Prevalence coeliac disease

Hi everyone,

A paper discussing the latest data on Coeliac Disease around the world has been published in the Gastroenterology Journal! Link to the paper can be found in the end of this post.

Ever wondered about the prevalence of Coeliac disease (CeD) around the world? Well, wonder no more! A recent paper has delved deep into the data, shedding light on how CeD affects people across different regions. But don’t worry, I’m here to break it down for you, so let’s dive in and explore the numbers together!

Hope you can share this post with your friends that say “nah, coeliac disease it’s not common!”. Here is the proof to refute that!

Celiac disease (CeD) is prevalent globally, affecting around 1-2% of the general population in most regions. For you to have an idea, several diseases have a global prevalence of around 1% or close to it. Here are some examples:

 

  1. Multiple Sclerosis (MS): MS affects about 0.3% to 0.4% of the global population.
  2. Rheumatoid Arthritis (RA): RA affects approximately 0.5% to 1% of people worldwide.
  3. Parkinson’s Disease: Parkinson’s affects around 0.3% to 1% of the population, varying by region.
  4. Crohn’s Disease: Crohn’s disease affects roughly 0.3% to 0.5% of individuals globally.

Let’s check the % of coeliac disease per region:

 

Region: North America

  • United States: 0.7%
  • Canada: 2.4%
  • Mexico: 2.7%

Regions: Central America, Caribbean and South America

  • Central American countries and the Caribbean: Not provided (limited information)
  • Argentina:
    • Prevalence among individuals attending prenuptial examination in La Plata region, Buenos Aires province: 0.55% after biopsy confirmation
    • Prevalence among children aged 3-16 years old in Buenos Aires province: 1.2% after biopsy confirmation
    • Prevalence among individuals from the Toba native Amerindian community in Argentina: 2% after biopsy confirmation
  • Brazil:
    • Prevalence among blood donors in Sao Paolo: 0.35% and 0.46% in two studies
    • Prevalence among Southern Brazilian Mennonites: 1.3% after biopsy confirmation  (where I’m from!! 😅)
  • Colombia:
    • Sero-prevalence for tTG-IGA and EMA among blood donors in Bogota: 1.32%
    • No positive test for tTG-IGA or EMA among healthy individuals in a study in Colombia
  • Peru:
    • Prevalence among individuals 18-29 years old living in 26 cities: 1.2% based on positive tTG-IGA
  • Chile:
    • Prevalence among individuals older than 15 years old according to the National Health Survey 2009-2010: 0.76%
  • Venezuela: Limited to case series
  • Bolivia, Paraguay, Ecuador, and Uruguay: No studies available

Region: Europe

  • Overall incidence in most European countries: Higher than 12.7/100,000 persons/year
  • Overall population level in Europe: Ranges between 0.9% and 2.8%, with a median value of about 1.6%

 

  • United Kingdom:
    • During the period 2010-2014: Twenty times more diagnosed patients than during 1975-1979  (the paper didn’t specify the percentage, but it’s around 1%, Information from Coeliac UK)
  • Sweden:
    • Mean age-standardized incidence rate during 1990-2015: 19.0 per 100,000 person-years
    • Lifetime risk of developing CeD: 1.8%
  • Italy:
    • Overall estimated prevalence in a European multicentre screening on adults in 2010: 1.0%
    • Prevalence among school-age children in Italy (2015-2020): Overall 1.62%, North 1.62%, Center 1.36%, South 1.93%
  • Sweden:
    • Prevalence among 12-year-old students: 2.2% and 2.9% in different birth cohorts
    • Proportion of clinically detected CeD among 3-year-old children: 29%
  • Norway:
    • Prevalence of previously diagnosed CeD: 0.37%
    • Prevalence of previously undiagnosed CeD: 1.10%
  • Germany:
    • Prevalence of undiagnosed CeD based on positive autoantibody findings: 0.8%
    • Overall prevalence: 0.9%
  • Netherlands:
    • Prevalence of undetected CeD in children: 0.91%
  • Spain:
    • Prevalence in children aged 10-12 years: 1.62%
  • Ireland: was not discussed in this study, but it’s around 1%. Information from Coeliac Society of Ireland.

Region: Africa

  • Overall:
    • Sero-prevalence: 1.1%
    • Biopsy-confirmed prevalence: 0.5%
  • Saharawis (Western Sahara):
    • Serological screening in children: 5.6%
    • Follow-up study in 1st-degree relatives: 8.5%
  • Burkina Faso (Mossi population):
    • None tested positive in serological screening (tTG-IGA and EMA)
  • Libya:
    • Prevalence among students aged 5-17 years: 0.79%
  • Tunisia:
    • Prevalence among adults: 0.14%
    • Prevalence among children from the district of Ariana: 0.63%
    • Seroprevalence among school children living in the island of Djerba: 0.34%
    • Biopsy-based prevalence among school children living in the island of Djerba: 0.29%
  • Sudan:
    • Seroprevalence among patients with gastrointestinal or extra-intestinal complaints: 74%
    • Seroprevalence among Sudanese children with type-1 diabetes: 6.97% with histological confirmation in 76.5%

Region: Asia

  • South Asia (India):
    • Prevalence in children: 1 in 310
    • Prevalence in adults: 1 in 96
    • Pan-India study:
      • Northern part: 1.23%
      • Southern part: 0.10%
  • Southeast Asia:
    • Vietnam: 1% seroprevalence among children
    • Malaysia: 1.2% seroprevalence among young healthy volunteers
  • East Asia (China):
    • Prevalence among adolescents and young adults: 2.19%
    • Seroprevalence among inpatients: 1.27%
    • Prevalence among patients with diarrhea-predominant irritable bowel syndrome: 2.8%
    • General population seroprevalence in high-risk population: 0.27%
    • Prevalence in high-risk population: 8.3%
  • Japan:
    • Lower prevalence compared to other parts of Asia
  • Western Asia and Middle-East:
    • Saudi Arabia: Prevalence in general population: 1.5-3%
    • Iran: Seroprevalence in general population: 3%, Prevalence of biopsy-confirmed CeD: 2%
    • Lebanon: Prevalence among adults: 1.5%
    • Turkey: Prevalence in children: 0.47-0.55%, Prevalence in adults: 0.39-0.70%
    • Israel: Serodiagnosis prevalence in adults: 0.7%
    • Egypt: Prevalence in pediatric general population: 0.53%, Prevalence in children with type 1 diabetes: 6.4%
  • Central Asia and Russia:
    • Lack of systematic studies, but a reported increase in prevalence among children, with at least 0.6% affected
  • Overall Asian region:
    • Pooled sero-prevalence: 1.2%
    • Pooled prevalence of biopsy-confirmed CeD: 0.61%

Region: Oceania

  • Australia:
    • Busselton Health Study (South-West Australia, 1994-95):
      • Prevalence: 0.4%
      • Clustering of cases in the 30-50-years age range
    • Barwon (New South Wales):
      • Prevalence in men: at least 1.1%
      • Prevalence in women: 1.0%
    • Sydney children’s hospital emergency department:
      • Prevalence of biopsy-confirmed CeD: 0.7% (7/1055)

 

Celiac disease (CeD) is prevalent globally, affecting around 1-2% of the general population in most regions. Despite a notable increase in clinically diagnosed cases, a significant proportion of CeD cases remain undiagnosed, highlighting the need for increased awareness, particularly in Asian regions where CeD is still considered uncommon.

Challenges in managing CeD vary by region, from the need for longitudinal care in high-income countries to improving awareness and serology test availability in others. Early recognition of CeD offers significant benefits, and systematic case-finding policies are crucial, with pediatric population screening representing a promising avenue for effective secondary prevention strategies.

It’s important to note that prevalence rates can vary over time and across different populations due to factors such as changes in diagnostic criteria, awareness, and environmental factors.

 

Disclosure

Please note that this blog discusses scientific publications related to celiac disease, autoimmune diseases, and personal experiences. I am a pharmacist with a Ph.D in immunology and a post-doctorate in gastroenterology so I enjoy reading publications 😁. By the way, my mom and I are both celiacs.

It is important to remember that scientific research is an ongoing process and findings can change over time. While I strive to present accurate information based on the publications I review, my discussion of these publications should not be taken as a confirmation of their findings.

It is also important to keep in mind that there is still much that is unknown about celiac disease, autoimmune diseases, and their treatment. Therefore, any information presented on this blog should be considered in the context of the discussed publication and should not be used as a substitute for professional medical advice.

We encourage readers to discuss any questions or concerns they may have about diseases with their healthcare provider, who can provide individualized guidance based on the latest clinical practice guidelines.

 

References

Publication to check references for each specific country/region: Patient and Community Health Global Burden in a World with more Celiac Disease

Published by: Simona Gatti, Alberto Rubio-Tapia, Govind Makharia, Carlo Catassi,
Patient and Community Health Global Burden in a World with more Celiac Disease,
Gastroenterology, 2024,
ISSN 0016-5085,
https://doi.org/10.1053/j.gastro.2024.01.035