The effects of the socioeconomic status of Serbian families with coeliac children on gluten-free diet
Sažetak
Objective: To determine the effects of the socioeconomic characteristics of Serbian families with coeliac children (education level, employment, number of family members, monthly family income) on a gluten-free diet outcomes, as measured by serologic tests (tTG).
Methods: The sample included 116 parents and the same number of children and adolescents (N = 116) diagnosed with the coeliac disease who had followed a gluten-free diet for at least a year. Children were aged 5-18 years. The research was carried out at the University Children's Hospital in Belgrade and the Institute of Mother and Child Health "Dr Vukan Čupić" in Belgrade. The research was conducted during the period April-December 2016. The instruments used in the research were the Socioeconomic Survey Questionnaire and the Documentation Sheet, both specially designed for the purpose of this study.
Results: The results of our study have shown that the mean age of mothers was 39.6 years and fathers 43.4 years. Parent respondents reported completed secondary education in 58% (116) of all cases. 46.55% of mothers and 35.34% fathers of the examined children with coeliac disease were not permanently employed. 82.76% of parents were married. Four-member families were most common. Considering the specific needs, 51% of the parents perceived their income level as very low and low. Serologic tests confirmed the efficacy of the therapy in 25.86% (30/116) of the children.
Conclusion: The poor success of a gluten-free diet in the coeliac children and adolescents pointed out to the major impact of a lower socioeconomic status of their families. Taking into account all the difficulties in the implementation of a gluten-free dietary restrictions for children in Serbia, it becomes clear that the engagement of the whole society, and not just the members of their families, is necessary.
Key words: Coeliac disease, children, gluten-free diet, quality of life
Reference
Radlović N.Celiac disease. Srp Arh Celok Lek. 2013;141(1-2):122-6.
Husby S, Koletzko S, Korponay-Szabo IR, Mearin ML, Phillips A, Shamir R, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012;54: 136-60. DOI: 10.1097/MPG.0b013e31821a23d0.
Kang, J, Kang A, Green A, Gwee K, Ho K. Systematic review: Worldwide variation in the frequency of coeliac disease and changes over time. Aliment. Pharmacol. Ther. 2013, 38, 226–245. DOI:10.1111/apt.12373
West J, Fleming KM, Tata LJ, Card TR, Crooks CJ. Incidence and prevalence of celiac disease and dermatitis herpetiformis in the uk over two decades: Population-based study. Am. J. Gastroenterol 2014, 109, 757–768. PMID: 24667576 PMCID: PMC4012300 DOI:10.1038/ajg.2014.55.
Rampertab SD, Pooran N, Brar P, Singh P. Green PH. Trends in the presentation of celiac disease. Am. J. Med. 2006; 119: 355.e9–355.e14. PMID:16564784
Kako žive oboleli od celijakije u Srbiji.Preuzeto jun 2016:Dostupno na: https://www.google.rs/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&cad
Radlović N. Celijačna bolest kod dece: savremeni dijagnostički pristup. Srp Arh Celok Lek. 2008;136:152-157 doi: 10.2298/SARH08S2152R
Schuppan D, Dennis MD, Kelly CP. Celiac disease: epidemiology, pathogenesis, diagnosis, and nutritional management. Nutr Clin Care 2005;8:54-69. PMID:16013224
Mulder CJ, Wierdsma NJ, Berkenpas M, Jacobs M A J M, Bouma G. Preventing complications in celiac disease: Our experience with managing adult celiac disease. Best Practice & Research Clinical Gastroenterology 2015; 29: 459-468. PMID:26060110 DOI:10.1016/j.bpg.2015.05.006
Altobelli E, Paduano R, Gentile T, Caloisi C, Marziliano C, Necozione S, et al. Health-related quality of life in children and adolescents with celiac disease: survey of a population from central Italy. Health Qual Life Outcomes 2013;11:204. DOI:10.1186/1477-7525-11-204
Di Filippo T, Orlando M, Concialdi G, et al. The quality of life in developing age children with celiac disease. Minerva Pediatr. 2013;65(6):599–608. PMID:24217629
Addolorato G, De Lorenzi G, Abenavoli L, Leggio L, Capristo E, Gasbarrini G. Psychological support couselling improves gluten free diet compliance in celiac patient with affective disordes. Aliment Pharmacol Ther 2004;777-82.
Rajpoot P. Makharia GK. Problems and Challenges to Adaptation of Gluten Free Diet by Indian Patients with Celiac Disease, Nutrients 2013;5:4869-4879. DOI: 10.3390/nu5124869
Roma E, Roubani A, Kolia E, Panayiotou J, Zellos A, Syriopoulou VP. Dietary compliance and lifestyle of children with coeliac disease. Journal of Human Nutrition and Dietetics 2010; 23: 176-182. DOI: 10.1111/j.1365- 277X.2009.01036.x
Rodríguez Gutiérrez AY. Psychological characterization of schoolchildren suffering from Celiac disease Rev. Ciencias Médicas 2013;17(3):102-111 doi .
Whitaker JK, West J, Holmes GK, Logan RF. Patient perceptions of the burden of coeliac disease and its treatment in the UK.Aliment PharmacolTher 2009; 29: 1131-1136. DOI: 10.1111/j.1365-2036.2009.03983.x
Sallfors C, Hallberg LR. A parental perspective on living with a chronically ill child: A qualitative study. Families, Systems, & Health 2003; 21(2)193-204. http://dx.doi.org/10.1037/1091-7527.21.2.193.
Zingone F, West J, Crooks CJ, Fleming KM, Card TR, Ciacci C, et al. Socioeconomic variation in the incidence of childhood coeliac disease in the UK. Arch. Dis. Child 2015; 100:466–473. DOI 10.1136/archdischild-2014-307105
Bacigalupe G, Plocha A. Celiac is a social disease: family challenges and strategies. Fam Syst Health 2015;33(1):46-54. DOI: 10.1037/fsh0000099.
Sarkhy A, Mohammad I. El Mouzan, Elshazaly Saeed, Aziz Alanazi, Sharifa Alghamdi,Shirin Anil,∥and Asaad Assiri.Socioeconomic Impacts of Gluten-Free Diet among Saudi Children with Celiac DiseasePediatr Gastroenterol Hepatol Nutr. 2016; 19(3): 162–167. DOI: 10.5223/pghn.2016.19.3.162
Singh J, Whelan K. Limited availability and higher cost of gluten-free foods. Journal of Human Nutrition and Dietetics 2011; 24:479-486.
Leffler DA, Edwards-George J, Dennis M, Schuppan D, Cook F, Franko DL, et al. Factors that influence adherence to a gluten-free diet in adults with celiac disease. Digestive Diseases and Sciences 2008; 53:1573-1581.
Green PHR, Jabri B. Coeliac disease. Lancet 2003; 362: 383-391.
Khurana1 B, Lomash1A, Khalil1 S, Bhattacharya M, Rajeshwari K.Evaluation of the impact of celiac disease and its dietary manipulation on children and their caregivers Indian J Gastroenterol 2015;34(2):112–116. DOI: 10.1007/s12664-015-0563-6.
Sverker A GO, Hallert C, Hensing G. Sharing life with a gluten-intolerant person-the perspective of close relatives, Journal of Human Nutrition and Dietetics 2007; 20(5):412-422. DOI:10.1111/j.1365-277X.2007.00815.x
Araújo HM, Araújo WM. Coeliac disease. Following the diet and eating habits of participating individuals in the Federal District, Brazil. Appetite 2011; 57: 105-109. DOI: 10.1016/j.appet.2011.04.007.
L B, C O. Impact of celiac disease on dietary habits and quality of life. J Hum Nutr Diet 2011; 24:582–587. DOI: 10.1111/j.1365-277X.2011.01170.x
Chauhan JC, Kumar P, Dutta AK, Basu S, Kumar A. Assessment of dietary compliance to gluten-free diet and psychosocial problems in indian children with celiac disease. Indian Journal of Pediatrics 2010; 77: 649-654.
Ciacci C, Iavarone A, Siniscalchi M, Romano R, De Rosa A. Psychological dimensions of celiac disease. Dig. Dis. Sci. 2002; 47: 2082–2087. PMID:12353859.
Biagetti Ch, Gesuitab R, Gattia S, Catassi C. Quality of life in children with celiac disease:A paediatric cross-sectional study, Digestive and Liver Disease 2015;47: 927-932. doi