Diagnostic screening for subclinical celiac disease using a rapid test in children aged 2–4

Abstract

Background: Our aim is to study the prevalence of subclinical celiac disease (CD) and analyze the diagnostic yield of a new rapid test in children aged 2-4. Methods: We carried out a cross-sectional study in a sample population of children aged 2-4 from the same metropolitan area. We recruited apparently healthy subjects, and collected clinical, anthropometric, analytical, and serological variables. We also tested for anti-gliadin IgA and anti-transglutaminase IgG and IgA using a rapid immunochromatographic test CD1WB and CD2WB (Operon, Zaragoza, Spain). results: One hundred and ninety-eight children were recruited, signed the informed consent form, and completed the protocol (mean age 32.3 ± 9.2 mo, 53% males). CD prevalence according to the serological tests was 3% (CI 95%, 1.4-6.4%). Biopsies were used to confirm the diagnosis in all suspected cases. The sensitivity and negative predictive value of the CD2WB immunochromatographic test strip were 100% and 1, respectively. The sensitivity of CD1WB was 16.6% and its specificity was high (89.1%). conclusion: The prevalence of subclinical CD in the sample group of 2-4-y old was higher than that found by other authors. The CD2WB immunochromatographic test strip is an excellent diagnostic screening tool with high sensitivity and negative predictive value.

Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis

“…We also grouped the studies based on their risk of bias (low, moderate, or high). The I 2 test for heterogeneity was 94% for studies with a low risk of bias [37][38][39]50,53,55,57,60,63,76,80,85,87,91,93 and 91% for studies with a moderate risk of bias. [9][10][11]31,33,34,36,[40][41][42]47,48,54,56,58,59,61,65,66,68,70,71,74,77,[82][83][84][88][89][90]92,96,[101][102][103]…”

“…Finally, 57 studies were included in this part of the analysis. [9][10][11]31,33,34,[36][37][38][39][40][41][42]47,48,50,[53][54][55][56][58][59][60][61]63,65,66,68,70,71,74,76,77,80,[82][83][84][85][87][88][89]92,93,96,[101][102][103]105,[109][110][111]115,11...…”

“…The pooled prevalence of biopsy-proven CD ranged from 0.5% (95% CI, 0.2%-0.9%) in Africa 11,31,33,34 to 0.8% (95% CI, 0.6%-1.1%) in Europe. [53][54][55][56][57][58][59][60][61]63,65,66,68,70,71,74,76,77,80,[82][83][84][85][87][88][89][90][91][92][93]115,116 Of 7 studies included in the calculation of seroprevalence from North America, 6,95-100 biopsies were not performed in 4 studies. 95,97,99,100 In 2 other studies only 22.6% and 26.9% seropositive individuals underwent a biopsy and thus could not be included in this part of the analysis.…”

“…Of 57 studies included in the calculation of the pooled prevalence of biopsy-confirmed CD, 43 studies reported a separate pooled prevalence for pediatric and adult CD patients. 10,11,31,33,34,[36][37][38][39][40][41][42]47,48,50,53,56,57,59,61,65,66,68,70,76,77,80,82,83,85,[88][89][90][91][92][93]101,102,105,109,111,116,117 A total of 276 of 40,076 screened adults had CD, providing a pooled prevalence of 0.5% (95% CI, 0.3-0.8). Of 65,957 screened children, 891 children had CD, with a pooled prevalence of 0.9% (95% CI, 0.6-1.3), which was higher than that in adults (P < .001).…”

“…The pooled global prevalence of CD between January 2011 and March 2016 was 0.8% (95% CI, 0.5%-1%), suggesting an increase in the prevalence of CD over time. 9,11,31,33,37,[39][40][41][42]47,48,74,77,80,82,84,85,87,[89][90][91][92][93]97,105,109,111 The heterogeneity for this group was 94%.…”