Screening for Celiac Disease
In Rural Areas in Egypt
Prof. Dr: Mona Abu Zekry
Cairo University
Situation of CD In EGYPT
Until the year 2000 Celiac Disease was
almost unknown in Egypt. Although
symptoms and signs of CD are very
common in the Egyptian population,
children as well as adults, it is very
rarely put in the differential diagnosis.
A previous pilot study done by our group in
2008 showed:
 Out of the total 1500 cases studied, 21 cases
were found to be positive for celiac disease.
 This represents prevalence of 1.4%.
 Prevalence detected in different serological
studies conducted worldwide ranges from 0.5%
- 1.5% (Dubé et.al.,2005).

Map Of Egypt
Egypt is mainly a rural and agricultural
country. Above seventy percent of the
population live in the rural areas out of 85
million ,around sixty million.
 In Egypt the main bulk of cases with acute
gastroenteritis and malnutrition is due to
infective and chronic diarrhea. In the
middle of these cases are certainly many
children with undiagnosed Celiac Disease.

 To
screen for Celiac Disease in the
rural areas we will choose two or
three villages near Cairo.
 There are health care units where
mothers and children are recorded
and can be recruited for health
education and physical assessment.
Health Care Unit In Egypt
We can recruit 5000 mother and children and
detect the symptomatic patients suffering from:
Chronic diarrhea/abnormal stool/Irregular
bowel function
Weight loss/Failure to thrive/ Short stature
Anorexia/ lack of appetite
Vomiting
Globous abdomen
Abdominal pain
Anaemia
Constipation
Asthenia/ irritability

We can do a rapid tTg test to spot the cases.
For confirmation we will take serum from
these cases and do all the serological tests
needed.
Positive cases will be offered intestinal biopsy.
 Another group with no sypmtoms ( normal
school children) will be taken as controls.
 This will give a good indication of the
prevalence of CD among Egyptian children

School Children in Egypt
For positive cases, genetic studies and
examination of family members will be offered.
 If resources are available, the same procedure
can be done in urban areas and we would have
results of 10000 individuals.
 The next step would be to provide educational
and social support through an International
Celiac Disease Foundation and the production
of suitable gluten free nutrition.

Health Education In Egypt