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  • Jefferson Adams
    Jefferson Adams

    Is Childhood Celiac Disease a Factor in Global Deaths Due to Diarrhea?

    Reviewed and edited by a celiac disease expert.

    Celiac.com 08/30/2011 - In a first of its kind study, a team of researchers is attempting a global estimate of the burden of celiac disease in childhood, and to to determine what role childhood celiac disease might play in global mortality due to diarrhea.

    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.

    Photo: CC-unknownTo 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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    An element of this situation the study and this article fail to address is whether the food aid itself might in fact be inducing mortality by introducing gluten into populations of the world where it is not normally eaten. This needs to be looked at quite closely by the UN and aid organizations. What is commonly diagnosed as "failure to thrive" might, in fact, be failure to feed what these already starving populations can digest safely.

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    I agree. Celiac was once considered a childhood disease. Studies have shown that most often, children who were diagnosed with celiac disease, grow up to be adults with unexplained symptoms. All celiacs know that this is one of the most difficult diagnoses to make. Many doctors still treat the individual symptoms, without treating the underlying cause, which is the very food we consume to stay alive. I have found that, in retrospect, I have had symptoms all my life. Having been misdiagnosed, it took my uncle, then my grandfather almost dying, and being diagnosed with celiac sprue to bring the disease to my attention. It seems my family was full of undiagnosed celiacs, and we have all benefited from a gluten-free diet.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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