EPIDEMIOLOGY, CLINICAL FEATURES AND DIAGNOSIS OF CELIAC DISEASE AMONG PEDIATRIC POPULATION IN KAZAKHSTAN.

BACKGROUND

Issues of epidemiology, clinical presentation and diagnostic approaches of celiac disease (CD) remain important for developing countries. At the moment, there are no objective data on the prevalence of CD/gluten sensitivity among children in Kazakhstan. Thus, this study was aimed at a retrospective evaluation of the prevalence of CD, as well as a prospective study of the clinical manifestations and diagnostic features of CD and gluten sensitivity among children in Kazakhstan.

METHODS

Epidemiological data were collected by regions of Kazakhstan for 2019 and was based on the number of confirmed cases of CD among children. To study the clinical features and diagnostic approaches of CD among children a prospective study was conducted during the 2018-2022 in the cities of Astana and Almaty.

RESULTS

The overall prevalence of confirmed cases of CD/gluten allergy among children in Kazakhstan was 5.66 per 100,000 population and showed a high difference between the results obtained with the global and predicted rates. Abdominal pain and nausea were more common in patients with CD. Extra-intestinal manifestations were seen more often in children with gluten allergy. The EMA titer test showed the highest value in CD diagnosis (AUC = 0.857). The IgA and IgG anti-tTG tests had the highest specificity. The sensitivity of genetic analysis in this study was 81.82%, and the specificity was 97.59% (AUC = 0.897). Moreover, the nausea, thirst, IgG anti-tTG test results were independent predictors of disease activity by MARSH.

CONCLUSIONS

The results of this study showed high implications for the health systems of developing countries. Thus, the differences between the available and actual epidemiological indicators may lead to large socio-economic consequences. Moreover, this study describes the clinical and diagnostic features of celiac disease and gluten sensitivity, which has a high clinical significance.