Researchers from Sweden and South Africa have compiled the first global estimates of celiac disease and associated mortality. These estimates suggest that in 2010, 2.2 million children under age 5 had undiagnosed celiac disease, and 42,000 children may die every year from undiagnosed celiac. In 2008 alone, celiac disease may have accounted for 4% of all childhood diarrheal mortalities, the researchers added.
Estimates were based on what the researchers described as a “relatively crude model” of celiac disease, using the limited data available. Researchers incorporated current estimates of celiac disease prevalence, diagnostic rates and the likelihood of mortality among the undiagnosed.
The study noted that mortality may be highest in parts of Asia and Africa, where awareness of celiac disease is limited.
“Celiac disease may not be one of the world’s biggest killers, but it is a readily preventable cause of death. Much more awareness is needed in the poorer parts of the world – and in particular gluten-bearing food supplements for malnourished children need to be used in the knowledge that they could be harmful to the small proportion suffering from celiac disease,” said Prof. Peter Byass, who led the research.
The researchers pointed out that gluten-free alternatives such as maize- and rice-based foods are "relatively easily available alongside wheat-based products," which could prove to be useful if future public health strategies consider celiac disease among the potential causes of diarrhea. Health workers could rely on these maize- and rice-based foods when removing gluten from a child’s diet to see if diarrhea improves.
The researchers stated that they made several assumptions in the study due to the lack of data related to celiac disease, especially on a global scale. However, the authors also said the estimates used to build their model were in fact "relatively conservative" compared to previous studies whose findings suggested particularly high-prevalence rates. Greater awareness of celiac disease and the risks of undiagnosed could yield better data, and therefore, better estimates in the future.
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