Coeliac disease in Libyan children: A screening study based on the rapid determination of anti-transglutaminase antibodies

Background: Coeliac disease is a common disorder in North Africa; however, there are no data on coeliac disease prevalence in Libya. Aim: (1) To determine coeliac disease prevalence in Libyan schoolchildren by screening with a rapid test for IgA anti-transglutaminase determination on a blood drop; (2) to evaluate the accuracy of the rapid anti-transglutaminase test. Patients and methods: We screened 2920 students (1452 females and 1468 males) attending school in El Beida (Libya) by the rapid anti-transglutaminase test. Conventional ELISA anti-transglutaminase in rapid test positives and small intestinal biopsy in ELISA positives were performed for coeliac disease diagnosis. Conventional IgA anti-transglutaminase was performed also in 800 rapid test negative subjects. Results: The rapid anti-transglutaminase test was positive in 50/2920(1.7%) subjects but only 20/50 were confirmed by the ELISA determination. The diagnosis of coeliac disease was biopsy-confirmed in 19 out of these 20. The serum ELISA IgA anti-transglutaminase was positive in 4 out of 800 rapid test negative children. Coeliac disease prevalence was 0.79-1.13%. Conclusions: Coeliac disease in Libyan children is as common as in Europe, affecting around 1% of the general population. The rapid test for IgA anti-transglutaminase determination on a blood drop was not an efficient screening test. (C) 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.