SAGES Magazine

THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2023 | VOLUME 21 | ISSUE 1 | 19 A STUDY Introduction Coeliac disease (CD) is an autoimmune-mediated enteropathy triggered by the ingestion of wheat, barley, or rye. It is characterized by total or subtotal villous atrophy resulting in mucosal damage 1 . Presentation can occur at any age 2 . It is considered a neglected public health issue contributing to the morbidity in young children. About 2,2 million children under the age of five are believed to currently have undiagnosed CD, and around 42,000 deaths per year may can be attributed to CD 3 Numerous studies have demonstrated that CD is a frequent lifelong disorder affecting humans in many parts of the world 4 . Coeliac disease was considered as a rare disorder worldwide, with a prevalence of <1% 5 . However, recent studies have reported a much higher prevalence and estimate that CD prevalence may be much higher 6,7 . The prevalence of has increased sharply in recent years due to improved diagnosis 8 . In Algeria, no study has yet specified the overall prevalence of CD. In western Algeria, in the region of Oran, a retrospective study has shown that coeliac disease has been decreasing since 1990 despite the use of markers and serological tests to detect silent and latent forms 9 . Our study aimed to estimate the burden of coeliac disease in the region of Sidi Bel Abbes based on data collected from the Gastroenterology Department. Methods The Gastroenterology Department is located at Hassani Abdelkader University Hospital Center in Sidi Bel Abbes. A CD Association was formed in 2014 to bring together those patients with CD and aid them in a gluten-free diet. We identified patients recruited over a six-year period from 2015 to 2020. Relevant data was extracted from patient records with 61 patients identified in the Department and 95 patients in the CD Association. Inclusion criteria All patients registered and whose diagnosis had been confirmed by intestinal biopsy, histopathological study and serology, were included. Data was collected using data sheets that included personal and medical data (age, sex, personal history, family history, associated diseases), clinical data (weight, height, BMI, biopsy) and data on their gluten-free diet (adherence to the diet). Table 1 notes the data. Table I: Quantitative and qualitative characteristics of coeliac disease subjects Parameter n (%) I Personal and medical data Age range (year) 4-14 20 (12.8) 15-29 53 (34) 30-44 43 (27.6) 45-55 29 (18.6) >56 11 (7.1) BMI Underweight 63 (40.4) Normal 82 (52.6) Overweight 11 (7.1) Family background Yes 44 (28.2) No 112 (71.8) Associated disease Yes 107 (68.6) No 49 (31.4) II Pre-diagnosis data Symptoms Gastrointestinal symptoms 156(100) Extra-intestinal symptoms Yes 122 (78.2) No 34 (21.8) Diagnosis in childhood Yes 64 (41) No 92 (59) III Diagnostic Data Serology 12 (7.7) Biopsy 51 (32.7) Serology + Biopsy 93 (59.6) IV Gluten free-diet Yes 136 (87.2) No 20 (12.8) Celiac disease in the Sidi Bel Abbes region of Northwestern Algeria A Remil 1 , H Yahiaoui 2 , N Bouanade 3 , N Benzina 4 , D Titsaoui 5 1 Laboratory of Molecular Microbiology Health and Proteomics, Djillali Liabes University, Sidi Bel Abbes, Algeria 2,3,4 Department of Biology, Faculty of Sciences, Nature and Life, Djillali Liabes University, Sidi Bel Abbes, Algeria 5 Gastroenterology Department, University Hospital of Sidi bel Abbes region, Western, Algeria Correspondence REMIL Asma, Laboratory of Molecular Microbiology Health and Proteomics, Djillali Liabes University, 22000, Sidi Bel Abbes, Algeria email: remilasma2018@gmail.com Abstract: This study aimed to determine the incidence and prevalence of coeliac disease (CD) among the population of Sidi Bel Abbes region in Northwestern Algeria. A retrospective analysis was performed on CD patients from records between 2015 and 2020. One hundred fifty-six (156) patients were included in the study (mean age 32.4 ± 1.3 years). The CD incidence decreased from 12.9 per 100 000 person-years in 2015 to 8.5 per 100 000 person-years in 2020. It was significantly higher in the age groups of 15-29 years compared to those of 4-14, p=0.04 and >56 years, p=0.004. The CD incidence was significant greater in women than men with a value of 7.3 per 100 000 person years, p=0.0002. The CD prevalence was 0,063%. The decrease of CD frequency could be explained by limited diagnosis given the ubiquitous clinical picture and sometimes asymptomatic nature of CD.