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.

HLA-DQ2 and -DQ8 genotypes in celiac and healthy Libyan children.

BACKGROUND: Few data are available on the prevalence of celiac disease (CD)-predisposing, HLA-related genes in Arab populations. AIM OF THE STUDY: To investigate the distribution of HLA-DQ2 and -DQ8 genotypes in Libyan children with CD and healthy controls. PATIENTS: We tested 31 Libyan children with CD (22 females and 9 males, median age 9.2 years) and 156 Libyan controls (81 females and 75 males, median age 10.9). METHODS: HLA genes were determined on a drop of dried blood by the DQ-CD Typing Plus kit (DiaGene, Palermo, Italy). RESULTS: The HLA-DQ pattern of the 31 CD children was: hetero DQ2 (n=15), DQ2 with homo beta2 (10), DQ8 and beta2 positive (3), DQ8 (2), and hetero beta2 (1). The HLA-DQ pattern of the 156 controls was: hetero DQ2 (n=36), hetero beta2 (30), DQ2-DQ8 negative (23), DQ8 (19), alpha5 (14), DQ2 with homo beta (12), homo beta2 (10), DQ8 and beta2 positive (7), and DQ2/DQ8 (5). CONCLUSIONS: HLA-DQ2 and -DQ8 in CD patients are as common in Libya as in Italy, but the frequency of "high-risk" genotypes is higher in Libyan than Italian patients. The prevalence of HLA-DQ2 and -DQ8 genes in the Libyan general population is higher than in Italy, indicating a strong genetic predisposition to CD.