UNIVERSITY CLINICAL CENTER TUZLA DEPARTMENT OF PEDIATRICS

BOSNIA AND HERZEGOVINA

Dr. SELMA TERZIĆ

Location: Southeast Europe Government: FederationCapital: SarajevoArea: 51.129 km ²Population : 4.498,976

Bosnia and Herzegovina

• Bosnia and Herzegovina has a 4,5 millions inhabitants and it is divided in 10 Cantons

• Each Canton has a Association of patiens with Celiac disease

Celiac disease in Bosnia and Herzegovina

• Unfortunately, in Bosnia there are no any statistics about how many children are with celiac disease

• According to unofficial data, the country has about 300 members in associations (no adults)

• Each association in the state is legally constituted; the association has a president and a legal entity

• At least three times a year meetings are held, with occasional lectures (pediatricians and internist's gastroenterologist) under the auspices of the cantonal and federal health ministry

• Each association has its own premises, which are modestly furnished

• There are brochures about celiac disease, according to the different cantons

The goals and tasks of the association:• Better prevention of ill health through

education in Canton• Common action with a network of

associations of people with celiac disease at the level of Bosnia

• Working on projects• Exchange of experiences in other societies

affected in Bosnia• Cooperation with the Network and similar

organisations at the international level

In Bosnia and Herzegovina there is no National society but now intensively working on networking (the political situation !!!)

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

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

In BiH, in three towns (Sarajevo, Tuzla, Mostar) and RS (Banja Luka) can be diagnosed CD:

• Serology - t-TG

- total IgA

• Endoscopy for a small bowel mucosal biopsy

• Genetic: HLA DQ2/DQ8 (in Tuzla)

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

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

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1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

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Tipična Atipična Asimptomatska

The incidence of certain forms of celiac disease in relation to years

• Serological screening for Celiac disease at the Clinical Center Tuzla started to work from year 2000

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

The total number of patients in relation to years

• Of the first 175 relatives of children with celiac disease 75 respondents consented to serological screening. With positive findings of some of the antibodies was 8 subjects

• On small bowel biopsy have agreed to two mothers with them on the basis of positive histopathological findings confirmed the earlier suspicion of celiac disease

• In Bosnia, unfortunately, there are no restaurants where food is prepared gluten free

• Our mothers are very motivated to prepare the higher quality and more varied meals for their children suffering from celiac disease

• Better conditions and prices are not available to everyone with a disease, but I hope that this is going to be changed for better in coming period

Thank you!Thank you!

terzic_selma@hotmail.com www.ukctuzla.bawww.ukctuzla.ba