Celiac disease care differs significantly between high- and low-middle-income countries: a global survey of celiac experts from 63 countries

Agarwal S 1 , Prasad S 1 , Agarwal A 2 , Raja Ali RA 3 , Leffler DA 4 , Green PHR 5 Show all authors , Sanders DS 6 , Anderson RP 7 , Ahuja V 1 , Mulder CJJ 8 , Makharia GK 1

Affiliations 

  • 1 Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
  • 2 Department of Gastroenterology, All India Institute of Medical Sciences, Jodhpur, India
  • 3 School of Medical and Life Sciences, Sunway University, Subang Jaya, Selangor, Malaysia
  • 4 Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  • 5 Celiac Disease Center, Phyllis and Ivan Seidenberg Professor of Medicine, Columbia University, New York, New York, USA
  • 6 Royal Hallamshire Hospital, Sheffield, UK
  • 7 Wesley Medical Research - The Wesley Hospital, Brisbane, Queensland, Australia
  • 8 Department of Gastroenterology, VU Medical Centre, Amsterdam, The Netherlands
J Gastroenterol Hepatol, 2024 Nov 11.
PMID: 39528309 DOI: 10.1111/jgh.16793

Abstract

BACKGROUND AND AIM: Celiac disease (CeD) is increasingly diagnosed but significant disparities exist in awareness, practices, resources, and legislation worldwide. We conducted a global online survey with CeD experts to assess this disparity internationally.

METHODS: A 55 questions survey encompassing nine domains relevant to CeD care (awareness, gluten-free [GF] foods availability/cost/quality, GF labeling, CeD dietician availability, insurance for CeD patients, medical training, research funding, patient support groups, and unmet needs) was generated and sent to CeD experts worldwide electronically. Countries were stratified based on per capita income as high-income (HIC) and lower-income countries (LIC) (including upper-middle-, lower-middle-, and low-income countries). Survey responses were summarized as a single score using principal component analysis.

RESULTS: Valid responses were obtained from 131(37.4%) [HIC: 71; LIC: 60] of contacted CeD experts from 63 countries. Compared with HIC, LIC experts perceived worse availability (HIC:80% vs LIC: 47%; P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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