Awareness of Celiac Disease among the General Public in Saudi Arabia

Maha H. Alhussain^1,

¹Department of Food Sciences and Nutrition, College of Food and Agriculture, King Saud University, Riyadh 11451, Saudi Arabia

Cite this paper:
Maha H. Alhussain. Awareness of Celiac Disease among the General Public in Saudi Arabia. International Journal of Celiac Disease. 2021; 9(2):71-76. doi: 10.12691/ijcd-9-2-4

Abstract

Background: Celiac disease (CD) is an immune-mediated systemic disorder triggered by dietary gluten and is considered one of the most common lifelong food-related disorders worldwide. The knowledge of CD among the general public in Saudi Arabia remains limited. Therefore, we aimed to assess the awareness and knowledge of CD among the general public in Saudi Arabia. Methods: A cross-sectional online survey including members of the general public was conducted in Saudi Arabia. The survey included questions assessing the public’s awareness about CD, gluten sensitivity, and peanut allergy, as well as celiac disease-related knowledge. Results: From a total of 1230 responses received, 76.7% (95% confidence interval [CI], 74.0%–79.4%) were females, 42.0% (95% CI, 37.7–46.3) were aged between 31–45 years, and 64.3% (95% CI, 61.0%–67.6%) had Bachelor’s degree. Less than half of the participants had heard of CD (48.4%; 95% CI, 44.4%–52.4%), but the majority had heard of peanut allergy (80.1%; 95% CI, 77.6%–82.6%) and gluten sensitivity (72.4%; 95% CI, 69.5%–75.3%). The prevalence of CD was estimated incorrectly by more than 80% of participants. Other questions on participants’ knowledge associated with CD were answered “Do not know” by the majority. Females demonstrated a greater awareness of CD, peanut allergy, and gluten sensitivity, and had a higher percentage of correct responses to questions related to CD than males. Conclusion: This study highlights the need to increase the awareness and knowledge of CD, especially in the recognition of its symptoms. Educational efforts toward increasing the awareness of the general public about CD could help optimize its diagnosis and management.

Keywords:
Celiac Disease Gluten-Free Diet Gluten Sensitivity Saudi Arabia questionnaire

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References:

[1]	Glissen Brown, J.R. and P. Singh, Coeliac disease. Paediatrics And International Child Health, 2019. 39(1): p. 23-31.
[2]	Green, P.H. and C. Cellier, Celiac disease. New England Journal of Medicine, 2007. 357(17): p. 1731-1743.
[3]	Hill, I.D., et al., Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Journal of pediatric gastroenterology and nutrition, 2005. 40(1): p. 1-19.
[4]	Husby, S., et al., European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. Journal of Pediatric Gastroenterology and Nutrition, 2012. 54(1): p. 136-160.
[5]	Murch, S., et al., Joint BSPGHAN and Coeliac UK guidelines for the diagnosis and management of coeliac disease in children. Archives of Disease in Childhood, 2013. 98(10): p. 806-811.
[6]	Green, P.H. and B. Jabri, Coeliac disease. The Lancet, 2003. 362(9381): p. 383-391.
[7]	Ediger, T.R. and I.D. Hill, Celiac disease. Pediatrics in Review, 2014. 35(10): p. 409-15; quiz 416.
[8]	Dubé, C., et al., The prevalence of celiac disease in average-risk and at-risk Western European populations: a systematic review. Gastroenterology, 2005. 128(4): p. S57-S67.
[9]	Rostami, K., et al., Coeliac disease in Middle Eastern countries: a challenge for the evolutionary history of this complex disorder? Digestive and Liver Disease, 2004. 36(10): p. 694-697.
[10]	Singh, P., et al., Prevalence of celiac disease in Asia: A systematic review and meta‐analysis. Journal of Gastroenterology and Hepatology, 2016. 31(6): p. 1095-1101.
[11]	Aljebreen, A.M., et al., Seroprevalence of celiac disease among healthy adolescents in Saudi Arabia. World Journal of Gastroenterology: WJG, 2013. 19(15): p. 2374.
[12]	Al-Hussaini, A., et al., Mass screening for celiac disease among school-aged children: Toward exploring celiac iceberg in Saudi Arabia. Journal of Pediatric Gastroenterology and Nutrition, 2017. 65(6): p. 646-651.
[13]	El-Metwally, A., et al., The Epidemiology of Celiac Disease in the General Population and High-Risk Groups in Arab Countries: A Systematic Review. BioMed Research International, 2020. 2020: p. 6865917.
[14]	Lohi, S., et al., Increasing prevalence of coeliac disease over time. Alimentary Pharmacology & Therapeutics, 2007. 26(9): p. 1217-1225.
[15]	Rubio–Tapia, A., et al., Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology, 2009. 137(1): p. 88-93.
[16]	Catassi, C., et al., Natural history of celiac disease autoimmunity in a USA cohort followed since 1974. Annals of Medicine, 2010. 42(7): p. 530-538.
[17]	Gasbarrini, G., et al., Celiac disease in the 21st century: issues of under-and over-diagnosis. 2009, SAGE Publications Sage UK: London, England.
[18]	Fasano, A., et al., Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Archives of Internal Medicine, 2003. 163(3): p. 286-292.
[19]	Rubio-Tapia, A., et al., The prevalence of celiac disease in the United States. American Journal of Gastroenterology, 2012. 107(10): p. 1538-1544.
[20]	Lebwohl, B., D.S. Sanders, and P.H. Green, Coeliac disease. The Lancet, 2018. 391(10115): p. 70-81.
[21]	Sicherer, S.H., et al., US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. Journal of Allergy and Clinical Immunology, 2010. 125(6): p. 1322-1326.
[22]	Simpson, S., et al., Awareness of gluten-related disorders: A survey of the general public, chefs and patients. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, 2011. 6(5): p. e227-e231.
[23]	Karajeh, M.A., et al., Chefs’ knowledge of coeliac disease (compared to the public): a questionnaire survey from the United Kingdom. Clinical Nutrition, 2005. 24(2): p. 206-210.
[24]	Larson, S.A., et al., Prevalence and morbidity of undiagnosed celiac disease from a community-based study. Gastroenterology, 2017. 152(4): p. 830-839. e5.
[25]	Lindfors, K., et al., Coeliac disease. Nature Reviews Disease Primers, 2019. 5(1): p. 1-18.
[26]	Fuchs, V., et al., Delayed celiac disease diagnosis predisposes to reduced quality of life and incremental use of health care services and medicines: A prospective nationwide study. United European Gastroenterology Journal, 2018. 6(4): p. 567-575.
[27]	Rampertab, S.D., et al., Trends in the presentation of celiac disease. The American Journal of Medicine, 2006. 119(4): p. 355. e9-355. e14.
[28]	Assiri, A.M., et al., Assessment of knowledge of celiac disease among health care professionals. Saudi Medical Journal, 2015. 36(6): p. 751.