SomeInfos Header

Celiac Disease Epidemiology

Until the last decade, celiac disease was considered to be a rare disease, but today it is known to be universally distributed, to involve all races, and it is one of the most commonly known genetic diseases, with a mean prevalence of 1%-2% in the general population, being clearly underestimated and underdiagnosed worldwide. This would represent an estimated 3 million people affected in Europe and at least another 3 million in the United States. Selected ethnic groups may have a lower prevalence than that suggested for the Caucasian race, but not far from them, as the worldwide distribution of celiac disease is pretty homogeneous, the only exception being the Saharawui population, which lives in refugee camps.

This population in North Africa has a mean estimate of 5%, the highest found all over the world[8-10]. In Southern Asia there are still no data available of celiac disease prevalence in the general population. This fact may be due to partly, because in past decades the reports of gluten intolerance were only of sporadic cases. Nowadays, several recent studies suggest that celiac disease is also common in South Asia. For instance, 26%-49% of Indian children presenting with chronic diarrhea, are diagnosed with celiac disease in tertiary care hospitals[11,12]. If we assume that China has approximately 1 billion inhabitants, we can extrapolate the same world proportion of celiac disease (around 1% of the general population), then the approximate number of possible celiac patients in this country would be around ten million people. There are few reports of celiac disease in Far East countries, yet recently, three adult cases have been reported in Canada among descendents of Japanese and Chinese immigrants[13].

These findings suggest that genetic susceptibility for celiac disease also exists among people of the Far East, where the real incidence of the disease is clearly underestimated because their dietary habits are different (more rice than wheat, in the staple diet), and possibly for the interest of doctors to recognize CD. These concerns pose important issues, which require further studies of celiac disease in the different countries of this important and extensive area of the world. Celiac disease is also very prevalent in people from the Middle East and these data are not surprising as they inhabit countries included in the “Fertile Crescent” such as Anatolia (South of Turkey), Lebanon, Syria, Palestine and Iraq, where some 10 000 years ago, some tribes changed from a nomadic lifestyle, to one of stable settlement, started the agriculture and probably propagated the spread of this disease throughout the world[14].

Thus, gluten intolerance appears to be a widespread public health problem and an increased level of awareness and clinical suspicion are needed to diagnose celiac disease all over the world. Moreover, the gluten-free diet possess a big problem in developing countries, since commercial gluten-free products are not available, while in others they are very expensive and are diffi cult to acquire.

 

DISCLAIMER
1 visitors online
SomeInfos Header
SomeInfos Header
Developed by Opti-Web