Cross-sectional studyindependent cross-checkabstract checked★ key study I-GRN-104 in-depth review
Coeliac disease affects about 1 in 190 Egyptian children
Prevalence of celiac disease in Egyptian children disputes the east-west agriculture-dependent spread of the disease.
Overview
Abu-Zekry M et al.. J Pediatr Gastroenterol Nutr 2008 · PMID 18664863 · DOI 10.1097/MPG.0b013e31815ce5d1
Screening of 1500 Egyptian children found coeliac disease in 0.53%, and much more often in children with diarrhoea or type 1 diabetes.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Measure coeliac disease frequency in Egyptian children.
- How was the study done?
Blood tests and biopsies.
- How many people, animals or samples were studied?
1900 children in three groups.
- What was actually found?
0.53% in the general sample; 4.7% and 6.4% in risk groups.
- How large was the observed effect?
About 1 in 187.
- What do the results mean in everyday life?
Coeliac disease is not rare in Egypt.
- What are the study's limitations?
Single study; children only.
- What does it say about Elawady's specific claim?
Contradicts the denial of gluten-related disease.
- Do the results apply to Germany and Europe?
Comparable to Europe.
- What can explicitly not be concluded from this study?
Does not give adult figures.
Scientific in-depth review
1. Full reference
- Authors
- Abu-Zekry M et al.
- Journal
- J Pediatr Gastroenterol Nutr
- Year
- 2008
- Identifier
- PMID 18664863 DOI 10.1097/MPG.0b013e31815ce5d1
- Verification
- verified – PubMed efetch 2026-10-26; Crossref works API 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract/PubMed record
2. Research question
How common is coeliac disease in Egyptian children?
3. Study design and population
- Study design
- Cross-sectional study – Population screening study (cross-sectional) with biopsy confirmation
- Population
Egyptian children: general population sample, children with diarrhoea/failure to thrive, children with type 1 diabetes
- Country
Egypt
- Period
not stated in abstract
- Sample size
1500 general population + 150 with diarrhoea/failure to thrive + 250 with type 1 diabetes
- Inclusion and exclusion criteria
Age 7 months-18 years (general sample)
4. Methods and endpoints
- Exposure / intervention
Coeliac serology (IgA anti-tTG, EMA) and small-bowel biopsy
- Comparator
none
- Endpoints
Prevalence of coeliac disease
- Statistical methods
Proportions with 95% CI
5. Actual results
- Results
General population: 8/1500 = 0.53% (95% CI 0.17-0.89), at least 1 in 187. Diarrhoea/failure to thrive: 7/150 = 4.7% (1.4-7.9). Type 1 diabetes: 16/250 positive for both IgA anti-tTG and EMA = 6.4% (3.4-9.4).
- Absolute risks
0.53% of children in the general sample
- Authors' conclusion
Coeliac disease is a frequent disorder among Egyptian children, both in the general population and at-risk groups.
6. Strengths
- Population sample from Egypt
- Serology plus biopsy confirmation
7. Weaknesses
- Single study; sampling frame details not in abstract
- Reported CI is a Wald interval (stats/C-GRN-01)
- Diabetes group based on serology only
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Prevalence study; representativeness uncertain.
9. Assessment of the statistical interpretation
Recalculated: Wald CI reproduces the reported 0.17-0.89%; Wilson CI 0.27-1.05% is more appropriate for a rare outcome.
10. Relevance to the specific claim
Shows that the gluten-driven disease the claim denies is present in Egypt at roughly the global frequency.
11. Independent contrary findings
None.
12. Transferability to Germany and Europe
Prevalence similar to European estimates (I-WHT-04).
13. Overall methodological judgement
Directly relevant regional evidence.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Adult prevalence in Egypt; diagnosis rates.
15. Linked fact checks
- 'There is no such thing as gluten sensitivity'; the real problem is only that white flour turns into a glue-like substance. – Studies contradicting or limiting the claim
- White flour coats the absorptive villi of the small intestine like glue and thereby causes malabsorption, which leads to irritable bowel syndrome, iron-deficiency anaemia, vitamin D deficiency, weak bones and teeth, fatty liver and hair loss. – Studies contradicting or limiting the claim