UNIVERSITY CLINICAL CENTER TUZLA DEPARTMENT OF PEDIATRICS

BOSNIA AND HERZEGOVINA

Dr. SELMA TERZIĆ, pediatrician

Bosnia and HerzegovinaBosnia and Herzegovina

• Bosnia and Herzegovina has a 4.5 millions inhabitants and it is divided in 10 Cantons

• Each Canton has the Association of patients with Celiac disease

Bosnia and HerzegovinaBosnia and Herzegovina

CD can be diagnosed in four towns:Tuzla, Sarajevo, Mostar and Banja Luka

Serological tests:• Anti-gliadin antibodies: IgA, IgG• Anti-endomysial antibodies IgA• Anti-tissue transglutaminase antibodies

IgA Endoscopy for a small bowel mucosal

biopsy Human leukocyte antibodies (HLA)

Bosnia and HerzegovinaBosnia and Herzegovina

•Children who suffer from Celiac disease have a social support of 20€ per month

• Depending on age, they also get from 5 to 10 kilos of gluten- free flour

Bosnia and HerzegovinaBosnia and Herzegovina

Children without health insurance have to pay for following finding:

Anti-tissue transglutaminase antibodies assay: 112 €

Small Intestinal Biopsy: 25 € Pathology exam of the biopsy: 30 € Gluten-free flour, 1 kilo 5.5 €

Bosnia and HerzegovinaBosnia and Herzegovina

• The University Clinical Center Tuzla was conducted study about epidemiology of celiac disease in Tuzla Canton for the period of 1995-2007. and obtained the following results:

Bosnia and HerzegovinaBosnia and Herzegovina

From the total of 68 celiac disease affected children:

• 44 children have typical forme, • 16 children have atypical forme,• 8 children have asymptomatic

forms and they were diagnosed in the screening of children with DMT1 and Hashimoto thyroiditis

L.Osmančević, S.Terzić, 2009

Bosnia and HerzegovinaBosnia and Herzegovina

• The overall average incidence rate of celiac disease in 1995 was

0.05/1000 children• Serological screening for Celiac

disease at the Clinical Center Tuzla started to work from year 2000

• The prevalence of celiac disease in 2007 was 0.73/1000 children

L.Osmančević, S.Terzić, 2009.

Bosnia and HerzegovinaBosnia and Herzegovina

Unfortunately, there is no statistical data about the prevalence of Celiac disease in Bosnia and Herzegovina or from each Canton

Today in Bosnia and Herzegovina has registered about 300 ill children

Bosnia and HerzegovinaBosnia and Herzegovina

• Social conditions and prices for gluten-free food are unfavourable for patients with celiac disease, but I hope that this is going to be changed for better in futur

Thank you!Thank you!

Tuzla,Bosnia and Herzegovina terzic_selma@hotmail.com