authors.forename: Nadia
authors.initials: N
authors.lastname: Siala
authors.forename: Saadia
authors.initials: S
authors.lastname: Bouraoui
authors.forename: Sonia
authors.initials: S
authors.lastname: Bouziri
authors.forename: Abdelhafidh
authors.initials: A
authors.lastname: Borgi
authors.forename: Faouzia
authors.initials: F
authors.lastname: Karouia
authors.forename: Ahmed
authors.initials: A
authors.lastname: Maherzi
authors.forename: Sondès
authors.initials: S
authors.lastname: Makni
mesh_terms: D001706:Biopsy; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D017098:IgA Deficiency / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D007070:Immunoglobulin A / Q000097:blood*; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D015995:Prevalence; D011503:Transglutaminases / Q000276:immunology*; D014416:Tunisia / Q000453:epidemiology
chemical_list: D007070:Immunoglobulin A; D011503:Transglutaminases