UNIVERSITY CLINICAL CENTER TUZLA DEPARTMENT OF PEDIATRICS BOSNIA

UNIVERSITY CLINICAL CENTER TUZLA DEPARTMENT OF PEDIATRICS BOSNIA AND HERZEGOVINA Dr. SELMA TERZIĆ

Bosnia and Herzegovina Location: Southeast Europe Government: Federation Capital: Sarajevo Area: 51. 129 km ² Population : 4. 498, 976

Celiac disease in 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

• 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 Bi. H, in three towns (Sarajevo, Tuzla, Mostar) and RS (Banja Luka) can be diagnosed CD: • Serology - t-TG - total Ig. A • Endoscopy for a small bowel mucosal biopsy • Genetic: HLA DQ 2/DQ 8 (in Tuzla)

The University Clinical Center Tuzla was conducted study for the period 19952007. 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 DMT 1 and Hashimoto thyroiditis L. Osmančević, S. Terzić, 2009

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! terzic_selma@hotmail. com www. ukctuzla. ba