Is Childhood Celiac Disease a Factor in Global Deaths Due to Diarrhea?
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The research team included Peter Byass, Kathleen Kahn, and Anneli Ivarsson. They are affiliated with the Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine at Umeå University in Umeå, Sweden, and with the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences at University of the Witwatersrand in Johannesburg, South Africa.
In the last several decades, celiac disease has become an an increasingly recognized public health problem. More recently, celiac disease has emerged as a global earth issue, in spite scant globally representative epidemiological data.
Because children with celiac disease often have chronic diarrhea and malnutrition, a proper diagnosis is often missed, especially in poorer settings, where water-borne infectious diarrheas are common, and many children fail to thrive.
To make their assessment, the two used available data to build a basic model of childhood celiac disease, incorporating estimates of population prevalence, probability of non-diagnosis, and likelihood of mortality among undiagnosed children of all countries from 1970 to 2010.
In their paper, the two state the assumptions underlying their model, and make the model available as a supplementary file.
Based on their model, in 2010 there were around 2.2 million children under 5 years of age living with celiac disease, while each year, there would be about 42,000 deaths related to celiac disease in these children. That would mean that, in 2008, deaths related to celiac disease likely totaled about 4% of all childhood diarrhea deaths worldwide.
Even if celiac disease accounts for only a small proportion of global diarrhea deaths, these deaths are preventable, but not by normal diarrhea treatment, which can often involve gluten-based food supplements.
They also note that, as other causes of diarrhea mortality decline, celiac disease will become a proportionately greater problem unless clinicians begin to try gluten-free diets for children with chronic diarrhea and malnutrition.
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