Celiac.com 03/23/2011 - A group of researchers in India recently conducted a community-based study on the prevalence of celiac disease in the northern part of India.
The research group included Govind K Makharia, Anil K Verma, Ritvik Amarchand, Shinjini Bhatnagar, Prasenjit Das, Anil Goswami, Vidyut Bhatia, Vineet Ahuja, Siddhartha Datta Gupta and Krishnan Anand.
They are affiliated with the Departments of Gastroenterology and Human Nutrition, and Pediatrics and Pathology at the Centre for Community Medicine of the All India Institute of Medical Sciences in New Delhi.
Worldwide celiac disease rates are estimated at about 1%, but the disease is thought to be uncommon in both India and Asia. However, there has generally been a lack of study data on the actual prevalence of celiac disease in Asian nations.
The research team set out to accurately estimate the prevalence of celiac disease in a specific Indian community. The team crafted a cross sectional study to estimate rates of celiac disease in urban and rural populations in the National Capital Region, Delhi, India.
The team gathered data using a structured questionnaire administered via door-to-door visits. The questionnaire provided socio-demographic data and basic screening for features of celiac disease, such as chronic or recurrent diarrhea, and anemia.
For children, the questionnaire included additional factors, namely short stature (linear height below 5th percentile for age) and failure to thrive/gain weight.
All test subjects with positive screens and 10% of negative screen individuals were called for anti-tissue transglutaminase antibody blood test.
All those with positive blood tests were invited to undergo endoscopic biopsy. The team diagnosed celiac disease on the basis of a positive blood screens, the presence of villous atrophy and/or response to gluten free diet.
The team contacted 12,573 people in all. A total of 10,488 (83.4%) (50.6% male) agreed to participate. Screening showed 5,622 (53.6%) positive results. Of those who screened positive, 2167 (38.5%) submitted to anti-tissue transglutaminase antibody blood tests. The team also tested 712 (14%) subjects who had tested negative.
The data showed an overall sero-prevalence of celiac disease was 1.44% (95% conﬁdence interval [CI] 1.22 1.69) and the overall prevalence of celiac disease was 1.04% (95% CI 0.85 1.25).
Celiac disease in this north Indian community is 1 in 96, or about 1%. That means that celiac disease is more common than is recognized in India, and that rates are about the same as in other parts of the world, not lower, as conventional wisdom has held.