FREQUENCY OF CELIAC DISEASE IN CHILDREN WITH SEVERE ACUTE MALNUTRITION PRESENTING TO MARDAN MEDICAL COMPLEX, MARDAN

Abstract

Background: Severe acute malnutrition remains a significant cause of child morbidity and mortality in the developing world. In children resistant to standard nutrition therapy, diseases such as celiac disease may be overlooked. Due to overlapping symptoms, celiac disease often goes unrecognized among malnourished children, especially in resource-poor zones with limited diagnostic facilities.

Objective: To determine the frequency of celiac disease in children with severe acute malnutrition presenting to MMC Mardan. Study Design: Descriptive cross-sectional study. Duration and Place of Study: This study was conducted from 2nd November 2024 to 1st May 2025 at the Department of Pediatrics, Mardan Medical Complex. Methodology: A total of 103 children aged 1–5 years with diagnosed SAM were enrolled using consecutive sampling. Anti-tTG IgA antibodies were measured via ELISA, and biopsy-confirmed cases were classified using Marsh criteria. Data were collected on age, weight, gender, malnutrition duration, socioeconomic status, parental education, and residential location. Results: Celiac disease was confirmed in 12.6% (n=13) of children with SAM. A significantly higher prevalence was found in children >3 years (21.3%) compared to ≤3 years (5.4%) (p=0.019), in females (23.8%) compared to males (4.9%) (p=0.006), in children weighing >12 kg (28.0%) vs ≤12 kg (7.7%) (p=0.008), and in those with SAM duration >12 months (28.1%) vs ≤12 months (5.6%) (p=0.003). Conclusion: Celiac disease is relatively prevalent among children with SAM and shows significant association with specific clinical and demographic factors.

Keywords: Severe Acute Malnutrition, Celiac Disease, Anti-tTG, Gluten Sensitivity, Pediatric Undernutrition