SCREENING large populations for coeliac disease (CD) is a contentious topic, largely due to a lack of substantial evidence backing its advantages. The Autoimmunity Screening for Kids study in Colorado, USA is a mass screening for paediatric CD and type 1 diabetes.
This research by Maeisa Stahl, Digestive Health Institute, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, USA, and colleagues, involved tracking children aged 1–17 years who tested positive for tissue transglutaminase IgA autoantibodies in the Autoimmunity Screening for Kids study, and were later referred for further diagnostic assessment. Those diagnosed with CD either through biopsy or serological criteria were included in this study. Various factors including demographics, laboratory results, symptoms, quality of life, anxiety/depression, and adherence to a gluten-free diet at both the initial assessment and a 12-month follow-up were evaluated in this study. Statistical analysis methods such as paired Student t-tests, chi-square tests, and Wilcoxon sign rank tests were used to compare data from the initial and follow-up evaluations. Additionally, the odds of symptom improvement were evaluated.
Out of the 52 children diagnosed with CD, 42 completed the 12-month follow-up assessment. Initially, 38 out of 42 children reported experiencing one or more symptoms. However, there was a notable improvement in the mean severity and frequency of CD symptoms from the beginning to the follow-up (P<0.001). Caregivers also noted an improvement in health-related quality of life scores (P=0.002), though there was no significant change in reported anxiety or depression levels. Iron deficiency without anaemia was prevalent at the start (21 out of 24 children; 87.5%), but this was normalised by the follow-up (11 out of 21 children; 52.3%). Moreover, the majority of families (26 out of 28) reported good or excellent adherence to a gluten-free diet.
This study concludes that children diagnosed with CD through a mass screening initiative showed significant enhancements in symptoms, quality of life, and resolution of iron deficiency within 1 year of follow-up. These findings suggest that there could be advantages to implementing mass screening for CD.
Reference
Stahl MG et al. One-year outcomes among children identified with celiac disease through a mass screening program. Clin Gastroenterol Hepatol. 2024;DOI:10.1016/j.cgh.2024.03.030.
